Considering that MRSA is still a ubiquitous problem in hospitals in every country, and vancomycin is continuously used as the first line antibiotic in most hospitals, hetero-VISA will stay as a significant threat to hospital infection control. Now, MRSA is a part of our natural flora, and will continue to be so in the future. Therefore, elucidation of the secret of genetic plasticity of this "dangerous neighbor" is of primary importance for us to protect ourselves by recognizing and outwitting its glaring strategies.