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Characterization of vanA-harboring plasmids supports differentiation of outbreak-related and sporadic vancomycin-resistant Enterococcus faecium isolates in a tertiary care hospital

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Publicado en:BMC Microbiology vol. 25 (2025), p. 1
Autor principal: Sobkowiak, A
Otros Autores: Scherff, N, V. van Almsick, Schuler, F, Brix, T J, Mellmann, A, Schwierzeck, V
Publicado:
Springer Nature B.V.
Materias:
United States > US
Germany
Infections
Plasmids
Antibiotic resistance
Software
Epidemiology
Nosocomial infection
Vancomycin
Genomes
Hospitals
Outbreaks
Nucleotide sequence
Genotype & phenotype
Drug resistance
Patients
Gene sequencing
Epidemics
Antimicrobial agents
Whole genome sequencing
Surveillance
Multilocus sequence typing
Disease control
Social
Enterococcus faecium
Acceso en línea:Citation/Abstract
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Resumen:BackgroundThe prevention of vancomycin-resistant Enterococcus faecium (VREfm) infections and transmissions poses a major challenge to hospitals. Vancomycin resistance can be plasmid encoded; however, as the analysis of plasmids is challenging, so far only a few reports have provided a detailed characterization of plasmids in nosocomial VREfm transmission. Here we describe a nosocomial VREfm outbreak caused by a vanA positive ST80 isolate. vanA plasmid sequence data was used to distinguish outbreak-associated isolates from sporadic VREfm cases and to investigate the spread of this plasmid within the local VREfm population.Methods446 VREfm isolates were collected from routine surveillance between 01/2022 and 02/2024 and analyzed using long-read whole genome sequencing (lrWGS). Genetic relatedness of isolates was evaluated based on core genome multilocus sequence typing (cgMLST). Genetically similar vanA plasmids were identified using a Mash based approach.Results30 genetically similar VREfm isolates were identified in patients’ screening and environmental samples. Infection control evaluation confirmed transmission through shared hospital rooms. All outbreak-related VREfm isolates, including environmental samples, carried a highly similar vanA plasmid (Mash distance of < 0.001) with an identical replicon type. After enhanced infection control measures were established, no new transmissions were detected. Comparison with additional VREfm isolates from the respective department showed no evidence for further plasmid transmission.ConclusionsOur study illustrates how vanA plasmid analysis can support the evaluation of VREfm transmission in hospitals. The outbreak-associated vanA plasmids were genetically highly similar, but could be clearly distinguished from other vanA plasmids in the local hospital population. Taken together, detailed analysis of hospital-associated vanA plasmids can improve our understanding of VREfm transmission and epidemiology.
ISSN:1471-2180
DOI:10.1186/s12866-025-04058-5
Fuente:Health & Medical Collection