Evidence map›Paper›PMID 41257595›Full record

ArticleBMC microbiology2025

Molecular epidemiology, antimicrobial resistance, and virulence determinants of Enterococcus faecium bloodstream isolates: a 7-year study in Shandong, China.

Huanxin Sun, Yujie Fang, Shengnan Hu, Dongyue Lyu, Xiutao Dong, Jiazheng Wang

Abstract read
In one paragraph

Article in BMC microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Clinical characteristics, predisposing factors and outcomes ofFrontiers in cellular and infection microbiology · 2026
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Huanxin Sun *Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, Shandong, China.
Yujie Fang *Department of Microbial Surveillance and Biosafety, School of Public Health, Qingdao University, Qingdao, Shandong, China.
Shengnan HuDepartment of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, Shandong, China.
Dongyue LyuNational Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Xiutao DongDepartment of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, Shandong, China.
Jiazheng WangDepartment of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, Shandong, China. wangjiazheng1210@163.com.

Funding

Natural Science Foundation of Shandong Province ZR2024QH268
6 · The paper itself

Abstract

backgroundEnterococcus faecium is a major cause of hospital-acquired infections, particularly bloodstream infections, which are associated with high mortality rates. This study aimed to characterize the molecular epidemiology, antimicrobial resistance profiles, and virulence determinants of E. faecium isolates from bloodstream infections in a tertiary hospital in Shandong, China, over a seven-year period (2017-2023).

resultsAmong 91 E. faecium isolates, 4 were vancomycin-resistant (VREfm), and 87 were vancomycin-susceptible (VSEfm). High resistance rates (> 87.9%) were observed for ciprofloxacin, levofloxacin, penicillin, ampicillin, and erythromycin. Multilocus sequence typing (MLST) identified 16 sequence types (STs), dominated by ST78 (41.8%) and ST555 (22.0%), with a novel ST designated ST2760. Notably, the prevalence of ST555 increased significantly from 18.2% in 2021 to 43.8% in 2023. Thirteen of the 16 STs (95.6% of isolates) were assigned to Clonal Complex 17 (CC17), while ST775, ST922, and the novel ST2760 were phylogenetically distinct from this predominant lineage. Virulence gene analysis revealed high detection rates (> 73%) of adhesion-associated genes (pilA, pilB, acm, sgrA, scm, esp, and ecbA). The pilA gene was significantly more prevalent in ST78 (92.1%) than in ST555 (40.0%), conferring higher biofilm-forming capacity. The absence of pilA in ST555 strains prior to 2021 correlated with lower detection rates, while its emergence post-2021 coincided with enhanced environmental fitness and increased clinical prevalence.

conclusionThis study highlights the predominance of ST78 and ST555 in E. faecium bloodstream infections, with their increasing prevalence linked to acquisition of the pilA gene and enhanced environmental survival through biofilm formation. The identification of a novel ST2760 underscores the ongoing genetic diversity of E. faecium. These findings provide critical insights for optimizing infection control strategies and guiding empirical therapy for E. faecium bloodstream infections.

Indexed as

BacteremiaDrug Resistance, BacterialEnterococcus faeciumGram-Positive Bacterial InfectionsVirulence FactorsAgedAnti-Bacterial AgentsChinaCross InfectionDrug Resistance, Multiple, BacterialFemaleHumansMaleMicrobial Sensitivity TestsMiddle AgedMolecular EpidemiologyAnti-Bacterial AgentsVirulence FactorsAntimicrobial resistanceBloodstream infectionsEnterococcus faeciumMolecular epidemiologyVirulence determinants

Identifiers

PMID41257595
PMCPMC12628980

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.