Journal article

Publication year: 2021

Journal: Infection prevention in practice

Volume number: 3

Issue number: 2

ISSN: 2590-0889

Open access status: Gold

DOI Link: https://doi.org/10.1016/j.infpip.2021.100138

Publisher: Elsevier

Abstract: 
Background: Vancomycin-resistant Enterococcus faecium (VREfm) are an emerging threat worldwide. In Germany, a VRE-belt with higher VREfm prevalences transversing its central east-west axis and including the state of Hesse was previously described. Recently, we detected a predominant VREfm clone in hospitals throughout the Rhine-Main metropolitan area of Hesse.Aim: Here we expanded our study on VREfm to a regional neurological acute hospital outside of the metropolitan area with patient referrals from throughout Hesse and the neighboring federal state of Rhineland-Palatinate.Material/Methods: VREfm isolates obtained between 2016-2018 from a regional neuro-logical acute hospital with intensive care and early rehabilitation units were investigated (n1/455). Patient data was collected and analyzed together with whole-genome sequencing data to investigate antibiotic resistance and virulence determinants of the VREfm. The population structure of VREfm was investigated using the Core genome-based multilocus sequence typing (cgMLST).Findings: The average age of the patients was 67.1 years. For 96% of the patients, a previous hospital stay was reported. 64% of the patients were treated with antibiotics. All VREfm harbored the vanB vancomycin resistance gene. The multilocus sequence types (STs) detected changed abruptly from four different STs in 2016 to a predominant ST in 2017 and 2018 (ST117). Most of the ST117 isolates were members of the cgMLST type CT71.Conclusion: The results indicate a sudden shift of the VREfm population structure from a semi-heterogeneous population to a pre-dominant clone within an interval of two years. Further investigations are warranted to understand the epidemiology and emergence of this clone.(C) 2021 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Harvard Citation style: Falgenhauer, L., Preuser, I., Imirzalioglu, C., Falgenhauer, J., Fritzenwanker, M., Mack, D., et al. (2021) Changing epidemiology of vancomycin-resistant Enterococcus faecium: Results of a genome-based study at a regional neurological acute hospital with intensive care and early rehabilitation treatment, Infection prevention in practice, 3(2), Article 100138. https://doi.org/10.1016/j.infpip.2021.100138

APA Citation style: Falgenhauer, L., Preuser, I., Imirzalioglu, C., Falgenhauer, J., Fritzenwanker, M., Mack, D., Best, C., Heudorf, U., & Chakraborty, T. (2021). Changing epidemiology of vancomycin-resistant Enterococcus faecium: Results of a genome-based study at a regional neurological acute hospital with intensive care and early rehabilitation treatment. Infection prevention in practice. 3(2), Article 100138. https://doi.org/10.1016/j.infpip.2021.100138