Resistance mechanisms of gram-positive bacteria.
The introduction and increasing use of antibiotics for antibacterial therapy has initiated a rapid development and expansion of antibiotic resistance in microorganisms, particularly in human pathogens. Additionally, a shift to an increase in number and severity of Gram-positive infections has been observed the last decades. Common to these pathogens is their tendency to accumulate multiple resistances under antibiotic pressure and selection. Methicillin-resistant Staphylococcus aureus (MRSA), that have acquired multiresistance to all classes of antibiotics, have become a serious nosocomial problem. Recently, the emergence of the first MRSA with reduced vancomycin susceptibility evoked the specter of a totally resistant S. aureus. Problems with multiresistance expand also to penicillin-resistant Streptococcus pneumoniae that are partially or totally resistant to multiple antibiotics, and to vancomycin-resistant Enterococcus ssp., completely resistant to all commonly used antibiotics. The rapid development of resistance is due to mutational events and/or gene transfer and acquisition of resistance determinants, allowing strains to survive antibiotic treatment.
Berger-Bächi
Brigitte
B
Institute of Medical Microbiology, University of Zürich, Switzerland. bberger@immv.unizh.ch
D000900:Anti-Bacterial Agents / Q000378:metabolism; D017714:Community-Acquired Infections / Q000188:drug therapy; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics / Q000502:physiology*; D006020:Glycopeptides; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000502:physiology*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D016106:Methicillin Resistance / Q000235:genetics / Q000502:physiology; D010455:Peptides; D012641:Selection, Genetic; D020713:Vancomycin Resistance / Q000235:genetics / Q000502:physiology
D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D010455:Peptides