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The first report of a fully vancomycin-resistant Staphylococcus aureus (VRSA; MIC >32 µg/mL) strain was published last summer (Journal Watch Infectious Diseases Jul 26 2002). New information regarding this patient's strain, its development, and transmission has recently appeared.
A 40-year-old Michigan woman with diabetes, peripheral vascular disease, chronic renal failure, and recurrent lower-extremity ulcers received several different antibiotics over a period of 6 months. She developed methicillin-resistant S. aureus (MRSA) bacteremia, was colonized with both MRSA and vancomycin-resistant enterococci (VRE), and received vancomycin therapy for a cumulative total of 6.5 weeks before VRSA developed. Isolates from a catheter-exit-site infecti…