Staphylococcus aureus, Vancomycin non-sensitive
Reportable by Laboratories and ProvidersAbout this Reportable Disease
Infectious agent: Staphylococcus aureus is a bacterium commonly found on the skin and in the nose of about 30% of individuals.
Description of illness: Staphylococcal infections of the skin include pimples, boils, or other skin conditions, and most are able to be treated by local drainage. When Staphlylococcal bacteria get into the bloodstream, they can cause serious infections which can be fatal, including:
- Bacteremia or sepsis when bacteria spread to the bloodstream; this may be a result of using catheters or having surgery.
- Pneumonia (infection of the lung)
- Endocarditis (infection of the heart valves), which can lead to heart failure.
- Osteomyelitis (bone infection), which can be caused by staph bacteria traveling in the bloodstream or put there by direct contact, such as following trauma (puncture wound of the foot or intravenous (IV) drug abuse).
Interactive Disease Data
Laboratory Reporting for this Disease
Staphylococcus aureus, VISA/VRSA
| TEST NAME | Staphylococcus aureus (VISA/VRSA) |
| DISEASE/DISORDER | Bacteremia, pneumonia, skin infections, surgical site infections |
| ALTERNATE NAME(S) | S.aureus, Vancomycin intermediate Staphylococcus aureus, Vancomycin resistant Staphylococcus aureus, VISA, VRSA |
| METHODOLOGY | Culture |
| SPECIAL INSTRUCTIONS | CEDEP approval required prior to isolate submission. |
| ORDERING INFORMATION | TDH DLS Requisition: PH-4182 Clinical Submission Requisition |
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Laboratory Reporting
Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.
- Manually report results to TDH by faxing or mailing a completed PH-1600 form to your local health department, or faxing to the state health office at (615) 741-3857
- Automatically submit results to TDH via electronic laboratory reporting (ELR), which automates the process of sharing data with TDH using interoperability standards.
- See the ELR Onboarding Handbook for details on the onboarding process, checklist, frequently asked questions, business rules, message format, and vocabulary.
- To initiate the ELR onboarding process with TDH, register in the Trading Partner Registration (TPR) system TPR provides documentation for Promoting Interoperability (PI) attestation and milestone letters to document onboarding progress. Contact MU.Health@tn.gov for assistance.
- Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
- Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for Healthcare Providers
Clinical Summary
- Vancomycin non-sensitive Staphylococcus aureus includes vancomycin-intermediate S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA). Vancomycin resistance in S. aureus is exceptionally rare.
- Clinical syndromes are similar to other S. aureus infections and can include skin/wound infections and invasive disease (e.g., bloodstream infection), with management complicated by limited antibiotic options when vancomycin susceptibility is reduced.
- Risk is higher in people with underlying health conditions (CDC examples include diabetes and kidney disease) and those with significant healthcare exposures.
- Laboratory confirmation is important. CDC notes automated and non-automated susceptibility methods can detect VISA/VRSA, and disk diffusion is not recommended for vancomycin susceptibility testing in S. aureus.
- In Tennessee, vancomycin non-sensitive Staphylococcus aureus is a reportable condition.
Healthcare Provider Reporting
Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.
Providers must report cases of all diseases and conditions listed through one of these methods:
• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857
• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.
• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for the Public
What It Is
Vancomycin non-sensitive Staphylococcus aureus refers to rare types of “staph” bacteria—VISA/VRSA—that are harder to treat because they don’t respond well to the antibiotic vancomycin.
Signs and Symptoms
These infections can look like other staph infections, including pimples, boils, or skin/wound infections. More serious infections can occur if bacteria spread to deeper tissues or the bloodstream.
Who Is at Higher Risk
Risk is higher for people with certain health conditions (CDC examples include diabetes and kidney disease) and people with more healthcare exposure (such as frequent medical care or devices).
How It Spreads
Staph bacteria are commonly carried on skin or in the nose and can spread through direct contact (skin-to-skin) or contact with contaminated items/surfaces, especially in healthcare settings.
Diagnosis and Treatment
Diagnosis requires laboratory testing to identify S. aureus and determine which antibiotics will work. Treatment depends on the infection site and test results; healthcare providers use susceptibility results to select effective antibiotics and may provide wound care (such as drainage) when needed.
This Page Last Updated: March 25, 2026 at 8:53 PM