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Cited by 334

The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index.

VanA-Type Vancomycin-Resistant Staphylococcus aureus

Open access
Périchon, Bruno, Courvalin, Patrice·2009·Antimicrobial Agents and Chemotherapy

Abstract

Since 2002, nine methicillin (meticillin)-resistant Staphylococcus aureus(MRSA) strains that are also resistant to vancomycin (VRSA) have been reported in the United States, including seven clinical isolates from Michigan. The strains harbor a plasmid-borne Tn 1546 element following conjugation from a glycopeptide-resistant Enterococcus strain. In the second step, Tn 1546 transposed to a resident plasmid in five strains; the acquired plasmid behaved as a suicide gene delivery vector, and the incoming DNA had been rescued by illegitimate recombination. Surprisingly, combination of a glycopeptide with a β-lactam has a strong synergistic effect against VRSA, both in vitro and in an animal model, despite resistance of the strains to both drug classes when administered separately. This results from the fact that the late peptidoglycan precursors ending in d-alanine-d-lactate (d-Ala-d-Lac) that are mainly synthesized in the presence of glycopeptide inducers are not substrates for PBP2′, which is the only transpeptidase that remains active in the presence of oxacillin. One VRSA strain is partially dependent on vancomycin for growth due to a mutation in the host d-Ala:d-Ala ligase, thus having to rely on the inducible resistance pathway for cell wall synthesis. Competition growth experiments in the absence of inducer between the MRSA recipient and isogenic VRSA transconjugant revealed a disadvantage for the transconjugant, accounting, in part, for the low level of dissemination of the VRSA clinical isolates. The association of multiple molecular and environmental factors has been implicated in the regional emergence of VRSA in Michigan.

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Metadata

Authors
Périchon, B., & Courvalin, P.
Venue
Antimicrobial Agents and Chemotherapy
Published
2009-11
Volume
53
Issue
11
Pages
4580-4587
ISSN
  • 0066-4804 (ISSN-L)
  • 1098-6596
OpenAlex
W2111691760
Cited by
334
References
44
FWCI
17.59
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: VanA-Type Vancomycin-Resistant Staphylococcus aureus. https://app.cochat.ai/papers/10.1128/aac.00346-09
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Périchon, B., & Courvalin, P. (2009). VanA-Type Vancomycin-Resistant Staphylococcus aureus. Antimicrobial Agents and Chemotherapy. https://doi.org/10.1128/aac.00346-09

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