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. Author manuscript; available in PMC: 2016 Oct 1.
Published in final edited form as: Microbiol Spectr. 2016 Apr;4(2):10.1128/microbiolspec.VMBF-0016-2015. doi: 10.1128/microbiolspec.VMBF-0016-2015

Figure 6. Schematic representation of peptidoglycan biosynthesis and mechanisms of vancomycin action (A) and resistance (B).

Figure 6

Panel A depicts normal peptidoglycan production and shows that binding of the antibiotic to the terminal D-Ala-D-Ala of the peptidoglycan precursors prevents transpeptidation and transglycosylation, interrupting cell wall synthesis and resulting in bacterial death. Panel B shows the change in peptidoglycan synthesis produced by the expression of the vanA gene cluster. Change of the terminal dipeptide from D-Ala-D-Ala to D-Ala-D-Lac markedly reduces the binding of vancomycin to the peptidoglycan target permitting cell wall synthesis to continue.