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Clinical Infectious Diseases
Article . 1997 . Peer-reviewed
Data sources: Crossref
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Resistance to Glycopeptides in Enterococci

Authors: R, Leclercq; P, Courvalin;

Resistance to Glycopeptides in Enterococci

Abstract

The development of resistance to glycopeptides (vancomycin and teicoplanin) is one of the best examples of the alternation between success and failure that spans the history of the antibiotic era. The introduction of penicillin G was revolutionary. However, the emergence in the 1950s of clinical isolates of Staphylococcus aureus that were resistant to penicillins and subsequently to erythromycin and tetracyclines stimulated the development of large-scale screening programs for new drugs. Under these circumstances, an American missionary, Reverend W. M. Bouw, provided Eli Lilly (Indianapolis) with a soil sample from Borneo [1]. The organism that produces vancomycin, Amycolatopsis orientalis, was isolated from this sample in 1954. Since vancomycin proved to be potent against grampositive bacteria, including penicillinase-producing staphylococci, it was licensed for human use in record time. However, the renal toxicity and ototoxicity associated with vancomycin therapy (due for the most part to impurities in the drug) together with the introduction of new penicillinase-resistant /-lactams led to a rapid decline in the use of vancomycin. In the 1980s, interest in vancomycin revived because of several factors. During this period, methicillin-resistant and multiresistant staphylococci, against which vancomycin is often the only active antibiotic, were emerging worldwide. At the same time, medical advances had resulted in the prolongation of life for increasingly fragile, immunocompromised patients who are exposed to opportunistic pathogens such as multiresistant gram-positive organisms. In addition, it was determined that pseudomembranous colitis could be treated with oral vancomycin, and a new glycopeptide, teicoplanin, was introduced in 1984 in certain European countries. The apparent absence of resistance to vancomycin in grampositive bacteria and a decrease in the toxicity associated with vancomycin therapy (purified formulations of the drug had become available) led to a notable increase in the prescription of this antibiotic. In the United States, a 20-fold increase in the consumption of vancomycin was observed over a 10-year period at a university hospital [2].

Keywords

Phenotype, Genotype, Vancomycin, Animals, Humans, Drug Resistance, Microbial, Enterococcus, Gram-Positive Bacterial Infections, Anti-Bacterial Agents

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
212
Top 10%
Top 1%
Top 1%
bronze