Resistance or decreased susceptibility to glycopeptides, daptomycin, and linezolid in methicillin-resistant Staphylococcus aureus
Resistance or decreased susceptibility to glycopeptides, daptomycin, and linezolid in methicillin-resistant Staphylococcus aureus
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DOI：
10.1016/j.coph.2010.06.006
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发表时间：
2010-10-01
影响因子：
4
通讯作者：
Arias, Cesar A.
中科院分区：
文献类型：
--
作者：
Nannini, Esteban;Murray, Barbara E.;Arias, Cesar A.
对糖肽类药物敏感性降低的耐甲氧西林金黄色葡萄球菌(MRSA)可分为三类：一是对万古霉素异耐药(HVISA)；二是对万古霉素中度敏感(VISA)；三是对万古霉素完全耐药(VRSA)。而hVISA和VISA分离株的特征是细胞壁厚增加，细胞壁合成激活，自溶减少，而VRSA含有VANA基因簇，导致肽聚糖重塑。对达托霉素不敏感与细胞包膜和表面电荷的结构和功能的变化有关。耐利奈唑胺金黄色葡萄球菌的耐药性通常与23S rRNA突变有关，尽管现在已在几个大陆和暴发环境中记录了由获得性基因(编码23S rRNA甲基转移酶的CFR)介导的耐药性。
Methicillin-resistant Staphylococcus aureus (MRSA) with decreased susceptibility to glycopeptides can be categorized as first, heteroresistant to vancomycin (hVISA); second, with intermediate susceptibility to vancomycin (VISA); and third, fully resistant to vancomycin (VRSA). Whereas the hVISA and VISA isolates are characterized by increased cell wall thickness, activated cell wall synthesis and reduced autolysis, VRSA harbor the vanA gene cluster resulting in a remodeled peptidoglycan. Nonsusceptibility to daptomycin has been associated with changes in the structure and function of the cell envelope and surface charge. Linezolid resistance in MRSA is often associated with mutations in the 23S rRNA, although resistance mediated by an acquired gene (cfr encoding a 23S rRNA methyltransferase) has now been documented in several continents and in outbreak settings.