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1 March 2008

Volume 46, Number 5
Clinical Infectious Diseases 2008;46:668–674
© 2008 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2008/4605-0004$15.00
DOI: 10.1086/527392
MAJOR ARTICLE

Vancomycin‐Resistant Staphylococcus aureus in the United States, 2002–2006

Dawn M. Sievert,1,2

James T. Rudrik,1

Jean B. Patel,2

L. Clifford McDonald,2

Melinda J. Wilkins,1 and

Jeffrey C. Hageman2

1Michigan Department of Community Health, Lansing; and 2Centers for Disease Control and Prevention, Atlanta, Georgia

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 μg/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.

Received 15 August 2007; accepted 31 October 2007; electronically published 30 January 2008.

  • (See the editorial commentary by Tenover on pages 675–7)

Reprints or correspondence: Dr. Dawn M. Sievert, Div. of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A‐24, Atlanta, GA 30333 ().

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  • The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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