Altered Penicillin-Binding Proteins and Meticillin-Resistant Staphylococcus aureus

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Chapter: Pharmaceutical Microbiology : Bacterial Resistance To Antibiotics

Altered PBPs are responsible for reduced sensitivity to β-lactam agents by Strep. pneumoniae (PBP1a, PBP2b and PBP2x) and Haemophilus influenzae (PBP3a and PBP3b), but by far the most clinically significant example is MRSA.


ALTERED PENICILLIN-BINDING PROTEINS AND METICILLIN-RESISTANT Staphylococcus Aureus

 

Altered PBPs are responsible for reduced sensitivity to β-lactam agents by Streppneumoniae (PBP1a, PBP2b and PBP2x) and Haemophilus influenzae (PBP3a and PBP3b), but by far the most clinically significant example is MRSA. By the early 1950s, the acquisition and spread of plasmid-encoded β-lactamases had blunted the effectiveness of penicillin for treating Staphaureus infections such as boils, carbuncles, pneumonia, endocarditis and osteomyelitis. The β-lactamase-stable agent meticillin was introduced in 1959, but by 1960, meticillin-resistant strains were identified. This was the result of Staphaureus acquiring the mecA gene, which encodes an altered PBP gene, PBP2a. The mecA gene is chromosomal and expression is either constitutive or inducible, but not by meticillin. PBP2a has low affinity for most β-lactam antibiotics.

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