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      Genetic analysis of a high-level vancomycin-resistant isolate of Staphylococcus aureus.

      Science (New York, N.Y.)

      Anti-Bacterial Agents, pharmacology, Bacterial Proteins, genetics, Carbon-Oxygen Ligases, Conjugation, Genetic, DNA Transposable Elements, Drug Resistance, Multiple, Bacterial, Enterococcus faecalis, drug effects, isolation & purification, Genes, Bacterial, Humans, Methicillin Resistance, Microbial Sensitivity Tests, Molecular Sequence Data, Plasmids, R Factors, Recombination, Genetic, Renal Dialysis, Staphylococcus aureus, Vancomycin, Vancomycin Resistance

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          Abstract

          Vancomycin is usually reserved for treatment of serious infections, including those caused by multidrug-resistant Staphylococcus aureus. A clinical isolate of S. aureus with high-level resistance to vancomycin (minimal inhibitory concentration = 1024 microg/ml) was isolated in June 2002. This isolate harbored a 57.9-kilobase multiresistance conjugative plasmid within which Tn1546 (vanA) was integrated. Additional elements on the plasmid encoded resistance to trimethoprim (dfrA), beta-lactams (blaZ), aminoglycosides (aacA-aphD), and disinfectants (qacC). Genetic analyses suggest that the long-anticipated transfer of vancomycin resistance to a methicillin-resistant S. aureus occurred in vivo by interspecies transfer of Tn1546 from a co-isolate of Enterococcus faecalis.

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          Journal
          14645850
          10.1126/science.1090956

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