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

DOI 10.1172/jci68834PMC PMC4071404

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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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Authors: Gardete, S., & Tomasz, A.
Affiliations: Rockefeller University (US)
Corresponding author: Tomasz, Alexander
ORCID: Gardete, Susana
Tomasz, Alexander
Venue: Journal of Clinical Investigation
Publisher: American Society for Clinical Investigation
Published: 2014-07-01
Volume: 124
Issue: 7
Pages: 2836-2840
ISSN: 0021-9738 (ISSN-L)
DOI: 10.1172/jci68834
PMC: PMC4071404
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: bronze
doi.org
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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Mechanisms of vancomycin resistance in Staphylococcus aureus

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