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PMID: 3069195 Published · ppublish English Journal Article Review

Methicillin-resistant staphylococci.

Clinical microbiology reviews ·Vol. 1 ·No. 2 ·1988-04-00 ·Pages 173-86

Chambers HF

Abstract

Strains of staphylococci resistant to methicillin were identified immediately after introduction of this drug. Methicillin-resistant strains have unusual properties, the most notable of which is extreme variability in expression of the resistance trait. The conditions associated with this heterogeneous expression of resistance are described. Methicillin resistance is associated with production of a unique penicillin-binding protein (PBP), 2a, which is bound and inactivated only at high concentrations of beta-lactam antibiotics. PBP2a appears to be encoded by the mec determinant, which also is unique to methicillin-resistant strains. The relationships between PBP2a and expression of resistance and implications for the mechanism of resistance are discussed. The heterogeneous expression of methicillin resistance by staphylococci poses problems in the detection of resistant strains. Experience with several susceptibility test methods is reviewed and guidelines for performance of these tests are given. Treatment of infections caused by methicillin-resistant staphylococci is discussed. Vancomycin is the treatment of choice. Alternatives have been few because methicillin-resistant strains often are resistant to multiple antibiotics in addition to beta-lactam antibiotics. New agents which are active against methicillin-resistant staphylococci are becoming available, and their potential role in treatment is discussed.

MeSH Terms
Bacteriological Techniques Humans Methicillin/pharmacology Penicillin Resistance/genetics Staphylococcal Infections/therapy Staphylococcus aureus/drug effects,genetics
Chemicals
Methicillin
Authors & Affiliations
1 authors, click to expand affiliations / ORCID
Chambers H F
Medical Service, San Francisco General Hospital, California.
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Article Info
Journal
Clinical microbiology reviews
Abbr.
Clin Microbiol Rev
ISSN
0893-8512
DOI
10.1128/CMR.1.2.173
Published
1988-04-00
Pages
173-86
Language
English
Region
United States
NLM ID
8807282
PMCID
PMC358041
Subset
IM
External Links
PubMed source DOI: 10.1128/CMR.1.2.173 PMC Full Text View journal details
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