title: Vancomycin resistance in gram-positive cocci.
abstract: The first vancomycin-resistant clinical isolates of Enterococcus species were reported in Europe in 1988. Similar strains were later detected in hospitals on the East Coast of the United States. Since then, vancomycin-resistant enterococci have spread with unexpected rapidity and are now encountered in hospitals in most countries. This article reviews the mode of action and the mechanism of bacterial resistance to glycopeptides, as exemplified by the VanA type, which is mediated by transposon Tn1546 and is widely spread in enterococci. The diversity, regulation, evolution, and recent dissemination of methicillin-resistant Staphylococcus aureus are then discussed.
authors.affiliation: Unite des Agents Antibacteriens, Institut Pasteur, Paris, France. pcourval@pasteur.fr
authors.forename: Patrice
authors.initials: P
authors.lastname: Courvalin
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics / Q000502:physiology; D019729:Carbon-Oxygen Ligases / Q000235:genetics / Q000502:physiology; D004352:Drug Resistance, Microbial / Q000235:genetics / Q000502:physiology; D016983:Enterococcus / Q000187:drug effects*; D015964:Gene Expression Regulation, Bacterial / Q000187:drug effects / Q000502:physiology; D006020:Glycopeptides / Q000502:physiology; D008025:Ligases / Q000235:genetics / Q000502:physiology; D010453:Peptide Synthases / Q000235:genetics; D010457:Peptidoglycan / Q000096:biosynthesis / Q000187:drug effects; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000502:physiology*; D014640:Vancomycin / Q000494:pharmacology*; D020713:Vancomycin Resistance / Q000502:physiology*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D006020:Glycopeptides; D010457:Peptidoglycan; C071437:VanA ligase, Bacteria; C079913:VanB protein, Enterococcus; C079914:VanC protein, Bacteria; C417270:VanG protein, Enterococcus faecalis; D014640:Vancomycin; D008025:Ligases; C469907:VanE protein, Enterococcus faecalis; D019729:Carbon-Oxygen Ligases; D010453:Peptide Synthases; C122181:VanD protein, Enterococcus faecium