title: Genetic analysis of a high-level vancomycin-resistant isolate of Staphylococcus aureus.
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.
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. lweigel@cdc.gov
authors.forename: Linda M
authors.initials: LM
authors.lastname: Weigel
authors.forename: Don B
authors.initials: DB
authors.lastname: Clewell
authors.forename: Steven R
authors.initials: SR
authors.lastname: Gill
authors.forename: Nancye C
authors.initials: NC
authors.lastname: Clark
authors.forename: Linda K
authors.initials: LK
authors.lastname: McDougal
authors.forename: Susan E
authors.initials: SE
authors.lastname: Flannagan
authors.forename: James F
authors.initials: JF
authors.lastname: Kolonay
authors.forename: Jyoti
authors.initials: J
authors.lastname: Shetty
authors.forename: George E
authors.initials: GE
authors.lastname: Killgore
authors.forename: Fred C
authors.initials: FC
authors.lastname: Tenover
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D019729:Carbon-Oxygen Ligases / Q000235:genetics*; D003227:Conjugation, Genetic; D004251:DNA Transposable Elements; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D013293:Enterococcus faecalis / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D005798:Genes, Bacterial; D006801:Humans; D016106:Methicillin Resistance / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D010957:Plasmids; D011815:R Factors; D011995:Recombination, Genetic; D006435:Renal Dialysis; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004251:DNA Transposable Elements; C071437:VanA ligase, Bacteria; D014640:Vancomycin; D019729:Carbon-Oxygen Ligases