Journal
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
Volume 12, Issue 10, Pages 1221-1236Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1586/14787210.2014.956092
Keywords
antimicrobial resistance; enterococcus; mechanisms of resistance; vancomycin-resistant enterococci
Funding
- Chilean Ministry of Education
- Clinical Alemana de Santiago and Universidad del Desarrollo School of Medicine, Chile
- NIH-NIAD grant [R01 AI093749]
- Pfizer Inc.
- Forest Pharmaceuticals
- Theravance Inc.
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Multidrug-resistant (MDR) enterococci are important nosocomial pathogens and a growing clinical challenge. These organisms have developed resistance to virtually all antimicrobials currently used in clinical practice using a diverse number of genetic strategies. Due to this ability to recruit antibiotic resistance determinants, MDR enterococci display a wide repertoire of antibiotic resistance mechanisms including modification of drug targets, inactivation of therapeutic agents, overexpression of efflux pumps and a sophisticated cell envelope adaptive response that promotes survival in the human host and the nosocomial environment. MDR enterococci are well adapted to survive in the gastrointestinal tract and can become the dominant flora under antibiotic pressure, predisposing the severely ill and immunocompromised patient to invasive infections. A thorough understanding of the mechanisms underlying antibiotic resistance in enterococci is the first step for devising strategies to control the spread of these organisms and potentially establish novel therapeutic approaches.
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