Vancomycin-Resistant Enterococcus Often Spreads From Hospitalized Patients Into the Local Environment and Less Often...

Area of Science:

• Microbiology
• Infectious Diseases
• Hospital Epidemiology

Background:

• Vancomycin-resistant Enterococcus (VRE) is a significant healthcare-associated pathogen.
• Understanding VRE transmission dynamics within hospitals, particularly the medical intensive care unit (ICU), is crucial for effective control.

Purpose of the Study:

• To investigate the primary direction of VRE transmission in a medical ICU setting.
• To determine if VRE spreads predominantly from patients to the environment or vice versa.

Main Methods:

• Collected rectal and environmental samples from ICU patients and their rooms over 30 days.
• Utilized 16S sequencing, selective culture, and whole genome sequencing (WGS) for VRE detection and characterization.
• Performed network analysis to assess patient-room Enterococcus connectivity.

Main Results:

• VRE colonization was detected in 52% of patients and 40% of rooms.
• Enterococcus abundance was significantly higher in rooms housing VRE-positive patients.
• Whole genome sequencing identified VRE transmission events from patients to rooms, with no instances of reverse transmission.

Conclusions:

• VRE transmission in the ICU predominantly occurs from the patient's gut to the surrounding environment.
• Findings support the potential efficacy of gut-directed interventions for VRE infection prevention.