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Science 28 November 2003:
Vol. 302. no. 5650, pp. 1569 - 1571
DOI: 10.1126/science.1090956
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Reports

Genetic Analysis of a High-Level Vancomycin-Resistant Isolate of Staphylococcus aureus

Linda M. Weigel,1* Don B. Clewell,2 Steven R. Gill,3 Nancye C. Clark,1 Linda K. McDougal,1 Susan E. Flannagan,2 James F. Kolonay,3 Jyoti Shetty,4 George E. Killgore,1 Fred C. Tenover1

Vancomycin is usually reserved for treatment of serious infections, including those caused by multidrug-resistant Staphylococcus aureus. A clinical isolate of S. aureus with high-level resistance to vancomycin (minimal inhibitory concentration = 1024 µg/ml) was isolated in June 2002. This isolate harbored a 57.9-kilobase multiresistance conjugative plasmid within which Tn1546 (vanA) was integrated. Additional elements on the plasmid encoded resistance to trimethoprim (dfrA), ß-lactams (blaZ), aminoglycosides (aacA-aphD), and disinfectants (qacC). Genetic analyses suggest that the long-anticipated transfer of vancomycin resistance to a methicillin-resistant S. aureus occurred in vivo by interspecies transfer of Tn1546 from a co-isolate of Enterococcus faecalis.

1 Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
2 Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA.
3 The Institute for Genomic Research, Rockville, MD 20850, USA.
4 J. Craig Venter Science Foundation Joint Technology Center, Rockville, MD 20850, USA.

* To whom correspondence should be addressed. E-mail: lweigel{at}cdc.gov

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vanA + MRSA = VRSA.
(2003)
Journal Watch Infectious Diseases 2003, 6
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