The potential of genome-oriented blood culture surveillance of vancomycin-resistant enterococcus faecium (VRE) to mirror local VRE epidemiology: a retrospective analysis and systematic comparison of VRE blood culture and VRE first patient isolates

URN zum Zitieren dieses Dokuments:

urn:nbn:de:bvb:355-epub-782540 Copy

DOI zum Zitieren dieses Dokuments:

10.5283/epub.78254 Copy

Caplunik-Pratsch, Aila ; Kieninger, Bärbel ; Hansch, Stefan ; Rath, Anca ; Fritsch, Jürgen ; Eichner, Anja ; Hanses, Frank ; Schneider-Brachert, Wulf ; Hitzenbichler, Florian

Lizenz: Creative Commons Namensnennung 4.0 International PDF - Veröffentlichte Version (2MB)

Veröffentlichungsdatum dieses Volltextes: 03 Dez 2025 05:54

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Details

Dokumentenart:	Artikel
Open Access Art:	DEAL (Springer Gold)
Titel eines Journals oder einer Zeitschrift:	BMC Infectious Diseases
Verlag:	Springer
Band:	25
Nummer des Zeitschriftenheftes oder des Kapitels:	1
Datum:	28 November 2025
Institutionen:	Medizin > Abteilung für Krankenhaushygiene und Infektiologie
Sonstige Projekte:	Federal Ministry of Education and Research 13N15774, Bavarian Research Foundation A.Z.-1411-19
Identifikationsnummer:	Wert Typ 10.1186/s12879-025-12183-9 DOI
Stichwörter / Keywords:	Genomic epidemiology, Hospital transmission, Genome-oriented surveillance, Bloodstream infections, Core genome multilocus sequence typing (cgMLST), VRE
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Ja
Dokumenten-ID:	78254

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Zusammenfassung

Objectives To evaluate whether vancomycin-resistant Enterococcus faecium (VRE) blood culture isolates reflect the broader hospital VRE epidemiology and to investigate the population structure of VRE in the context of rising bloodstream infection (BSI) rates at our institution. Methods Whole genome sequencing (WGS) of VRE BSI isolates and all VRE first annual patient isolates (screening and ...

Zusammenfassung

Objectives
To evaluate whether vancomycin-resistant Enterococcus faecium (VRE) blood culture isolates reflect the broader hospital VRE epidemiology and to investigate the population structure of VRE in the context of rising bloodstream infection (BSI) rates at our institution.
Methods
Whole genome sequencing (WGS) of VRE BSI isolates and all VRE first annual patient isolates (screening and clinical specimens) at a university tertiary care hospital from 2018 to 2021 was performed. Isolates were analysed using multi-locus sequence typing (MLST), core-genome (cg) MLST, and cluster analysis based on pairwise allelic differences.
Results
From 2018 to 2021, 128 patients had VRE BSI and 218 had VSE (vancomycin-susceptible Enterococcus faecium) BSI, however, VRE became dominant in 2021 (2018: 53 vs. 21; 2021: 42 vs. 48). Concurrently, VRE incidence at our institution rose from 2.7 to 4.3 per 1000 patient days. WGS was performed for 125/128 VRE BSI isolates (97.7%) and 1175/1534 first annual isolates (76.6%). Distribution of complex types (CTs) within VRE blood culture isolates and first annual isolates was generally similar: ST80/CT1065, ST117/CT5130, ST1299/CT1903 and ST117/CT71 were detected most often both in BSI and among first annual isolates (26.5% vs. 26.6%; 14.4% vs. 10.8%; 12.0% vs. 13.5%; 10.4% vs. 13.3%, respectively). Eleven large clusters comprising 10 or more isolates were identified within the representative isolate cohort (a curated dataset including all sequenced blood culture isolates and non-redundant first annual patient isolates), consistent with clonal expansion of successful lineages, likely driven at least in part by in-hospital transmission events, but also possibly by repeated introductions of circulating clones, contributing to the rise in VRE incidence.
Conclusions
Performing WGS on both VRE blood culture and first annual isolates points to several outbreaks as the reason behind the increase in VRE BSI rate. Our results demonstrate that sequencing VRE blood culture isolates alone roughly reflects the distribution of all VRE CTs, making it a pragmatic and resource-efficient approach for obtaining valuable information about the epidemiology of VRE within a hospital.

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