Research progress on the mechanism of β-lactam resistance in group A Streptococciin vivo
GUO Meng-Yang, YAO Kai-Hu
National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Microbiology, Beijing Pediatric Research Institute/National Clinical Medical Research Center for Respiratory Diseases/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China (Yao K-H, Email: yaokaihu@bch.com.cn)
Abstract β-lactams, including penicillin, have been used for over 80 years in the treatment of group A Streptococcus (GAS) infections. Although β-lactam-resistant GAS strains have not been identified in vitro tests, clinical treatment failures have been reported since the 1950s. The mechanism underlying the clinical failure of β-lactam treatment in GAS infections remains unclear. Previous research has suggested that β-lactam resistance in GAS in vivo is associated with reduced drug susceptibility of strains, bacterial inoculation effects, biofilm formation, the effect of coexisting bacteria, bacterial persistence, and bacterial internalization into host cells. This article reviews the main reports on β-lactam treatment failure in GAS infections and analyzes the possible mechanisms of β-lactam resistance in vivo. The findings aim to contribute to future research and clinical approaches in the field.
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