Clinical Microbiology Procedures Handbook

Section 5: Antimicrobial Susceptibility Testing

5.7 Detection of VRSA, VISA, and Vancomycin‐Heteroresistant Staphylococcus aureus (hVISA)

Last Updated:2022

Vancomycin‐resistant Staphylococcus aureus (VRSA) and vancomycin‐intermediate S. aureus (VISA) can be detected using routine broth microdilution methods (BMD) (see Procedure 5.2); the vancomycin agar screen test is another…

Preanalytical Considerations

The detection of vancomycin heteroresistance in S. aureus (hVISA) is challenging and labor‐intensive, and it is complicated in the clinical realm by a lack of routine screening procedures. hVISA is typically present as small subpopulations…

Analytical Considerations

Quality control (QC) strains S. aureus ATCC 29213 (vancomycin susceptible) S. aureus Mu3 ATCC 700698 (hVISA strain). Note that this strain is an indicator strain and not strictly a QC strain…

Postanalytical Considerations

The modified PAP‐AUC has been widely tested on methicillin‐resistant S. aureus isolates and is considered a reliable method for detection of hVISA strains (thus, this protocol is only…

Section Editors: Romney M. Humphries and Patricia J. Simner

Editor in Chief: Amy L. Leber And Carey-Ann D. Burnham

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