George M. Eliopoulos, Section Editor Staphylococcus aureus with Reduced Susceptibility to

Infections with Staphylococcus aureus with reduced susceptibility to vancomycin continue to be reported, including 2 cases caused by S. aureus isolates with full resistance to vancomycin. This review first outlines the definitions of vancomycin-intermediate S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA) and risk factors for infection. Next, we describe the mechanisms of resistance and methods of laboratory detection of the organisms. Finally, we address infection control and management issues associated with isolation of VISA and VRSA. The first report of a clinical Staphylococcus aureus isolate that demonstrated reduced susceptibility to vancomycin in 1997 has been followed by multiple reports of additional isolates seen in all parts of the world. In the United States, there have now been 9 reported clinical cases of infection with S. aureus with intermediate resistance to vancomycin, as well as 2 known clin-ical cases of infection with S. aureus isolates that are fully re-sistant to vancomycin [1]. This brief review will address the epidemiology, mechanisms of resistance, laboratory identifi-cation, containment, and treatment of S. aureus isolates wit