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Genomic analysis revealed distinct transmission clusters of vancomycin-resistant Enterococcus faecium ST80 in

H Fang1, I Fröding1, M Ullberg2

  • 1Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden; Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.

The Journal of Hospital Infection
|October 31, 2020
PubMed

Insights

Sequence type 80 (ST80) vancomycin-resistant Enterococcus faecium (VREfm) is the main cause of VRE infections in Stockholm. Genomic analysis revealed transmission clusters and challenges in detecting resistant isolates.

Area of Science:

  • Microbiology
  • Genomics
  • Epidemiology

Background:

  • Vancomycin-resistant Enterococcus faecium (VREfm) poses a significant healthcare challenge.
  • Sequence type 80 (ST80) has emerged as a predominant clonal lineage of VREfm in Stockholm.
  • ST80 VREfm has been associated with both vanA-type and vanB-type outbreaks.

Purpose of the Study:

  • To investigate the genomic epidemiology of ST80 VREfm in Stockholm.
  • To identify transmission clusters and understand the drivers of VREfm outbreaks.
  • To characterize antimicrobial resistance mechanisms within ST80 VREfm isolates.

Main Methods:

  • Whole genome sequencing of 188 non-duplicate ST80-VREfm isolates.
  • Genomic analysis to identify distinct transmission clusters.
  • Phenotypic testing for vancomycin resistance detection.

Main Results:

  • Genomic analysis identified three distinct transmission clusters of ST80 VREfm.
  • Difficulties in detecting low-grade vancomycin resistance phenotypically may prolong vanB-type outbreaks.
  • The first optrA-positive linezolid-resistant VRE isolate in Stockholm was identified.

Conclusions:

  • ST80 VREfm is the predominant lineage driving VRE infections in Stockholm.
  • Improved detection methods for low-grade vancomycin resistance are needed.
  • Emergence of novel resistance mechanisms, such as optrA, requires ongoing surveillance.
Keywords:
Linezolid resistanceST80Transmission clusterVancomycin-resistant enterococciWhole genome sequencing

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