We propose to survey clinical pharmacists, infectious diseases practitioners and clinical microbiologists at these 53 hospitals during the summer of 2009 to characterize the hospital policy toward isolation of SA-MICcreep and to investigate the relationship of SA-MICcreep to vancomycin use. Specifically, we will determine (1) if the hospital attempts to isolate SA-MICcreep (2) the method(s) of testing SA susceptibility to vancomycin, (3) interpretative criteria for MICs to vancomycin and whether there is a policy toward differential treatment of isolated with SA-MICcreep. In addition we will determine (1) the relationship of SA-MICcreep to vancomycin use and (2) the relationship to other hospital and patient demographics to SA-MICcreep. A pilot study (Dec. 2008) found that 7 of 8 hospitals surveyed do determine the vancomycin MIC for Staphylococcus aureus. However the interpretation of these findings, and the action taken, differ between hospitals. This may be because this is a newly described phenomenon, and professional organizations have not yet issued guidelines regarding the interpretation of these isolates (6).