Genetic Analysis of a High-Level Vancomycin-Resistant Isolate of <i>Staphylococcus aureus</i>

Linda M. Weigel(Centers for Disease Control and Prevention), Don B. Clewell(Centers for Disease Control and Prevention), Steven R. Gill(Centers for Disease Control and Prevention), Nancye C. Clark(Centers for Disease Control and Prevention), Linda K. McDougal(Centers for Disease Control and Prevention), Susan E. Flannagan(Centers for Disease Control and Prevention), James F. Kolonay(Centers for Disease Control and Prevention), Jyoti Shetty(Centers for Disease Control and Prevention), George Killgore(Centers for Disease Control and Prevention), Fred C. Tenover(Centers for Disease Control and Prevention)
Science
November 28, 2003
10.1126/science.1090956
Cited by 889

Abstract

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 microg/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), beta-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.

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