Vancomycin-resistant Staphylococcus aureus: a new model of antibiotic resistance.
Vancomycin-resistant Staphylococcus aureus: a new model of antibiotic resistance.
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DOI：
10.1016/s1473-3099(01)00091-3
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发表时间：
2001-10-01
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影响因子：
--
通讯作者：
Hiramatsu, K
中科院分区：
文献类型：
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作者：
Hiramatsu, K
万古霉素一直是治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染最可靠的药物。然而，1996年，从一名日本患者身上分离出了第一种对万古霉素产生耐药性的MRSA。患者感染了手术后的伤口感染，对长期的万古霉素治疗无效。随后从美国、法国、韩国、南非和巴西分离到的几株万古霉素耐药金黄色葡萄球菌证实了S金黄色葡萄球菌对万古霉素的耐药性是一个全球性的问题。一组金黄色葡萄球菌，被称为异型VRSA，在接触万古霉素时经常产生VRSA，并与可能对万古霉素治疗无效的感染有关。异型VRSA的存在可能是医院内万古霉素临床疗效潜伏下降的一个重要指标。万古霉素耐药性是通过突变和细胞壁增厚而获得的，这是由于多肽聚糖的积累造成的。这似乎是迄今为止世界上所有分离的VRSA菌株的共同耐药机制。
Vancomycin has been the most reliable therapeutic agent against infections caused by meticillin-resistant Staphylococcus aureus (MRSA). However, in 1996 the first MRSA to acquire resistance to vancomycin, was isolated from a Japanese patient. The patient had contracted a post-operative wound infection that was refractory to long-term vancomycin therapy. Subsequent isolation of several vancomycin resistant S. aureus (VRSA) strains from USA, France, Korea, South Africa, and Brazil has confirmed that emergence of vancomycin resistance in S aureus is a global issue. A certain group of S. aureus, designated hetero-VRSA, frequently generate VRSA upon exposure to vancomycin, and are associated with infections that are potentially refractory to vancomycin therapy. Presence of hetero-VRSA may be an important indicator of the insidious decline of the clinical effectiveness of vancomycin in the hospitals. Vancomycin resistance is acquired by mutation and thickening of cell wall due to accumulation of excess amounts of peptidoglycan. This seems to be a common resistance mechanism for all VRSA strains isolated in the world so far.