Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Future Microbiol. 2013 Aug;8(8):993-1010. doi: 10.2217/fmb.13.66.
The cell wall of Gram-positive bacteria functions as a surface organelle that continuously interacts with its environment through a plethora of cell wall-associated molecules. Enterococcus faecium is a normal inhabitant of the GI tract of mammals, but has recently become an important etiological agent of hospital-acquired infections in debilitated patients. Insights into the assembly and function of enterococcal cell wall components and their interactions with the host during colonization and infection are essential to explain the worldwide emergence of E. faecium as an important multiantibiotic-resistant nosocomial pathogen. Understanding the biochemistry of cell wall biogenesis and principles of antibiotic resistance at the molecular level may open up new frontiers in research on enterococci, particularly for the development of novel antimicrobial strategies. In this article, we outline the current knowledge on the most important antimicrobial resistance mechanisms that involve peptidoglycan synthesis and the role of cell wall constituents, including lipoteichoic acid, wall teichoic acid, capsular polysaccharides, LPxTG cell wall-anchored surface proteins, WxL-type surface proteins and pili, in the pathogenesis of E. faecium.
革兰氏阳性菌的细胞壁作为一种表面细胞器，通过大量与细胞壁相关的分子与环境持续相互作用。屎肠球菌是哺乳动物胃肠道的正常寄居者，但最近已成为衰弱患者医院获得性感染的重要病原体。深入了解肠球菌细胞壁成分的组装和功能，以及它们在定植和感染过程中与宿主的相互作用，对于解释屎肠球菌作为一种重要的多抗生素耐药性医院病原体在全球范围内的出现至关重要。在分子水平上了解细胞壁生物发生的生物化学和抗生素耐药性的原则，可能为肠球菌的研究开辟新的前沿，特别是为新型抗菌策略的发展开辟新的前沿。本文概述了涉及肽聚糖合成和细胞壁成分（包括脂磷壁酸、壁磷壁酸、荚膜多糖、LPxTG 细胞壁锚定表面蛋白、WxL 型表面蛋白和菌毛）的最重要的抗菌耐药机制在屎肠球菌发病机制中的作用。
