Glycopeptide-resistant Staphylococcus aureus.

Abstract
Fourteen years ago, two near-simultaneous reports documented the emergence of enterococci with high-level resistance to vancomycin and teicoplanin.1,2 These reports featured a cluster of isolates from a single hospital in London and isolates from two patients in France, but over the next decade, glycopeptide-resistant enterococci (GRE) were isolated from many countries worldwide, and are now a major problem, particularly in North America. The recent report of the isolation of a fully glycopeptide-resistant Staphylococcus aureus (GRSA; vancomycin MIC > 128 mg/L; teicoplanin MIC 32 mg/L),3 in Michigan, USA, therefore begs the question: ‘Will history repeat itself?’ Are we just looking at an interesting isolate from a single patient, or is it the forerunner of a potentially major crisis in health care?