Antibiotic resistance in Staphylococcus aureus and its relevance in therapy.
Staphylococcus aureus is a major cause of infections. Only approximately 20% of the strains remain sensitive to penicillin. Beta-lactamase stable penicillins such as flucloxacillin form the mainstay of treatment of staphylococcal infection. Meticillin-resistant S. aureus (MRSA) are resistant to all beta-lactam antibiotics. Glycopeptide antibiotics are effective against most MRSA strains but, in the last few years, isolates of MRSA that have reduced susceptibility to glycopeptides (glycopeptide-intermediate S. aureus) have been isolated. Some strains exhibit frank resistance to glycopeptides (vancomycin-resistant S. aureus). Infections due to these strains are difficult to treat. This review summarises the therapeutic options for MRSA, glycopeptide-intermediate S. aureus and vancomycin-resistant S. aureus. Novel therapeutic strategies such as immunotherapy and vaccines are also discussed.
Bal
Abhijit M
AM
Department of Medical Microbiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, Scotland. a.bal@abdn.ac.uk
Gould
Ian M
IM
D000081:Acetamides / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D024881:Drug Resistance, Bacterial; D006020:Glycopeptides / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D000069349:Linezolid; D016106:Methicillin Resistance; D023303:Oxazolidinones / Q000494:pharmacology / Q000627:therapeutic use; D010406:Penicillins / Q000494:pharmacology / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000276:immunology / Q000302:isolation & purification; D014611:Vaccination; D019444:Vaccines, DNA / Q000008:administration & dosage / Q000627:therapeutic use; D014640:Vancomycin / Q000494:pharmacology / Q000627:therapeutic use; D020713:Vancomycin Resistance; D047090:beta-Lactams / Q000494:pharmacology / Q000627:therapeutic use
D000081:Acetamides; D000900:Anti-Bacterial Agents; D006020:Glycopeptides; D023303:Oxazolidinones; D010406:Penicillins; D019444:Vaccines, DNA; D047090:beta-Lactams; D014640:Vancomycin; D000069349:Linezolid