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Journal of Antimicrobial Chemotherapy (1999) 44, 675-678
© 1999 The British Society for Antimicrobial Chemotherapy

Brief report

Expression and detection of hetero-vancomycin resistance in Staphylococcus aureus

Robin A. Howea,*, Mandy Woottona, Timothy R. Walshb, Peter M. Bennettb and Alasdair P. MacGowana

a Bristol Centre for Antimicrobial Research and Evaluation, Southmead Health Services NHS Trust and University of Bristol, Department of Microbiology, Southmead Hospital, Bristol BS10 5NB b Department of Pathology and Microbiology, School of Medical Sciences, University of Bristol, University Walk, Bristol BS8 1TD, UK

Isolates of Staphylococcus aureus resistant to vancomycin have been reported but appear to be extremely rare. However, isolates displaying hetero-resistance to vancomycin (hVRSA) are reportedly common in parts of Japan (9.3% of MRSA isolated from a group of university hospitals). We have investigated the reliability of the proposed method for detection of hetero-resistant isolates and the ability of clinical S. aureus isolates to express vancomycin resistance. The original method for identification of hVRSA was found to have poor reproducibility and may select for, rather than detect, vancomycin resistance. There appears to be a spectrum of heterogeneity in the expression of resistance to vancomycin among S. aureus. Until there is a clearer understanding of the mechanism and control of vancomycin resistance in S. aureus, and reliable tests are devised, the clinical relevance of different degrees of hetero-resistance cannot be assessed.

* Corresponding author.


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