Originofdenovodaptomycinnonsusceptibleenterococci
摘要: Theemergenceofdaptomycinnon-susceptibleenterococci(DNSE)posesbothtreatmentandinfectioncontrolchallenges.CliniciansshouldbevigilantthatDNSEmaybeisolatedfrompatientswithorwithout(denovoDNSE)prioruseofdaptomycin.RecentepidemiologicaldatasuggestthepresenceofacommunityreservoirforDNSEwhichmaybeassociatedwithenvironmental,foodborneandagriculturalexposures.ThemechanismsofnonsusceptibilitytodaptomycinhavenotbeenwellcharacterizedandmaynotparallelthoseforStaphylococcusaureus.Theidentificationofdaptomycinresistancegenesinanaerobes,infarmanimalsandinanecosystemthathasbeenisolatedformillionyears,suggestthattheenvironmentalreservoirfordenovoDNSEmaybelargerthanpreviouslythought.Herein,thelimitedavailablescientificevidenceregardingthepossibleoriginofdenovoDNSEisdiscussed.ThecurrentexistingevidenceisnotsufficienttodrawfirmconclusionsontheoriginofDNSE.Furtherstudiestodeterminethemechanismsofdenovodaptomycinnonsusceptibilityamongenterococciareneeded. ...
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