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PMID: 8665471 Published · ppublish English Journal Article Review

Current perspectives on glycopeptide resistance.

Clinical microbiology reviews ·Vol. 8 ·No. 4 ·1995-10-00 ·Pages 585-615

Woodford N, Johnson AP, Morrison D, Speller DC

Abstract

In the last 5 years, clinical isolates of gram-positive bacteria with intrinsic or acquired resistance to glycopeptide antibiotics have been encountered increasingly. In many of these isolates, resistance arises from an alteration of the antibiotic target site, with the terminal D-alanyl-D-alanine moiety of peptidoglycan precursors being replaced by groups that do not bind glycopeptides. Although the criteria for defining resistance have been revised frequently, the reliable detection of low-level glycopeptide resistance remains problematic and is influenced by the method chosen. Glycopeptide-resistant enterococci have emerged as a particular problem in hospitals, where in addition to sporadic cases, clusters of infections with evidence of interpatient spread have occurred. Studies using molecular typing methods have implicated colonization of patients, staff carriage, and environmental contamination in the dissemination of these bacteria. Choice of antimicrobial therapy for infections caused by glycopeptide-resistant bacteria may be complicated by resistance to other antibiotics. Severe therapeutic difficulties are being encountered among patients infected with enterococci, with some infections being untreatable with currently available antibiotics.

MeSH Terms
Anti-Bacterial Agents Cross Infection/drug therapy,epidemiology,microbiology Drug Resistance, Microbial/genetics Drug Therapy, Combination/therapeutic use Glycopeptides Gram-Positive Bacterial Infections/drug therapy,epidemiology,microbiology Gram-Positive Cocci/genetics Microbial Sensitivity Tests
Chemicals
Anti-Bacterial Agents Glycopeptides
Authors & Affiliations
4 authors, click to expand affiliations / ORCID
Woodford N
Antibiotic Reference Unit, Central Public Health Laboratory, London, England.
Johnson A P
Morrison D
Speller D C
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Article Info
Journal
Clinical microbiology reviews
Abbr.
Clin Microbiol Rev
ISSN
0893-8512
DOI
10.1128/CMR.8.4.585
Published
1995-10-00
Pages
585-615
Language
English
Region
United States
NLM ID
8807282
PMCID
PMC172877
Subset
IM
External Links
PubMed source DOI: 10.1128/CMR.8.4.585 PMC Full Text View journal details
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