Fig. 1 shows the association between resistance to oxacillin (similar to methicillin) and resistance to vancomycin for isolates of S. aureus. The trend line indicates the results of the linear model (B1=0.28\(\frac{+}{-}\)0.08)

There is an association between resistance to vancomycin and resistance to oxacillin in the samples isolated. This trend has also been observed across studies in nosocomial infections \cite{Hasan_2016}. The high prevalence of MRSA isolates demonstrating full or intermediate resistance to vancomycin (46%) is concerning. Though these samples were primarily taken from young, healthy individuals, the incidence of community acquired MRSA is increasing. These strains may easily be transmitted to other individuals or become pathogenic if their current host becomes immunocompromised (CDC 2013). Individuals infected with MRSA that is resistant to vancomycin will be more costly and difficult to treat, and are at increased risk of death. 

It is also interesting that vancomycin resistance is more common in MRSA than in methicillin-sensitive isolates. This indicates that there is some selective pressure that makes vancomycin resistance more advantageous in MRSA than in methicillin-sensitive isolates. This study emphasizes the need for alternative treatments for MRSA and VRSA including new antibiotic targets. 

Future studies including extensive metadata for samples may offer insight into why some individuals are more likely to harbor multi-drug resistant (MDR) S. aureus than others. Because bacteria are able to share plasmids via horizontal gene transfer, it may also be beneficial to examine how the microbiome of an individual influences the prevalence of MDR S. aureus. Information about why some people are more likely to be colonized with MDR S. aureus may also provide ways to prevent drug-resistant S. aureus infection in individuals who are at risk.