Chapter 48 : Antibiotic Resistance in the Staphylococci

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This chapter summarizes specific resistance mechanisms found in the staphylococci. When discussing resistance among the staphylococci, it is important to draw a distinction between community-acquired versus hospital-acquired (nosocomial) infections. Strains resistant to arsenicals and mercury were identified well before what is now known as the antibiotic era. From the genetic point of view, resistance falls into one of two classes: mutation of a bacterial gene or acquisition of a dedicated resistance gene from some other organism by some form of genetic exchange (transduction, conjugation, or transformation). In the history of antimicrobial chemotherapy, the most useful of antistaphylococcal agents have been the beta-lactam antibiotics, the prototype of which is penicillin. These agents, which include several structural classes, all contain one common structural feature: the beta-lactam ring. Rifampin, a member of the rifamycin class of antibiotics, inhibits transcription by attacking the beta-subunit of RNA polymerase. The fluoroquinolone antimicrobials are one of the few classes of antibacterial agents that are not based on a natural product. Sulfonamide resistance in the staphylococci, which arose soon after the introduction of the sulfa drugs, is chromosomally encoded (by the sulA gene) and is attributed to the overproduction of -aminobenzoate. Mupirocin (formulated with the trade name Bactroban) has come into wide use as a topical agent for the treatment of gram-positive infections and more recently has been employed successfully to treat nasal carriers of methicillin-resistant (MRSA), especially those in chronic care settings (e.g., nursing homes) and hospital staff.

Citation: Projan S, Ruzin A. 2006. Antibiotic Resistance in the Staphylococci, p 587-598. In Fischetti V, Novick R, Ferretti J, Portnoy D, Rood J (ed), Gram-Positive Pathogens, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816513.ch48
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Table 1

Agents used to treat staphylococcal infections

Citation: Projan S, Ruzin A. 2006. Antibiotic Resistance in the Staphylococci, p 587-598. In Fischetti V, Novick R, Ferretti J, Portnoy D, Rood J (ed), Gram-Positive Pathogens, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816513.ch48

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