Staphylococcus aureus is a common cause of both community- and hospital-acquired infections, ranging from simple skin pustules to wound abscesses, systemic infection with toxic shock, and death [
]. Resistance to penicillin G developed soon after its introduction due to staphylococcal β-lactamase production. This was followed by development of resistance in the 1960s to all currently available β-lactams through altered penicillin binding protein (PBP) 2a encoded by the mecA gene [
in: Benenson A.S Control of communicable diseases manual. 16th edition. American Public Health Association, Washington, DC1995: 428-438
- Hartman B.J
- Tomasz A
Low-affinity penicillin-binding protein associated with beta-lactam resistance in Staphylococcus aureus.
J Bacteriol. 1984; 158: 513-516
- Reynolds P.E
- Brown D.F
Penicillin-binding proteins of beta-lactam-resistant strains of Staphylococcus aureus. Effect of growth conditions.
FEBS Lett. 1985; 192: 28-32
4]. Such strains are referred to as methicillin-resistant S aureus (MRSA) based on resistance to methicillin, the first β-lactamase stable penicillin derivative introduced into clinical use. Current estimates are that up to 50% of S aureus in the United States are MRSA [
- Utsui Y
- Yokota T
Role of an altered penicillin-binding protein in methicillin- and cephem-resistant Staphylococcus aureus.
Antimicrob Agents Chemother. 1985; 28: 397-403
]. Until recently, MRSA was predominantly a problem of institutions such as acute and chronic care hospitals, but it is now also a problem in other institutions, such as jails and child care centers, and is increasingly community acquired, for example by competitive contact sports participants [
- Chambers H.F
The changing epidemiology of Staphylococcus aureus?.
Emerg Infect Dis. 2001; 7: 178-182
Methicillin-resistant Staphylococcus aureus infections among competitive sports participants–Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000–2003.
Morbid Mortal Wkly Report. 2003; 52: 793-795
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- Staphylococcal diseases.in: Benenson A.S Control of communicable diseases manual. 16th edition. American Public Health Association, Washington, DC1995: 428-438
- Low-affinity penicillin-binding protein associated with beta-lactam resistance in Staphylococcus aureus.J Bacteriol. 1984; 158: 513-516
- Penicillin-binding proteins of beta-lactam-resistant strains of Staphylococcus aureus. Effect of growth conditions.FEBS Lett. 1985; 192: 28-32
- Role of an altered penicillin-binding protein in methicillin- and cephem-resistant Staphylococcus aureus.Antimicrob Agents Chemother. 1985; 28: 397-403
- The changing epidemiology of Staphylococcus aureus?.Emerg Infect Dis. 2001; 7: 178-182
- Methicillin-resistant Staphylococcus aureus infections among competitive sports participants–Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000–2003.Morbid Mortal Wkly Report. 2003; 52: 793-795
- Antimicrobial resistance amongst isolates of Streptococcus pyogenes and Staphylococcus aureus in the PROTEKT antimicrobial surveillance programme during 1999–2000.J Antimicrob Chemother. 2002; : 9-24
- Activity of daptomycin against susceptible and multidrug-resistant Gram-positive pathogens collected in the SECURE study (Europe) during 2000–2001.J Antimicrob Chemother. 2003; 51: 639-649
- Performance standards for antimicrobial susceptibility testing; twelfth informational supplement. M100–S12.NCCLS, Wayne, PA2002
- Clinical impact of vancomycin-resistant enterococci.J Antimicrob Chemother. 2003; 51: 13-21
- High-level vancomycin-resistant enterococci causing hospital infections.Epidemiol Infect. 1989; 103: 173-181
- Vancomycin-resistant enterococci: mechanisms and clinical observations.Clin Infect Dis. 2001; 33: 210-219
- Co-transfer of vancomycin and other resistance genes from Enterococcus faecalis NCTC 12201 to Staphylococcus aureus.FEMS Microbiol Lett. 1992; 72: 195-198
- Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility.J Antimicrob Chemother. 1997; 40: 135-136
- Staphylococcus aureus with reduced susceptibility to vancomycin–United States, 1997.MMWR Morb Mortal Wkly Rep. 1997; 46: 765-766
- Update. Staphylococcus aureus with reduced susceptibility to vancomycin–United States, 1997.MMWR Morb Mortal Wkly Rep. 1997; 46: 813-815
- Emergence of vancomycin resistance in Staphylococcus aureus. Glycopeptide-Intermediate Staphylococcus aureus Working Group.N Engl J Med. 1999; 340: 493-501
- Vancomycin-intermediate and -resistant Staphylococcus aureus: what the infectious disease specialist needs to know.Clin Infect Dis. 2001; 32: 108-115
- The prevalence and mechanisms of vancomycin resistance in Staphylococcus aureus.Annu Rev Microbiol. 2002; 56: 657-675
- Vancomycin-intermediate Staphylococcus aureus in a home health-care patient.Emerg Infect Dis. 2001; 7: 1023-1025
- The development of vancomycin resistance in a patient with methicillin-resistant Staphylococcus aureus infection.N Engl J Med. 1999; 340: 517-523
- Contribution of a thickened cell wall and its glutamine nonamidated component to the vancomycin resistance expressed by Staphylococcus aureus Mu50.Antimicrob Agents Chemother. 2000; 44: 2276-2285
- Evolution of a vancomycin-intermediate Staphylococcus aureus strain in vivo: multiple changes in the antibiotic resistance phenotypes of a single lineage of methicillin-resistant S. aureus under the impact of antibiotics administered for chemotherapy.J Clin Microbiol. 2003; 41: 1687-1693
- High level oxacillin and vancomycin resistance and altered cell wall composition in Staphylococcus aureus carrying the Staphylococcal mecA and the enterococcal vanA gene complex.J Biol Chem. 2003; 279: 3398-3407
- Infection with vancomycin-resistant Staphylococcus aureus containing the vanA resistance gene.N Engl J Med. 2003; 348: 1342-1347
- Vancomycin-resistant Staphylococcus aureus–Pennsylvania, 2002.MMWR Morb Mortal Wkly Rep. 2002; 51: 902
- Antibacterial susceptibility of a vancomycin-resistant Staphylococcus aureus strain isolated at the Hershey Medical Center.J Antimicrob Chemother. 2003; 52: 864-868
- Vancomycin-resistant Staphylococcus aureus isolate from a patient in Pennsylvania.Antimicrob Agents Chemother. 2004; 48: 275-280
- Genetic analysis of a high-level vancomycin-resistant isolate of Staphylococcus aureus.Science. 2003; 302: 1569-1571
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