Specificity of induction of the vanA and vanB operons in vancomycin-resistant enterococci by telavancin

Antimicrob Agents Chemother. 2010 Jul;54(7):2814-8. doi: 10.1128/AAC.01737-09. Epub 2010 Apr 19.

Abstract

Telavancin is a bactericidal, semisynthetic lipoglycopeptide indicated in the United States for the treatment of complicated skin and skin structure infections caused by susceptible gram-positive bacteria and is under investigation as a once-daily treatment for nosocomial pneumonia. The related vanA and vanB gene clusters mediate acquired resistance to glycopeptides in enterococci by remodeling the dipeptide termini of peptidoglycan precursors from D-alanyl-D-alanine (D-Ala-D-Ala) to D-alanyl-D-lactate (D-Ala-D-Lac). In this study, we assessed the ability of telavancin to induce the expression of van genes in VanA- and VanB-type strains of vancomycin-resistant enterococci. Vancomycin, teicoplanin, and telavancin efficiently induced VanX activity in VanA-type strains, while VanX activity in VanB-type isolates was inducible by vancomycin but not by teicoplanin or telavancin. In VanA-type strains treated with vancomycin or telavancin, high levels of D-Ala-D-Lac-containing pentadepsipeptide were measured, while D-Ala-D-Ala pentapeptide was present at very low levels or not detected at all. In VanB-type strains, vancomycin but not telavancin induced high levels of pentadepsipeptide, while pentapeptide was not detected. Although vancomycin, teicoplanin, and telavancin induced similar levels of VanX activity in VanA-type strains, these organisms were more sensitive to telavancin, which displayed MIC values that were 32- and 128-fold lower than those of vancomycin and teicoplanin, respectively.

MeSH terms

  • Aminoglycosides / pharmacology*
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics
  • Bacterial Proteins / metabolism*
  • Blotting, Western
  • Carbon-Oxygen Ligases / genetics
  • Carbon-Oxygen Ligases / metabolism*
  • Drug Resistance, Bacterial / drug effects
  • Drug Resistance, Bacterial / genetics
  • Enterococcus / drug effects*
  • Enterococcus / genetics
  • Enterococcus / metabolism*
  • Gene Expression Regulation, Bacterial / drug effects
  • Gene Expression Regulation, Bacterial / genetics
  • Lipoglycopeptides
  • Operon / drug effects*
  • Operon / genetics
  • Teicoplanin / pharmacology
  • Vancomycin / pharmacology
  • Vancomycin Resistance / drug effects
  • Vancomycin Resistance / genetics

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Lipoglycopeptides
  • VanA ligase, Bacteria
  • VanB protein, Enterococcus
  • Teicoplanin
  • Vancomycin
  • Carbon-Oxygen Ligases
  • telavancin