Gholizadeh Y, Courvalin P
Unité des Agents Antibactériens, Institut Pasteur, 25, rue du Docteur Roux, 75724 Paris Cedex 15, France.
Int J Antimicrob Agents. 2000 Nov;16 Suppl 1:S11-7. doi: 10.1016/s0924-8579(00)00300-9.
Enterococci are Gram-positive cocci responsible for severe human infections, such as endocarditis, meningitis, and septicemia and constitute an increasingly frequent cause of nosocomial infections. Enterococci are resistant to nearly all classes of drugs including, since 1986, glycopeptides. Vancomycin and teicoplanin act by blocking cell wall formation and resistance is due to synthesis of modified late peptidoglycan precursors. Glycopeptide resistance can be intrinsic or acquired and strains may be resistant to vancomycin and teicoplanin, or to vancomycin only. Five types of glycopeptide resistance and their biochemical mechanisms have been described in enterococci. Clinical isolates that are dependent on vancomycin for growth have been isolated. Data suggest a dual origin for resistance: glycopeptide-producing organisms or enterococcal species intrinsically resistant to these drugs.
肠球菌是革兰氏阳性球菌，可引发严重的人类感染，如心内膜炎、脑膜炎和败血症，并且日益成为医院感染的常见病因。自1986年以来，肠球菌对几乎所有种类的药物都具有抗性，包括糖肽类药物。万古霉素和替考拉宁通过阻断细胞壁形成发挥作用，而抗性则源于修饰后的晚期肽聚糖前体的合成。糖肽类抗性可以是固有抗性或获得性抗性，菌株可能对万古霉素和替考拉宁都有抗性，或者仅对万古霉素有抗性。在肠球菌中已描述了五种糖肽类抗性及其生化机制。已分离出依赖万古霉素生长的临床分离株。数据表明抗性有双重起源：产生糖肽类的生物体或对这些药物具有固有抗性的肠球菌种类。
