Vancomycin resistant Staphylococcus aureus in the United States

Since the first reports of glycopeptide resistant enterococci (GRE) in 1987, concern has been expressed about enterococcal van genes, which encode vancomycin resistance, reaching Staphylococcus aureus. This often voiced fear has now been realised, with the reported isolation of a VanA MRSA (vancomycin minimum inhibitory concentration (MIC) >128 mg/L; teicoplanin MIC 32 mg/L) from the tip of a dialysis catheter and from a chronic foot ulcer of a patient in Michigan, in the United States; glycopeptide resistant Enterococcus faecalis (genotype not specified) was also isolated from the ulcer (1).