CONSTITUTIVELY VANCOMYCIN-RESISTANT ENTEROCOCCUS-FAECIUM RESISTANT TO SYNERGISTIC BETA-LACTAM COMBINATIONS

被引:21
作者
GREEN, M
BINCZEWSKI, B
PASCULLE, AW
EDMUND, M
BARBADORA, K
KUSNE, S
SHLAES, DM
机构
[1] UNIV PITTSBURGH,CHILDRENS HOSP,SCH MED,DEPT PATHOL,PITTSBURGH,PA 15213
[2] UNIV PITTSBURGH,CHILDRENS HOSP,SCH MED,DEPT SURG,PITTSBURGH,PA 15213
[3] UNIV PITTSBURGH,CHILDRENS HOSP,SCH MED,DEPT PEDIAT,PITTSBURGH,PA 15213
[4] PRESBYTERIAN UNIV HOSP,SCH MED,PITTSBURGH,PA 15213
[5] CASE WESTERN RESERVE UNIV,DEPT VET AFFAIRS MED CTR,RES SERV,CLEVELAND,OH 44106
[6] CASE WESTERN RESERVE UNIV,DEPT VET AFFAIRS MED CTR,MED SERV,CLEVELAND,OH 44106
关键词
D O I
10.1128/AAC.37.6.1238
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Vancomycin resistance among enterococci has recently been recognized. Synergy between vancomycin and penicillin has been shown in vitro for isolates of Enterococcus faecium resistant to both of these antibiotics. We describe three isolates of vancomycin-resistant E. faecium which demonstrate unique phenotypic characteristics. The isolates exhibited high-level resistance to both vancomycin and teicoplanin, consistent with the VanA phenotype. However, resistance in these isolates could not be induced or cured, and mating experiments failed to detect a transfer of resistance. The combination of vancomycin and penicillin did not significantly change the MIC of penicillin for any of the three isolates. Immunoblotting with polyclonal anti-VanB antibody showed no reaction with the cellular proteins of these strains. Probing with a vanA oligonucleotide revealed hybridization with chromosomal but not plasmid DNA. The mechanism of constitutive resistance of those strains remains unclear. A second mutational change, perhaps involving PBP 5, may explain the presence of resistance to synergistic combination penicillin-vancomycin therapy. In vitro evaluation of penicillin-vancomycin should be carried out in all clinical cases where this therapeutic regimen is being considered.
引用
收藏
页码:1238 / 1242
页数:5
相关论文
共 30 条
[1]   COMPARISON OF VANCOMYCIN-INDUCIBLE PROTEINS FROM 4 STRAINS OF ENTEROCOCCI [J].
ALOBEID, S ;
GUTMANN, L ;
SHLAES, DM ;
WILLIAMSON, R ;
COLLATZ, E .
FEMS MICROBIOLOGY LETTERS, 1990, 70 (01) :101-105
[2]  
AUSBEL FM, 1987, CURRENT PROTOCOLS MO
[3]   CLONING AND HETEROSPECIFIC EXPRESSION OF THE RESISTANCE DETERMINANT-VANA ENCODING HIGH-LEVEL RESISTANCE TO GLYCOPEPTIDES IN ENTEROCOCCUS-FAECIUM BM4147 [J].
BRISSONNOEL, A ;
DUTKAMALEN, S ;
MOLINAS, C ;
LECLERCQ, R ;
COURVALIN, P .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1990, 34 (05) :924-927
[4]   MOLECULAR-BASIS FOR VANCOMYCIN RESISTANCE IN ENTEROCOCCUS-FAECIUM BM4147 - BIOSYNTHESIS OF A DEPSIPEPTIDE PEPTIDOGLYCAN PRECURSOR BY VANCOMYCIN RESISTANCE PROTEINS VANH AND VANA [J].
BUGG, TDH ;
WRIGHT, GD ;
DUTKAMALEN, S ;
ARTHUR, M ;
COURVALIN, P ;
WALSH, CT .
BIOCHEMISTRY, 1991, 30 (43) :10408-10415
[5]   VANCOMYCIN-RESISTANT STREPTOCOCCI OR LEUCONOSTOC SP [J].
BUUHOI, A ;
BRANGER, C ;
ACAR, JF .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1985, 28 (03) :458-460
[6]   THE VANA GLYCOPEPTIDE RESISTANCE PROTEIN IS RELATED TO D-ALANYL-D-ALANINE LIGASE CELL-WALL BIOSYNTHESIS ENZYMES [J].
DUTKAMALEN, S ;
MOLINAS, C ;
ARTHUR, M ;
COURVALIN, P .
MOLECULAR AND GENERAL GENETICS, 1990, 224 (03) :364-372
[7]   TRANSFER-FUNCTIONS OF THE STREPTOCOCCUS-FAECALIS PLASMID PAD1 - ORGANIZATION OF PLASMID DNA ENCODING RESPONSE TO SEX-PHEROMONE [J].
EHRENFELD, EE ;
CLEWELL, DB .
JOURNAL OF BACTERIOLOGY, 1987, 169 (08) :3473-3481
[8]   IDENTIFICATION OF GRAM-POSITIVE COCCAL AND COCCOBACILLARY VANCOMYCIN-RESISTANT BACTERIA [J].
FACKLAM, R ;
HOLLIS, D ;
COLLINS, MD .
JOURNAL OF CLINICAL MICROBIOLOGY, 1989, 27 (04) :724-730
[9]   IDENTIFICATION OF ENTEROCOCCUS SPECIES ISOLATED FROM HUMAN INFECTIONS BY A CONVENTIONAL TEST SCHEME [J].
FACKLAM, RR ;
COLLINS, MD .
JOURNAL OF CLINICAL MICROBIOLOGY, 1989, 27 (04) :731-734