Staphylococcus aureus, Vancomycin non-sensitive

Reportable by Laboratories and Providers

About 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

Specimen Requirements

Patient Preparation
  • None
Specimen Collection
  • Isolate: Pure cultures
Specimen Labeling
  • Specimen must be labeled with at least two unique patient identifiers and match accompanying PH-4182 Clinical Submission Requisition.
Specimen Processing
  • None
Specimen Storage and Preservation
  • Isolates should be stored at ambient conditions.
Specimen Transport
  • Ship isolates in ambient conditions.
  • Do not send isolates refrigerated or frozen.
  • All infectious substance shipments must conform to U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR 49 C.F.R. Parts 171-180). 
Specimen Acceptability and Rejection
  • Specimens that do not adhere to all specimen requirements will be rejected.
Testing Location
  • Nashville

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.

 

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