title: Vancomycin-resistant Staphylococcus aureus isolate from a patient in Pennsylvania.
abstract: A vancomycin-resistant Staphylococcus aureus (VRSA) isolate was obtained from a patient in Pennsylvania in September 2002. Species identification was confirmed by standard biochemical tests and analysis of 16S ribosomal DNA, gyrA, and gyrB sequences; all of the results were consistent with the S. aureus identification. The MICs of a variety of antimicrobial agents were determined by broth microdilution and macrodilution methods following National Committee for Clinical Laboratory Standards (NCCLS) guidelines. The isolate was resistant to vancomycin (MIC = 32 micro g/ml), aminoglycosides, beta-lactams, fluoroquinolones, macrolides, and tetracycline, but it was susceptible to linezolid, minocycline, quinupristin-dalfopristin, rifampin, teicoplanin, and trimethoprim-sulfamethoxazole. The isolate, which was originally detected by using disk diffusion and a vancomycin agar screen plate, was vancomycin susceptible by automated susceptibility testing methods. Pulsed-field gel electrophoresis (PFGE) of SmaI-digested genomic DNA indicated that the isolate belonged to the USA100 lineage (also known as the New York/Japan clone), the most common staphylococcal PFGE type found in hospitals in the United States. The VRSA isolate contained two plasmids of 120 and 4 kb and was positive for mecA and vanA by PCR amplification. The vanA sequence was identical to the vanA sequence present in Tn1546. A DNA probe for vanA hybridized to the 120-kb plasmid. This is the second VRSA isolate reported in the United States.
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. fnt1@cdc.gov
authors.forename: Fred C
authors.initials: FC
authors.lastname: Tenover
authors.forename: Linda M
authors.initials: LM
authors.lastname: Weigel
authors.forename: Peter C
authors.initials: PC
authors.lastname: Appelbaum
authors.forename: Linda K
authors.initials: LK
authors.lastname: McDougal
authors.forename: Jasmine
authors.initials: J
authors.lastname: Chaitram
authors.forename: Sigrid
authors.initials: S
authors.lastname: McAllister
authors.forename: Nancye
authors.initials: N
authors.lastname: Clark
authors.forename: George
authors.initials: G
authors.lastname: Killgore
authors.forename: Caroline M
authors.initials: CM
authors.lastname: O'Hara
authors.forename: Laura
authors.initials: L
authors.lastname: Jevitt
authors.forename: Jean B
authors.initials: JB
authors.lastname: Patel
authors.forename: Bülent
authors.initials: B
authors.lastname: Bozdogan
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D015139:Blotting, Southern; D019729:Carbon-Oxygen Ligases / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D008826:Microbial Sensitivity Tests; D015242:Ofloxacin / Q000494:pharmacology; D010068:Oxacillin / Q000494:pharmacology; D010406:Penicillins / Q000494:pharmacology; D010414:Pennsylvania; D010957:Plasmids / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012293:Rifampin / Q000494:pharmacology; D013203:Staphylococcal Infections / Q000235:genetics / Q000382:microbiology*; D014640:Vancomycin / Q000494:pharmacology*; D020713:Vancomycin Resistance / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D010406:Penicillins; C071437:VanA ligase, Bacteria; D014640:Vancomycin; D015242:Ofloxacin; D019729:Carbon-Oxygen Ligases; D010068:Oxacillin; D012293:Rifampin