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August 13, 1997

Interim Guidelines for Prevention and Control of Staphylococcal Infection Associated With Reduced Susceptibility to Vancomycin

JAMA. 1997;278(6):461-462. doi:10.1001/jama.1997.03550060029014

STAPHYLOCOCCI are one of the most common causes of community- and hospital-acquired infection. In many U.S. hospitals, strains of staphylococci (i.e., Staphylococcus aureus or coagulasenegative staphylococci) are resistant to all available antimicrobials except vancomycin. Rare cases of infection in the United States1 have been caused by coagulase-negative staphylococci with reduced susceptibility to vancomycin (minimum inhibitory concentration [MIC] ≥8μg/mL).*2

In May 1996, an infection caused by a strain of S. aureus with reduced susceptibility to vancomycin (MIC=8 μg/mL) was diagnosed in a patient in a hospital in Japan3,4; no such infections have been reported in the United States. Although the strain from Japan was not fully resistant to vancomycin (i.e., MIC ≥32 pg/mL), its appearance increases the likelihood that fully resistant strains may emerge. Because the occurrence of fully vancomycin-resistant staphylococcal infection in a hospital could result in serious public health consequences, CDC and the Hospital