Cited by 567Antimicrobial Resistance in StaphylococcusAntibiotic Resistance in BacteriaBacterial Genetics and Biotechnology

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Mechanisms of vancomycin resistance in Staphylococcus aureus

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Gardete, Susana, Tomasz, Alexander·2014·Journal of Clinical Investigation

Abstract

Vancomycin is a glycopeptide antibiotic used for the treatment of Gram-positive bacterial infections. Traditionally, it has been used as a drug of last resort; however, clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) strains with decreased susceptibility to vancomycin (vancomycin intermediate-resistant S. aureus [VISA]) and more recently with high-level vancomycin resistance (vancomycin-resistant S. aureus [VRSA]) have been described in the clinical literature. The rare VRSA strains carry transposon Tn1546, acquired from vancomycin-resistant Enterococcus faecalis, which is known to alter cell wall structure and metabolism, but the resistance mechanisms in VISA isolates are less well defined. Herein, we review selected mechanistic aspects of resistance in VISA and summarize biochemical studies on cell wall synthesis in a VRSA strain. Finally, we recapitulate a model that integrates common mechanistic features of VRSA and VISA strains and is consistent with the mode of action of vancomycin.

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Metadata

Authors
Gardete, S., & Tomasz, A.
Affiliations
Rockefeller University (US)
Corresponding author
Tomasz, Alexander
Venue
Journal of Clinical Investigation
Published
2014-07-01
Volume
124
Issue
7
Pages
2836-2840
ISSN
0021-9738 (ISSN-L)
OpenAlex
W1983784984
Cited by
565
References
66
Citations by year
2026: 26 · 2025: 53 · 2024: 71 · 2023: 48 · 2022: 53 · 2021: 57 · 2020: 49 · 2019: 66 · 2018: 40 · 2017: 43 · 2016: 29 · 2015: 25 · 2014: 4
FWCI
4.68
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Allergy and Infectious Diseases (2 R01 AI457838-14)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
  • Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Bacterial Genetics and Biotechnology
Keywords
vancomycin resistance, Staphylococcus aureus, vancomycin-intermediate Staphylococcus aureus, vancomycin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Tn1546 transposon, vancomycin-resistant Enterococcus faecalis, cell wall biosynthesis, glycopeptides, antibiotic resistance mechanisms, cell wall metabolism
MeSH terms
Cell Wall, DNA Transposable Elements, DNA, Bacterial, Genes, Bacterial, Humans, Microbial Sensitivity Tests, Models, Biological, Mutation, Staphylococcal Infections, Staphylococcus aureus, Virulence, Vancomycin Resistance, Methicillin-Resistant Staphylococcus aureus

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