Vancomycin-resistant Staphylococcus aureus infection

Vancomycin-resistant Staphylococcus aureus (VRSA) infection is caused by S. aureus strains that have acquired resistance to the glycopeptide antibiotic vancomycin ^[1]. In documented cases, resistance is typically conferred by plasmid-mediated vanA gene and operon acquisition from enterococci ^[1]. The evidence distinguishes VRSA from vancomycin-intermediate S. aureus (VISA), which develops reduced susceptibility through cell-wall mutations rather than vanA uptake ^[1].

Vancomycin-resistant Staphylococcus aureus (VRSA) infection typically presents with clinical manifestations characteristic of staphylococcal disease, including skin and soft-tissue lesions that can resemble pimples or boils, as well as wound infections ^[6]. Laboratory diagnosis requires susceptibility testing of a single S. aureus isolate against vancomycin, beginning with determination of the minimum inhibitory concentration (MIC) using methods such as disc diffusion, gradient strip diffusion, or automated antimicrobial susceptibility testing systems; resistance is then assigned by comparing the MIC to established breakpoints from standards-setting bodies such as the U.S. Clinical and Laboratory Standards Institute, the British Society for Antimicrobial Chemotherapy, and European counterparts ^[1]. As a resistant phenotype, VRSA is often co-resistant to multiple other antibiotic classes, which complicates therapeutic decision-making once susceptibility results are available ^[6][1].

VRSA isolates were detected in a study of 150 blood and sputum samples from intensive care patients ^[2]; 19 isolates were identified, corresponding to 12.67% of samples, including sputum and blood sources ^[2].

VRSA emergence is described as acquisition of vanA/Tn1546 resistance elements from glycopeptide-resistant enterococci by methicillin-resistant S. aureus through horizontal gene transfer ^[4][5]. The evidence notes limited dissemination of clinical isolates ^[4] and association with molecular and environmental factors in regional emergence ^[4].

The evidence identifies people with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in the setting of vancomycin treatment failure as a relevant group ^[1].

Transmission of vancomycin-resistant Staphylococcus aureus can be mitigated through consistent hand hygiene and strict adherence to standard healthcare infection-control protocols ^[6]. Caregivers, visitors, and clinical staff interacting with affected individuals should utilize personal protective equipment, such as gloves, particularly before and after contact with wounds or potentially contaminated materials ^[6]. Implementing these core precautionary measures within hospital settings significantly reduces the likelihood of pathogen dissemination among vulnerable populations ^[6].

VRSA case detection should be interpreted with attention to healthcare-associated exposure and medical tourism, as illustrated by a first reported VRSA infection in an Indonesian patient after liposuction in South Korea ^[3]. Cross-border case reports may reflect pathogen transfer associated with healthcare travel and should prompt review of travel and procedure histories in public-health surveillance ^[3]. Because antibiotic-resistant infections are reported to be increasing in some regions, rare VRSA detections can serve as relevant signals for monitoring antimicrobial resistance in healthcare settings ^[3].

1. 1 Wikipedia contributors. Vancomycin-resistant Staphylococcus aureus - Wikipedia [Internet]. Wikipedia. cited 3 Sept 2026. Available from: https://en.wikipedia.org/wiki/Vancomycin-resistant_Staphylococcus_aureus
2. 2 Elsawy S et al. Effect of silver nanoparticles on vancomycin resistant Staphylococcus aureus infection in critically ill patients. Pathog Glob Health. 2021 Jul. PMID: 33872131. doi: 10.1080/20477724.2021.1914412. PubMed: https://pubmed.ncbi.nlm.nih.gov/33872131/
3. 3 Nelwan EJ et al. Vancomycin-Resistant Staphylococcus Aureus Infection Post-Liposuction in South Korea. Cureus. 2021 Apr 7. PMID: 33987041. doi: 10.7759/cureus.14357. PubMed: https://pubmed.ncbi.nlm.nih.gov/33987041/
4. 4 Périchon B et al. VanA-type vancomycin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2009 Nov. PMID: 19506057. doi: 10.1128/AAC.00346-09. PubMed: https://pubmed.ncbi.nlm.nih.gov/19506057/
5. 5 Witte W et al. Glycopeptide resistant Staphylococcus. J Vet Med B Infect Dis Vet Public Health. 2004 Oct-Nov. PMID: 15525368. doi: 10.1111/j.1439-0450.2004.00774.x. PubMed: https://pubmed.ncbi.nlm.nih.gov/15525368/
6. 6 US Centers for Disease Control and Prevention. About Vancomycin-resistant Staphylococcus aureus | S. aureus | CDC [Internet]. cited 3 Sept 2026. Available from: https://www.cdc.gov/staphylococcus-aureus/about/vancomycin-resistant-staph.html