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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Publikašuvnnas:BMC Microbiology vol. 25 (2025), p. 1
Váldodahkki: Sobkowiak, A
Eará dahkkit: Scherff, N, V. van Almsick, Schuler, F, Brix, T J, Mellmann, A, Schwierzeck, V
Almmustuhtton:
Springer Nature B.V.
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LEADER 00000nab a2200000uu 4500
001 3216562944
003 UK-CbPIL
022 |a 1471-2180 
024 7 |a 10.1186/s12866-025-04058-5  |2 doi 
035 |a 3216562944 
045 2 |b d20250101  |b d20251231 
084 |a 58455  |2 nlm 
100 1 |a Sobkowiak, A 
245 1 |a Characterization of <i>vanA</i>-harboring plasmids supports differentiation of outbreak-related and sporadic vancomycin-resistant <i>Enterococcus faecium</i> isolates in a tertiary care hospital 
260 |b Springer Nature B.V.  |c 2025 
513 |a Journal Article 
520 3 |a 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. 
651 4 |a United States--US 
651 4 |a Germany 
653 |a Infections 
653 |a Plasmids 
653 |a Antibiotic resistance 
653 |a Software 
653 |a Epidemiology 
653 |a Nosocomial infection 
653 |a Vancomycin 
653 |a Genomes 
653 |a Hospitals 
653 |a Outbreaks 
653 |a Nucleotide sequence 
653 |a Genotype & phenotype 
653 |a Drug resistance 
653 |a Patients 
653 |a Gene sequencing 
653 |a Epidemics 
653 |a Antimicrobial agents 
653 |a Whole genome sequencing 
653 |a Surveillance 
653 |a Multilocus sequence typing 
653 |a Disease control 
653 |a Social 
653 |a Enterococcus faecium 
700 1 |a Scherff, N 
700 1 |a V. van Almsick 
700 1 |a Schuler, F 
700 1 |a Brix, T J 
700 1 |a Mellmann, A 
700 1 |a Schwierzeck, V 
773 0 |t BMC Microbiology  |g vol. 25 (2025), p. 1 
786 0 |d ProQuest  |t Health & Medical Collection 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3216562944/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3216562944/fulltext/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3216562944/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch