Vancomycin-ResistantStaphylococcus aureus,Michigan, USA, 2007

Vancomycin-resistant Staphylococcus aureus (VRSA) infections, which are always methicillin-resistant, are a rare but serious public health concern.We examined 2 cases in Michigan in 2007.Both patients had underlying illnesses.Isolates were vanA-positive.VRSA was neither transmitted to or from another known VRSA patient nor transmitted from patients to identified contacts.V ancomycin continues to be used as a first-line anti- microbial agent for the treatment of infection with methicillin-resistant Staphylococcus aureus (MRSA).Because alternative treatments are limited, development of resistance to vancomycin can make treatment of MRSA infections increasingly difficult.Fortunately, only 7 cases of vancomycin-resistant S. aureus (VRSA) infection, which is always methicillin-resistant, have been reported in the United States (Table) (1); 5 of these cases occurred in Michigan.We report 2 additional cases of VRSA that occurred in Michigan in 2007.The Michigan Department of Community Health (MDCH) examined the patients' records, compared genetic characteristics of isolates, assessed possible transmission to contacts, and assessed infection control practices at facilities providing patient care.