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Regional VRE surveillance using routine centralised, multicentre whole genome sequencing.
Djamayl L H H Engelen1, Jean-Luc Murk1,2,3,4,5, Veronica A T C Weterings6
1Microvida, Laboratory of Medical Microbiology, Amphia Hospital, Breda, The Netherlands.
Plos One
|June 25, 2026
Summary
Routine whole genome sequencing (WGS) effectively detects vancomycin-resistant Enterococcus faecium (VREfm) outbreaks in hospitals. Centralized WGS surveillance strengthens infection control by revealing complex transmission patterns within and between healthcare facilities.
Area of Science:
- Microbiology
- Infectious Diseases
- Genomics
Background:
- Whole genome sequencing (WGS) is a growing tool for infection control.
- Routine regional surveillance of vancomycin-resistant Enterococcus faecium (VREfm) using WGS is still developing.
- Understanding VREfm transmission across multiple healthcare facilities is crucial.
Purpose of the Study:
- To implement and assess routine, centralized, multicenter WGS surveillance for VREfm.
- To evaluate WGS utility in detecting VREfm clusters and transmission events.
- To investigate VREfm transmission within and between healthcare institutions in a regional network.
Main Methods:
- Whole genome sequencing (WGS) of 57 VREfm isolates from five Dutch hospitals over one year.
- Core genome multilocus sequence typing (cgMLST) for isolate typing.
- Correlation of sequence data with patient admission data to identify transmission events.
Main Results:
- 66.7% (38/57) of VREfm isolates clustered together.
- Intrahospital transmission was demonstrated in 37/38 clustered cases.
- Interhospital transmission was identified in 3/38 clustered cases, revealing multicenter and local outbreaks.
Conclusions:
- Routine WGS is powerful for detecting, tracing, and defining VREfm outbreaks.
- Centralized WGS surveillance in collaborative networks enhances understanding of VRE transmission.
- This approach strengthens infection control strategies in healthcare settings.
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