A last-gasp Brad Evans goal gave the States a 2-1 win in Jamaica, who sit bottom of the six-team table on two points.
On the half-hour mark, USA forward Jozy Altidore headed home Graham Suzi's long ball but Jermaine Beckford levelled the clash a minute from time to send Kingston's National Stadium into raptures.
There was still time, however, for Evans to take advantage of a loose ball and seal the points for America.
At Estadio Nacional, Costa Rica edged out Honduras 1-0 thanks to Roy Miller, who reacted quickest in the 25th minute to head home the rebound after Noel Valladares saved a shot from Celso Borges.
Mexico, who have played a game more than their rivals, missed the opportunity to maintain their two-point lead as they drew 0-0 with Panama.