ArticleThe Journal of antimicrobial chemotherapy2024
Consideration of within-patient diversity highlights transmission pathways and antimicrobial resistance gene variability in vancomycin-resistant Enterococcus faecium.
Article in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Culture-enriched metagenomic sequencing reveals within-patient diversity and transmission of vancomycin-resistantMicrobial genomics · 2026Article
- Genomic investigation of the vancomycin-resistant Enterococcus faecium in a tertiary hospital in China.Antimicrobial resistance and infection control · 2026Article
- Culture-enriched metagenomic sequencing reveals within-patient diversity and transmission of vancomycin-resistantmedRxiv : the preprint server for health sciences · 2026Article
- Co-carriage of diverse vancomycin-resistantJAC-antimicrobial resistance · 2025Article
- Integrated population clustering and genomic epidemiology with PopPIPE.Microbial genomics · 2025Article
- Development of a strain-specific PCR as a diagnostic tool for surveillance, detection, and monitoring of vancomycin-resistant Enterococcus faecium during outbreak.Antimicrobial resistance and infection control · 2025Article
- Deciphering vancomycin resistance inFrontiers in microbiology · 2025Article
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Authors and funding
8 authors.
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Abstract
backgroundWGS is increasingly being applied to healthcare-associated vancomycin-resistant Enterococcus faecium (VREfm) outbreaks. Within-patient diversity could complicate transmission resolution if single colonies are sequenced from identified cases.
objectivesDetermine the impact of within-patient diversity on transmission resolution of VREfm. MATERIALS AND
methodsFourteen colonies were collected from VREfm positive rectal screens, single colonies were collected from clinical samples and Illumina WGS was performed. Two isolates were selected for Oxford Nanopore sequencing and hybrid genome assembly to generate lineage-specific reference genomes. Mapping to closely related references was used to identify genetic variations and closely related genomes. A transmission network was inferred for the entire genome set using Phyloscanner. RESULTS AND DISCUSSION: In total, 229 isolates from 11 patients were sequenced. Carriage of two or three sequence types was detected in 27% of patients. Presence of antimicrobial resistance genes and plasmids was variable within genomes from the same patient and sequence type. We identified two dominant sequence types (ST80 and ST1424), with two putative transmission clusters of two patients within ST80, and a single cluster of six patients within ST1424. We found transmission resolution was impaired using fewer than 14 colonies.
conclusionsPatients can carry multiple sequence types of VREfm, and even within related lineages the presence of mobile genetic elements and antimicrobial resistance genes can vary. VREfm within-patient diversity could be considered in future to aid accurate resolution of transmission networks.
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