biostudies-literatureRossi FNIAID NIH HHSNHGRI NIH HHS1524-31https://www.ebi.ac.uk/biostudies/studies/S-EPMC4112484biostudies-literatureUnknown370(16)We report the case of a patient from Brazil with a bloodstream infection caused by a strain of methicillin-resistant Staphylococcus aureus (MRSA) that was susceptible to vancomycin (designated BR-VSSA) but that acquired the vanA gene cluster during antibiotic therapy and became resistant to vancomycin (designated BR-VRSA). Both strains belong to the sequence type (ST) 8 community-associated genetic lineage that carries the staphylococcal chromosomal cassette mec (SCCmec) type IVa and the S. aureus protein A gene (spa) type t292 and are phylogenetically related to MRSA lineage USA300. A conjugative plasmid of 55,706 bp (pBRZ01) carrying the vanA cluster was identified and readily transferred to other staphylococci. The pBRZ01 plasmid harbors DNA sequences that are typical of the plasmid-associated replication genes rep24 or rep21 described in community-associated MRSA strains from Australia (pWBG745). The presence and dissemination of community-associated MRSA containing vanA could become a serious public health concern.The New England journal of medicineTransferable vancomycin resistance in a community-associated MRSA lineage.PMC4112484U54 HG0049681U54 HG004968R01 AI093749U54 HG003079K08 AI101005Rossi FWollam ATran TTWeinstock GMZhou YPanesso DDoi AHernandez-Roldan ANarechania AReyes JBrandao DRincon SXing GDiaz LPlanet PJCarvajal LPDi Gioia TSMunita JMvan der Heijden IMMurray BEArias CAfalseTransferable vancomycin resistance in a community-associated MRSA lineage.We report the case of a patient from Brazil with a bloodstream infection caused by a strain of methicillin-resistant Staphylococcus aureus (MRSA) that was susceptible to vancomycin (designated BR-VSSA) but that acquired the vanA gene cluster during antibiotic therapy and became resistant to vancomycin (designated BR-VRSA). Both strains belong to the sequence type (ST) 8 community-associated genetic lineage that carries the staphylococcal chromosomal cassette mec (SCCmec) type IVa and the S. aureus protein A gene (spa) type t292 and are phylogenetically related to MRSA lineage USA300. A conjugative plasmid of 55,706 bp (pBRZ01) carrying the vanA cluster was identified and readily transferred to other staphylococci. The pBRZ01 plasmid harbors DNA sequences that are typical of the plasmid-associated replication genes rep24 or rep21 described in community-associated MRSA strains from Australia (pWBG745). The presence and dissemination of community-associated MRSA containing vanA could become a serious public health concern.2014-01-01T00:00:00Z2014 Apr2024-11-11T18:39:01.493Z2019-03-27T01:32:54ZS-EPMC41124842473866910.1056/nejmoa130335910.1056/NEJMoa1303359