Abstract
Within the past year, infections caused by methicillin-resistant Staphylococcus aureus (MRSA) strains with reduced susceptibility to vancomycin (MIC = 8 μg/mL) have been
reported in both Japan and the United States. The emergence of these strains poses
a potentially serious threat to public health. After 2 such strains (Mu3 and Mu50)
were identified at Juntendo Hospital in 1996, a screening program to identify MRSA
strains with reduced susceptibility to vancomycin was initiated. Of 970 MRSA strains
tested at 195 nonuniversity hospitals throughout Japan, 13 (1.3%) were found to have
subpopulations with reduced vancomycin susceptibility (heterogeneous vancomycin resistance).
Among 129 MRSA strains identified at 7 university hospitals, 12 (9.3%) demonstrated
heterogeneity for vancomycin resistance; 1 of these strains had a vancomycin MIC of
7 μg/mL. Although resistance in these strains is not the result of the transfer of
enterococcal vancomycin resistance genes (vanA or vanB), the clonal dissemination of MRSA strains with vancomycin-resistant subpopulations
is obviously undesirable. Intensified testing of MRSA strains for resistance to vancomycin
and appropriate measures for the prevention of the spread of such strains are recommended.
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© 1998 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
