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December 1997

Staphylococcus aureus With Reduced Susceptibility to Vancomycin—United States, 1997

Arch Dermatol. 1997;133(12):1641. doi:10.1001/archderm.1997.03890480167032

Staphylococcus aureus is one of the most common causes of both hospital- and community-acquired infections worldwide, and the antimicrobial agent vancomycin has been used to treat many S. aureus infections, particularly those caused by methicillin-resistant S. aureus (MRSA). In 1996, the first documented case of infection caused by a strain of S. aureus with intermediate levels of resistance to vancomycin (VISA; minimum inhibitory concentration [MIC] =8 μg/mL) was reported from Japan.1 This report describes the first isolation of VISA from a patient in the United States, which may be an early warning that S. aureus strains with full resistance to vancomycin will emerge.

In July 1997, VISA-associated peritonitis was diagnosed in a patient who was being treated with long-term ambulatory peritoneal dialysis. DuringJanuary 1996-June 1997, the patient had been treated with multiple courses of both intraperitoneal and intravenous vancomycin for repeated episodes of MRSA-associated peritonitis. The patient received medical

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