Transferable vancomycin resistance in a community-associated MRSA lineage

Flávia Rossi, Lorena Diaz, Aye Wollam, Diana Panesso, Yanjiao Zhou, Sandra Rincon, Apurva Narechania, Galen Xing, Thais S.R. Di Gioia, André Doi, Truc T. Tran, Jinnethe Reyes, Jose M. Munita, Lina P. Carvajal, Alejandra Hernandez-Roldan, Denise Brandão, Inneke Marie Van Der Heijden, Barbara E. Murray, Paul J. Planet, George M. WeinstockCesar A. Arias

Research output: Contribution to journalArticlepeer-review

134 Scopus citations


We report the case of a patient from Brazil with a bloodstream infection caused by a strain of methicillin-resistant Staphylococcus aureus (MRSA) that was susceptible to vancomycin (designated BR-VSSA) but that acquired the vanA gene cluster during antibiotic therapy and became resistant to vancomycin (designated BR-VRSA). Both strains belong to the sequence type (ST) 8 community-associated genetic lineage that carries the staphylococcal chromosomal cassette mec (SCCmec) type IVa and the S. aureus protein A gene (spa) type t292 and are phylogenetically related to MRSA lineage USA300. A conjugative plasmid of 55,706 bp (pBRZ01) carrying the vanA cluster was identified and readily transferred to other staphylococci. The pBRZ01 plasmid harbors DNA sequences that are typical of the plasmid-associated replication genes rep24 or rep21 described in community-associated MRSA strains from Australia (pWBG745). The presence and dissemination of community-associated MRSA containing vanA could become a serious public health concern.

Original languageEnglish (US)
Pages (from-to)1524-1531
Number of pages8
JournalNew England Journal of Medicine
Issue number16
StatePublished - 2014

ASJC Scopus subject areas

  • Medicine(all)


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