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VanA-Positive Vancomycin–Resistant Staphylococcus aureus: Systematic Search and Review of Reported Cases

Askari, Emran*; Tabatabai, Seyed Meghdad PharmD(c)*; Arianpoor, Arash*; Nasab, Mahboobeh Naderi PhD*†

Infectious Diseases in Clinical Practice: March 2013 - Volume 21 - Issue 2 - p 91–93
doi: 10.1097/IPC.0b013e31826e8199
Review Articles

At the 10th anniversary of the first report of vanA vancomycin-resistant Staphylococcus aureus (VRSA), we aimed to determine the total number of vanA-VRSA reported in the literature. Relevant key words were used to search through PubMed, Sciverse, and Google Scholar, as well as the abstract book of recent related meetings, university theses, and the CDC website. All studies reporting vanA-positive S aureus confirmed by the polymerase chain reaction were included. Final analysis revealed that 33 VRSA isolates have been reported worldwide, of which one isolate was from Pakistan, 3 isolates were from Iran, 13 isolates were from the United States, and 16 isolates were from India. One Indian isolate was susceptible to methicillin. Possible community origin and nasal carriage of VRSA cases have been recently described in the literature. This study showed that vanA-VRSA seems to be still limited, but more than half of the reported VRSA cases were not included in previous reviews.

Supplemental Digital Content is available in the text.This article reviews the current literature regarding vanA-mediated vancomycin resistance in S.aureus isolates. Askari et al. show that the worldwide prevalence of this type of resistance is higher than thought before. They also review the clinical and molecular features of these isolates.

From the *Mashhad Medical Microbiology Student Research Group, Mashhad University of Medical Sciences and †Department of Microbiology, Central Laboratory, Imam Reza Teaching Hospital, Mashhad, Iran.

Correspondence to: Mahboobeh Naderi Nasab, PhD, Microbiology Laboratory, Central Laboratory, Imam Reza Hospital, Mashhad, Iran. E-mail:,

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2013 by Lippincott Williams & Wilkins.