Related Experiment Video
Updated: Jun 9, 2026
12:14
A Duplex Digital PCR Assay for Simultaneous Quantification of the Enterococcus spp. and the Human Fecal-associated HF183 Marker in Waters
Published on: March 9, 2016
10.1K
Quantifying acquisition and transmission of Enterococcus faecium using genomic surveillance
Theodore Gouliouris1,2, Francesc Coll3, Catherine Ludden4
1University of Cambridge, Cambridge, UK.
Nature Microbiology
|October 27, 2020
Summary
Hospital-acquired vancomycin-resistant Enterococcus faecium (VREfm) is common in patients, driving carriage and invasive infections. Genomic analysis revealed widespread transmission and environmental contamination, highlighting the need for better infection control.
Area of Science:
- Infectious Diseases
- Genomics
- Epidemiology
Background:
- Nosocomial acquisition of vancomycin-resistant Enterococcus faecium (VREfm) drives patient carriage, a risk factor for invasive infections in immunocompromised individuals.
- Understanding E. faecium transmission dynamics in hospitals is crucial for effective infection control.
Purpose of the Study:
- To comprehensively map E. faecium transmission within a hospitalized patient population using a sequence-driven approach.
- To assess the prevalence of E. faecium carriage and environmental contamination.
- To evaluate the utility of genomic and informatics approaches for outbreak detection.
Main Methods:
- Prospective study of 149 hematology patients over 6 months.
- Collection and culture of stool samples and environmental swabs.
- Whole-genome sequencing of 1,560 E. faecium isolates, focusing on the hospital-adapted clade A1.
- Network analysis and informatics approaches (subtype categorization, SNP cut-off) to infer transmission.
Main Results:
- Genomic analysis identified E. faecium carriage in 63% of patients, compared to 40% by culture, with 73% being VREfm.
- Nearly half (48%) of environmental swabs tested positive for VREfm.
- Network analysis supported nosocomial transmission, linking 67 patients to others or the environment.
- Six patients developed invasive E. faecium infections, with half linked to nosocomial acquisition.
Conclusions:
- The hospital-adapted E. faecium lineage is hyperendemic, with significant patient carriage and environmental contamination.
- Genomic sequencing and advanced informatics are valuable tools for tracking E. faecium transmission.
- Enhanced infection control measures are necessary to reduce hospital acquisition rates of E. faecium.
