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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

A bug in Brazil: Is VRSA back with a vengeance?

Though the health care continuum is currently under siege by a host of emerging gram negatives like CRE, at one time a much-feared single pathogen was thought to herald the arrival of the post-antibiotic era: Vancomycin-resistant Staphylococcus aureus (VRSA).

Sporadic cases of VRSA eventually occurred in the U.S., as MRSA infections appeared that were impervious to vancomycin — the mainstay drug against resistant staph strains for decades. But the vaunted superbug was not able to sustain itself and establish an endemic presence in hospitals or communities. Some theorized that the price of greater drug resistance in the microorganism was the loss of vigor and transmissibility, and the VRSA threat was largely forgotten.

Now we have this — an alarm blinking in Brazil, warning that VRSA is back and showing true threat potential. In answer to our first skeptical question about the finding, lead researcher Cesar Arias, MD, PhD, says, “To dismiss this as an anomaly would be unwise.”

Three disturbing factors about the case:

  • The potential for VRSA in the widely dispersed MRSA USA300 community strain.
  • Caused a bloodstream infection instead of the soft tissue infections typical for VRSA.
  • The genetic plasmid that carried vancomycin resistance appears to be able to move between staph species.
For more on this story see the July 2014 issue of Hospital Infection Control & Prevention