Krzysztof Sieradzki; Paolo Villari; Alexander Tomasz
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Sieradzki K, Villari P, Tomasz A. Low-Level Teicoplanin Resistance and Heteroresistance to Vancomycin. Ann Intern Med. 1998;128:245. doi: 10.7326/0003-4819-128-3-199802010-00021
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Published: Ann Intern Med. 1998;128(3):245.
TO THE EDITOR:
Concern about the appearance of glycopeptide resistance among staphylococci prompted us to examine 41 methicillin-resistant coagulase-negative staphylococcal clinical isolates recovered in a New York City hospital during a 5-month period between September 1995 and February 1996. Twenty-eight of 41 strains showed elevated teicoplanin MICs (8 to 32 µg/mL), and all 6 strains examined in more detail by population analysis profiles  also exhibited heteroresistance to vancomycin: Dense cultures contained bacteria with low frequencies (10−5 to 10−7) that could grow at 12 µg of the antibiotic per mL . Pulsed-field gel electrophoresis showed that the 28 isolates represented unrelated strains (24 distinct patterns). Addition of teicoplanin to cultures of resistant bacteria caused inhibition of autolysis, formation of large cellular aggregates, and excretion of large amounts of extracellular material that had the appearance of cell walls. Such cultures could quantitatively remove teicoplanin from the medium during growth. All of these features are reminiscent of the properties of a recently described, highly vancomycin-resistant laboratory mutant of methicillin-resistant Staphylococcus aureus. This mutant did not cross-react with DNA probes for the enterococcal vancomycin-resistant genes but showed the unique ability to “capture” vancomycin molecules in biologically inactive cell-bound form .
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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