Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay
Vancomycin-resistant enterococci (VRE) are relevant nosocomial pathogens with an increasing incidence in the last decades. Their transmission is optimal in the hospital setting, as it offers two potential, large reservoirs that are closely related: susceptible patients and their environment. Here we...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-01-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/8/2/203 |
| _version_ | 1811192957871587328 |
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| author | Carlos L. Correa-Martinez Hauke Tönnies Neele J. Froböse Alexander Mellmann Stefanie Kampmeier |
| author_facet | Carlos L. Correa-Martinez Hauke Tönnies Neele J. Froböse Alexander Mellmann Stefanie Kampmeier |
| author_sort | Carlos L. Correa-Martinez |
| collection | DOAJ |
| description | Vancomycin-resistant enterococci (VRE) are relevant nosocomial pathogens with an increasing incidence in the last decades. Their transmission is optimal in the hospital setting, as it offers two potential, large reservoirs that are closely related: susceptible patients and their environment. Here we investigate the role of the hospital environment in the nosocomial transmission of VRE by establishing concrete links between contaminated surfaces and colonized/infected patients in outbreak and non-outbreak settings. Environmental and patient VRE isolates were collected between 2013 and 2019 and analyzed by whole-genome sequencing (WGS), subsequent multilocus sequence typing (MLST), and core genome (cg) MLST. Pairs of isolates differing in <3 alleles were rated as closely related, making a transmission likely. Fifty-three environmental VRE isolates were analyzed. MLST sequence types (ST) ST203 (50.0%), ST192 (21.3%), ST117 (17.3%), ST721 (8.8%), ST80 (2%), and ST1489 (0.7%) were detected, carrying the resistance determinants <i>vanA</i> (72.7%), <i>vanB</i> (24%), or both (3.3%). Of the 53 environmental isolates, 51 were found to form five clusters with genetically related patient isolates (<i>n</i> = 97 isolates). WGS confirms the role of the environment in the transmission dynamics of VRE in both the outbreak and non-outbreak settings, highlighting the importance of prevention and control of VRE spread. |
| first_indexed | 2024-04-12T00:00:34Z |
| format | Article |
| id | doaj.art-57fdd2500bec413799fd5f82e48d17a3 |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-04-12T00:00:34Z |
| publishDate | 2020-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-57fdd2500bec413799fd5f82e48d17a32022-12-22T03:56:14ZengMDPI AGMicroorganisms2076-26072020-01-018220310.3390/microorganisms8020203microorganisms8020203Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment InterplayCarlos L. Correa-Martinez0Hauke Tönnies1Neele J. Froböse2Alexander Mellmann3Stefanie Kampmeier4Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, GermanyInstitute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, GermanyInstitute of Medical Microbiology, University Hospital Münster, Domagkstraße 10, 48149 Münster, GermanyInstitute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, GermanyInstitute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, GermanyVancomycin-resistant enterococci (VRE) are relevant nosocomial pathogens with an increasing incidence in the last decades. Their transmission is optimal in the hospital setting, as it offers two potential, large reservoirs that are closely related: susceptible patients and their environment. Here we investigate the role of the hospital environment in the nosocomial transmission of VRE by establishing concrete links between contaminated surfaces and colonized/infected patients in outbreak and non-outbreak settings. Environmental and patient VRE isolates were collected between 2013 and 2019 and analyzed by whole-genome sequencing (WGS), subsequent multilocus sequence typing (MLST), and core genome (cg) MLST. Pairs of isolates differing in <3 alleles were rated as closely related, making a transmission likely. Fifty-three environmental VRE isolates were analyzed. MLST sequence types (ST) ST203 (50.0%), ST192 (21.3%), ST117 (17.3%), ST721 (8.8%), ST80 (2%), and ST1489 (0.7%) were detected, carrying the resistance determinants <i>vanA</i> (72.7%), <i>vanB</i> (24%), or both (3.3%). Of the 53 environmental isolates, 51 were found to form five clusters with genetically related patient isolates (<i>n</i> = 97 isolates). WGS confirms the role of the environment in the transmission dynamics of VRE in both the outbreak and non-outbreak settings, highlighting the importance of prevention and control of VRE spread.https://www.mdpi.com/2076-2607/8/2/203vreenvironmentcontaminationinfectiontransmissionwhole-genome sequencing |
| spellingShingle | Carlos L. Correa-Martinez Hauke Tönnies Neele J. Froböse Alexander Mellmann Stefanie Kampmeier Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay Microorganisms vre environment contamination infection transmission whole-genome sequencing |
| title | Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay |
| title_full | Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay |
| title_fullStr | Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay |
| title_full_unstemmed | Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay |
| title_short | Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay |
| title_sort | transmission of vancomycin resistant enterococci in the hospital setting uncovering the patient environment interplay |
| topic | vre environment contamination infection transmission whole-genome sequencing |
| url | https://www.mdpi.com/2076-2607/8/2/203 |
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