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ANTIMICROBIAL

RESISTANCE
• Vancomycin resistance is caused by an
• altered peptidoglycan terminus
• (d-ala-d-lac instead of the usual d-ala-d-ala),
• resulting in reduced vancomycin binding and
• failure to prevent cell wall synthesis. 
• Resistance in vancomycin-intermediate S. aureus and glycopeptide-
intermediate S

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