will require constant innovation

resistant to vancomycin and now linezolid illustrates the urgent need for novel antibiotic design strategies.

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While enterococci are always quick to devise mechanisms for developing resistance to novel antibiotics, staphylococci seem to take longer. The differential pace of the development of resistance is fortunate in that enterococci have a tendency to be less virulent than staphylococci, but it only delays the inevitable — sooner or later staphylococci catch up.

Cases of methicillin resistant Staphylococcus aureus (MRSA) first arose in the 1980s, plaguing hospital wards and more recently moving out to attack people living in the community. Latest UK statistics show a 2% increase in reports of MRSA between 1999 and 2000.

The problem did not really initially cause widespread concern because it was thought the glycopeptide vancomycin could cope. But in May 1996 this assumption came under threat with the first reported case of S. aureus resistant to vancomycin. This first patient was in Japan, and it took a couple of years before one showed ...

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