Last Bacteria Standing: VREfm Persistence in the Hospitalized Gut

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Madison E Stellfox1, Daria Van Tyne1

  • 1Division of Infectious Diseases, University of Pittsburgh School of Medicinegrid.471408.e, Pittsburgh, Pennsylvania, USA.

Mbio
|June 28, 2022
PubMed

Insights

A persistent clone of vancomycin-resistant Enterococcus faecium (VREfm) adapted to hospital environments. Whole genome sequencing revealed mutations and a new plasmid contributing to its dominance in patients' gastrointestinal tracts.

Area of Science:

  • Microbiology
  • Genomics
  • Infectious Diseases

Background:

  • Enterococci are gram-positive bacteria, commonly found in the gastrointestinal tract.
  • Multidrug-resistant strains, particularly vancomycin-resistant Enterococcus faecium (VREfm), have emerged as significant nosocomial pathogens.
  • Enterococci possess intrinsic hardiness and adaptive capabilities that facilitate colonization and transmission in healthcare settings.

Purpose of the Study:

  • To characterize the genomic features of vancomycin-resistant Enterococcus faecium (VREfm) isolates from a Swiss hospital.
  • To investigate the genetic basis of VREfm persistence and adaptation within the hospitalized patient population.

Main Methods:

  • Whole genome sequencing (WGS) was employed to analyze 69 VREfm isolates.
  • Genomic data was used to identify specific clones, mutations, and mobile genetic elements.

Main Results:

  • WGS identified a dominant VREfm clone that was repeatedly isolated from numerous patients over several years.
  • This persistent clone had acquired specific mutations and a novel linear plasmid.
  • These genetic alterations are hypothesized to enhance the clone's persistence in the gastrointestinal tract.

Conclusions:

  • VREfm exhibits significant genetic plasticity, enabling adaptation to the hospital environment.
  • The accumulation of mutations and acquisition of novel plasmids contribute to the success of persistent VREfm clones.
  • Understanding these adaptive mechanisms is crucial for controlling the spread of VREfm in healthcare settings.
Keywords:
Enterococcusantibiotic resistancewhole genome sequencing

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