Abstract
Strains of staphylococci resistant to methicillin were identified immediately after introduction of this drug. Methicillin-resistant strains have unusual properties, the most notable of which is extreme variability in expression of the resistance trait. The conditions associated with this heterogeneous expression of resistance are described. Methicillin resistance is associated with production of a unique penicillin-binding protein (PBP), 2a, which is bound and inactivated only at high concentrations of beta-lactam antibiotics. PBP2a appears to be encoded by the mec determinant, which also is unique to methicillin-resistant strains. The relationships between PBP2a and expression of resistance and implications for the mechanism of resistance are discussed. The heterogeneous expression of methicillin resistance by staphylococci poses problems in the detection of resistant strains. Experience with several susceptibility test methods is reviewed and guidelines for performance of these tests are given. Treatment of infections caused by methicillin-resistant staphylococci is discussed. Vancomycin is the treatment of choice. Alternatives have been few because methicillin-resistant strains often are resistant to multiple antibiotics in addition to beta-lactam antibiotics. New agents which are active against methicillin-resistant staphylococci are becoming available, and their potential role in treatment is discussed.
Keywords
AntibioticsMicrobiologyPenicillinPenicillin resistancePenicillin binding proteinsMethicillin-resistant Staphylococcus aureusVancomycinBiologyAntibiotic resistanceDrug resistanceStaphylococcus aureusAntibacterial agentBacteriaGenetics
MeSH Terms
Bacteriological TechniquesHumansMethicillinPenicillin ResistanceStaphylococcal InfectionsStaphylococcus aureus
Affiliated Institutions
Related Publications
Evidence for a Clonal Origin of Methicillin Resistance in <i>Staphylococcus aureus</i>
Soon after methicillin was introduced into clinical practice in the early 1960s, resistant strains of Staphylococcus aureus (MRSA) appeared, bearing a newly acquired resistance ...
Insights on Evolution of Virulence and Resistance from the Complete Genome Analysis of an Early Methicillin-Resistant <i>Staphylococcus aureus</i> Strain and a Biofilm-Producing Methicillin-Resistant <i>Staphylococcus epidermidis</i> Strain
ABSTRACT Staphylococcus aureus is an opportunistic pathogen and the major causative agent of numerous hospital- and community-acquired infections. Staphylococcus epidermidis has...
Methicillin-resistant Staphylococcus aureus
Since the 1960s, methicillin-resistant Staphylococcus aureus (MRSA) has emerged, disseminated globally and become a leading cause of bacterial infections in both health-care and...
Susceptibility of Staphylococcus aureus growing on fibronectin-coated surfaces to bactericidal antibiotics
Several recent studies have shown that bacteria either grown in vitro as adherent biofilms or recovered from infected prosthetic devices have decreased susceptibilities to antim...
Methicillin-Resistant Staphylococcus aureus: Molecular Characterization, Evolution, and Epidemiology
Staphylococcus aureus , a major human pathogen, has a collection of virulence factors and the ability to acquire resistance to most antibiotics. This ability is further augmente...
Publication Info
- Year
- 1988
- Type
- review
- Volume
- 1
- Issue
- 2
- Pages
- 173-186
- Citations
- 260
- Access
- Closed
External Links
Social Impact
Altmetric
PlumX Metrics
Social media, news, blog, policy document mentions
Citation Metrics
260
OpenAlex
1
Influential
Cite This
Henry F. Chambers
(1988).
Methicillin-resistant staphylococci.
Clinical Microbiology Reviews
, 1
(2)
, 173-186.
https://doi.org/10.1128/cmr.1.2.173
Identifiers
- DOI
- 10.1128/cmr.1.2.173
- PMID
- 3069195
- PMCID
- PMC358041