Vancomycin-resistant Staphylococcus aureus: Perspectives on measures needed for control

Given the dramatic increase in the incidence of vancomycin resistance among the enterococci and experimental evidence for the transfer of vancomycin resistance from enterococci to Staphylococcus aureus, there is concern that strains of S. aureus will emerge that are resistant to vancomycin. The result would be a highly virulent pathogen for which effective antimicrobial therapy would not be available. To prevent the nosocomial transmission of such an organism, stringent infection control policies need to be developed and implemented. We offer proposals that are based on the limited data available on the transmission and control of S. aureus and that may be used as starting points for the development of formal guidelines for the isolation of colonized and infected patients and for microbiology laboratory precautions.