Nicas T I, Cole C T, Preston D A, Schabel A A, Nagarajan R
Lilly Research Laboratories, Eli Lilly & Co., Indianapolis, Indiana 46285-0438.
Antimicrob Agents Chemother. 1989 Sep;33(9):1477-81. doi: 10.1128/AAC.33.9.1477.
Gram-positive bacteria resistant to vancomycin are rare; but they include members of the genera Leuconostoc, Lactobacillus, and Pediococcus, as well as recently emerging vancomycin-resistant strains of Enterococcus faecium and Enterococcus faecalis. Vancomycin, teicoplanin, and several vancomycin derivatives were tested for their activities against vancomycin-resistant gram-positive bacteria. Vancomycin-resistant E. faecium and E. faecalis were generally cross-resistant to other glycopeptides, but some N-substituted vancomycin derivatives were active against the resistant strains, with MICs of 2 to 32 micrograms/ml. These vancomycin derivatives also had significant levels of activity against intrinsically vancomycin-resistant organisms such as Leuconostoc sp. While vancomycin resistance in E. faecium and E. faecalis was inducible, resistance in members of the genera Leuconostoc, Lactobacillus, and Pediococcus appeared to be expressed constitutively. Antibody to a vancomycin-induced membrane protein found in membranes of resistant enterococci did not detect a cross-reacting protein in other vancomycin-resistant species.
对万古霉素耐药的革兰氏阳性菌很罕见；但其中包括明串珠菌属、乳杆菌属和片球菌属的成员，以及最近出现的耐万古霉素屎肠球菌和粪肠球菌菌株。对万古霉素、替考拉宁和几种万古霉素衍生物针对耐万古霉素革兰氏阳性菌的活性进行了测试。耐万古霉素的屎肠球菌和粪肠球菌通常对其他糖肽类药物交叉耐药，但一些N-取代的万古霉素衍生物对耐药菌株有活性，最低抑菌浓度为2至32微克/毫升。这些万古霉素衍生物对诸如明串珠菌属等天然耐万古霉素的微生物也有显著的活性水平。虽然屎肠球菌和粪肠球菌中的万古霉素耐药性是可诱导的，但明串珠菌属、乳杆菌属和片球菌属成员中的耐药性似乎是组成性表达的。在耐药肠球菌膜中发现的一种万古霉素诱导膜蛋白的抗体在其他耐万古霉素物种中未检测到交叉反应蛋白。
