Vancomycin-Resistant Staphylococcus aureus in the United States, 2002-2006
Abstract
BACKGROUND: This report compares the clinical characteristics, epidemiologic investigations, infection-control evaluations, and microbiologic findings of all 7 of the cases of vancomycin-resistant Staphylococcus aureus (VRSA) infection in the United States during the period 2002-2006. METHODS: Epidemiologic, clinical, and infection-control information was collected. VRSA isolates underwent confirmatory identification, antimicrobial susceptibility testing, pulsed-field gel electrophoresis, and typing of the resistance genes. To assess VRSA transmission, case patients and their contacts were screened for VRSA carriage. RESULTS: Seven cases were identified from 2002 through 2006; 5 were reported from Michigan, 1 was reported from Pennsylvania, and 1 was reported from New York. All VRSA isolates were vanA positive and had a median vancomycin minimum inhibitory concentration of 512 microg/mL. All case patients had a history of prior methicillin-resistant S. aureus and enterococcal infection or colonization; all had several underlying conditions, including chronic skin ulcers; and most had received vancomycin therapy prior to their VRSA infection. Person-to-person transmission of VRSA was not identified beyond any of the case patients. Infection-control precautions were evaluated and were consistent with established guidelines. CONCLUSIONS: Seven patients with vanA-positive VRSA have been identified in the United States. Prompt detection by microbiology laboratories and adherence to recommended infection control measures for multidrug-resistant organisms appear to have prevented transmission to other patients.
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Development of high-level vancomycin resistance in S. aureus, VRSA, was first described in 2002 and resulted from acquisition by an MRSA strain of the vanA gene cluster from a VRE E. faecalis isolate.
“Development of high-level vancomycin resistance in S. aureus (vancomycin-resistant S. aureus, VRSA) was first described in 2002 and was the result of acquisition by an MRSA strain of the vanA gene cluster from a VRE (E. faecalis) isolate (79).”
From Mechanisms of Antibiotic Resistance (2016) · cites this paper as [79]
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- Authors
- Sievert, D. M., Rudrik, J. T., Patel, J. B., McDonald, L. C., Wilkins, M. J., & Hageman, J. C.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Michigan Department of Health and Human Services (US)
- Corresponding author
- Sievert, D. M.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-03-01
- Volume
- 46
- Issue
- 5
- Pages
- 668-674
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2023638940
- Cited by
- 483
- References
- 33
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 7 · 2023: 16 · 2022: 14 · 2021: 15 · 2020: 16 · 2019: 21 · 2018: 25 · 2017: 20 · 2016: 19 · 2015: 27 · 2014: 39 · 2013: 36 · 2012: 37
- FWCI
- 37.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Keywords
- vancomycin-resistant Staphylococcus aureus, vanA gene, methicillin-resistant Staphylococcus aureus, enterococcal infections, human-to-human transmission, infection control, multidrug-resistant organisms, antimicrobial resistance, chronic skin ulcers, United States
- MeSH terms
- Adult, Aged, Bacterial Proteins, Carrier State, DNA, Bacterial, Family Health, Female, Genotype, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Risk Factors, Staphylococcal Infections, Staphylococcus aureus, United States, Bacterial Typing Techniques, Electrophoresis, Gel, Pulsed-Field, Infection Control, Carbon-Oxygen Ligases, Guideline Adherence, Vancomycin Resistance
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