Abstract
Methicillin resistant Staphylococcus aureus strains pose a serious treatment problem because of their multi-drug resistance (MDR). In staphylococcal strains, resistance to macrolides, lincosamides, and streptogramin B (MLSB) correlates with resistance to methicillin. The rapid transmission of erm genes responsible for MLSB resistance has strongly limited the clinical application of traditional macrolides such as erythromycin. On the other hand, in the age of increasing insensitivity to antibiotics the idea of implementing a therapy based on older generation drugs brings hope that the spread of antibiotic resistance will be limited. A thorough understanding of the resistance mechanisms contributes to design of antibiotics that avoid bacterial insensitivity. This review highlights the mechanisms of action of macrolides and mechanism of resistance to these antibiotics among Staphylococcus aureus.
Highlights
The discovery of antibiotics revolutionized the treatment of bacterial infections
The World Health Organization (WHO) published a list of 12 pathogens that pose threats to public health and for which the discovery of effective antibiotics is a priority with Staphylococcus aureus (S. aureus) being one the list [1,3]
The products of msr genes determine another mechanism of resistance to macrolide antibiotics, which is manifested by resistance to macrolides and streptogramin B (MSB phenotype)
Summary
The discovery of antibiotics revolutionized the treatment of bacterial infections. the widespread and inappropriate use of antibacterial drugs in human and veterinary medicine, as well as food industry, has led to the selection and expansion of resistant bacteria and an increased treatment failure ratio [1]. Receiving the Nobel Prize for his discovery, Fleming warned against the development of penicillin resistance Just as he predicted only 20 years after the discovery of penicillin the world was dominated by staphylococcal strains resistant to this antibiotic. The correlation of S. aureus resistance to methicillin and macrolides depends on many mechanisms, such as changing the target of the antibiotic action (erm genes) or active removal of macrolides from the bacterial cell (msr genes). The MRSA strains show resistance to MLSB antibiotics mostly determined by the presence of the ermA or ermC genes.
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