Elucidating vancomycin-resistant Enterococcus faecium outbreaks: the role of clonal spread and movement of mobile

X Zhou1, M A Chlebowicz1, E Bathoorn1

  • 1University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, Groningen, The Netherlands.

Abstract

Insights

Understanding vancomycin-resistant Enterococcus faecium (VREfm) transmission requires combining whole-genome sequencing with transposon analysis. This approach reveals both clonal spread and mobile genetic element transfer, crucial for controlling VREfm outbreaks.

Area of Science:

  • Microbiology
  • Genomics
  • Epidemiology

Background:

  • Vancomycin-resistant Enterococcus faecium (VREfm) is a significant global nosocomial pathogen.
  • VREfm spreads through both clonal expansion and mobile genetic elements (MGEs) like transposons.

Purpose of the Study:

  • To investigate VREfm transmission pathways during nosocomial outbreaks.
  • To integrate vanB-carrying transposon data with core-genome MLST (cgMLST) and epidemiological data.

Main Methods:

  • Analysis of 36 VREfm isolates from seven outbreaks (2014).
  • Whole-genome sequencing using MiSeq and MinION platforms.
  • Hybrid assembly with Unicycler, cgMLST with SeqSphere+, and transposon analysis with ACT and BLAST.

Main Results:

  • Four distinct vanB transposons were identified.
  • cgMLST differentiated isolates into distinct cluster types (CTs).
  • Specific CTs showed variations or identical vanB transposons, indicating complex transmission.

Conclusions:

  • cgMLST offers high discriminatory power for VREfm epidemiology.
  • Transposon analysis is essential for detecting horizontal gene transfer.
  • Combining cgMLST and transposon analysis enhances understanding of VREfm transmission routes.

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