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Published on: April 20, 2021
Genomic investigation of the vancomycin-resistant Enterococcus faecium in a tertiary hospital in China
Huimei Zhang1, Ying Deng1, You-Xiang Chan2
1Department of Clinical Laboratory, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, 518033, China.
Objectives:
In light of a VREfm spread in a large tertiary hospital in China, this study aimed to explore the transmission dynamics and genetic characteristics of these isolates within a global context.
Methods:
A total of 27 VREfm were collected from a hospital in Guangdong province, China. Antimicrobial susceptibility testing, whole-genome sequencing, and transmission dynamics analysis were performed. Additionally, global sequence type 80 (ST80) data were gathered for genetic comparison, and complete plasmid sequences were reconstructed to characterize the genetic environment surrounding the vanA genes.
Results:
The study identified VREfm ST80 as the main agent of the patient infection, with the exception of four ST789 isolates identified on environmental surfaces within one bed. The genomes displayed high clustering, with similar profiles of virulence factors and antimicrobial resistance genes. The study observed that genetically similar VREfm strains were distributed across different beds. Moreover, VREfm ST80 from the hospital clustered with other Chinese isolates and exhibited a higher number of VFs compared to other lineages. Although vanA genes were present in different STs, the vanA-carrying plasmids shared highly similar backbone structure, with Tn1546-associated elements detected in each.
Conclusion:
This study sheds light on the genetic epidemiology of a VREfm spread in a Chinese hospital through comparison with global isolates. To control the spread of VREfm within hospitals, the implementation of active screening programs and rigorous infection control measures is essential.
Insights
This study investigated the spread of vancomycin-resistant Enterococcus faecium (VREfm) ST80 in a Chinese hospital. Findings reveal genetic similarities among VREfm strains, emphasizing the need for enhanced infection control measures to prevent further transmission.
Area of Science:
- Microbiology
- Infectious Diseases
- Genetics
Background:
- Vancomycin-resistant Enterococcus faecium (VREfm) poses a significant threat in healthcare settings.
- The emergence and spread of VREfm, particularly specific sequence types (STs), require detailed epidemiological investigation.
Purpose of the Study:
- To explore the transmission dynamics and genetic characteristics of VREfm isolates in a Chinese tertiary hospital.
- To compare these isolates with global data to understand their genetic epidemiology within a broader context.
Main Methods:
- Whole-genome sequencing and antimicrobial susceptibility testing of 27 VREfm isolates.
- Analysis of transmission dynamics and comparison with global ST80 data.
- Reconstruction of complete plasmid sequences to characterize vanA gene environments.
Main Results:
- VREfm ST80 was identified as the predominant strain, with ST789 found on environmental surfaces.
- Genetically similar VREfm strains, exhibiting comparable virulence factors and resistance genes, were distributed across different hospital beds.
- Chinese VREfm ST80 isolates clustered together and showed more virulence factors than other lineages; vanA genes were located on similar plasmid backbones.
Conclusions:
- The study elucidates the genetic epidemiology of VREfm spread in a Chinese hospital by comparing isolates globally.
- Active screening and stringent infection control are crucial for managing VREfm transmission within healthcare facilities.
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