Vancomycin-intermediate Staphylococcus aureus (VISA), and Vancomycin-resistant Staphylococcus aureus (VRSA)

2007 Case Definition

Clinical Description

S. aureus can produce a variety of syndromes with clinical manifestations including skin and soft tissue infections, empyema, bloodstream infection, pneumonia, osteomyelitis, septic arthritis, endocarditis, sepsis, and meningitis. S. aureus may also colonize individuals who remain asymptomatic. The most frequent site of S. aureus colonization is the nares.

Laboratory Criteria

• Isolation of S. aureus from any body site.
  AND
• Intermediate or resistance of the S. aureus isolate to vancomycin, detected and defined according to Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS) approved standards and recommendations (Minimum Inhibitory Concentration [MIC]=4-8 µg/ml for VISA and MIC≥16 µg/ml for VRSA).

Case Classification

Confirmed: A case of vancomycin-intermediate or vancomycin-resistant S. aureus that is laboratory-confirmed (MIC=4-8 µg/ml for VISA and MIC≥16 µg/ml for VRSA).

Reference

Clinical and Laboratory Standards Institute/NCCLS. Performance Standards for Antimicrobial Susceptibility Testing. Sixteenth informational supplement. M100-S16. Wayne, PA: CLSI, 2006.

See also:

• 2004 VISA and VRSA case definition