β-Lactam Resistance Mechanisms: Gram-Positive Bacteria and Mycobacterium tuberculosis.
The value of the β-lactam antibiotics for the control of bacterial infection has eroded with time. Three Gram-positive human pathogens that were once routinely susceptible to β-lactam chemotherapy-Streptococcus pneumoniae, Enterococcus faecium, and Staphylococcus aureus-now are not. Although a fourth bacterium, the acid-fast (but not Gram-positive-staining) Mycobacterium tuberculosis, has intrinsic resistance to earlier β-lactams, the emergence of strains of this bacterium resistant to virtually all other antibiotics has compelled the evaluation of newer β-lactam combinations as possible contributors to the multidrug chemotherapy required to control tubercular infection. The emerging molecular-level understanding of these resistance mechanisms used by these four bacteria provides the conceptual framework for bringing forward new β-lactams, and new β-lactam strategies, for the future control of their infections.
Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556-5670.
Jed F
JF
Fisher
Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana 46556-5670.
Shahriar
S
Mobashery
D000900:Anti-Bacterial Agents / Q000737:chemistry / Q000494:pharmacology*; D013293:Enterococcus faecalis / Q000187:drug effects; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D013211:Staphylococcus aureus / Q000187:drug effects; D013296:Streptococcus pneumoniae / Q000187:drug effects; D018440:beta-Lactam Resistance; D047090:beta-Lactams / Q000737:chemistry / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D047090:beta-Lactams