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Antibiotic resistance

A vancomycin surprise

Nature volume 399, pages 525–527 (1999)Cite this article

Vancomycin is the last line of defence against organisms such as Streptococcus pneumoniae and Enterococcus, some strains of which are resistant to most other antibiotics. Whereas S. pneumoniae is responsible for diseases such as pneumonia, meningitis and otitus media (ear infection), Enterococcus bacteria cause many hospital-acquired infections. Because pneumococcal pneumonia alone results in over a million deaths each year worldwide1, any compromise in our ability to treat these infections is an important public-health concern. In just ten years, vancomycin resistance has spread among the enterococci from one initial observation to the situation now, where 52% of clinical E. faecium isolates are resistant2. This rapid spread seems to be due, in part, to an association between resistance to vancomycin and resistance to penicillin and ampicillin2. On page 590of this issue, Novak and colleagues3 report a new threat to antibiotic therapy — the emergence of penicillin-resistant clinical isolates of S. pneumoniae, which are also tolerant to a number of other antibiotics, including vancomycin.

Tolerance and resistance are somewhat different. Whereas antibiotic-resistant microorganisms are insensitive to the antibiotic, and continue to grow in its presence, the antibiotic-tolerant strains stop growing but do not die in the presence of the antibiotic. In neither case does antibiotic therapy eliminate the infective agent, meaning that the infection can continue once therapy is curtailed. Antibiotic tolerance is particularly insidious because it cannot be detected using conventional in vitro tests — tolerant strains seem to be sensitive to antibiotics.

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Figure 1: A two-component signal-transduction system.

References

  1. WHO Global Programme for Vaccines and Immunization, Vaccine Research and Development Rep. Tech. Rev. Group Mtg 10 (WHO, Geneva, 1998).

  2. Huycke, M. M., Sahm, D. F. & Gilmore, M. S. Emerg. Infect. Dis. 4, 239–249 (1998).

    Google Scholar 

  3. Novak, R., Henriques, B., Charpentier, E., Normark, S. & Tuomanen, E. Nature 399, 590–593 (1999).

    Article  ADS  CAS  Google Scholar 

  4. Centers for Disease Prevention and Control Prevention of Pneumococcal Disease: Recommendations of the Advisory Committee on Immunization Practices 1-24 (MMWR 46 (RR-08), 1997).

  5. Swanson, R. V., Alex, L. A. & Simon, M. I. Trends Biochem. Sci. 19, 485–490 (1994).

    Google Scholar 

  6. Barrett, J. F. & Hoch, J. A. Antimicrob. Agents Chemother. 42, 1529–1536 (1998).

    Google Scholar 

  7. Dziejman, M. & Mekalanos, J. J. in Two-Component Signal Transduction (eds Hoch, J. A. & Silhavy, T. J.) 305-317 (ASM Press, Washington DC, 1995).

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Authors and Affiliations

  1. Departments of Ophthalmology and Microbiology, University of Oklahoma Health Sciences Center, Oklahoma City, 73190, Oklahoma, USA

    Michael S. Gilmore & James A. Hoch

  2. Division of Cellular Biology, Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, 92037, California, USA

    Michael S. Gilmore & James A. Hoch

Authors
  1. Michael S. Gilmore
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  2. James A. Hoch
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Gilmore, M., Hoch, J. A vancomycin surprise. Nature 399, 525–527 (1999). https://doi.org/10.1038/21070

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