ReviewInfection2026
Limited, outbreak-biased and unevenly reported: genomic insights into vancomycin-resistant Enterococcus faecium in Germany as reported between 2015 and 2025.
Review in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
2 authors.
Funding
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Abstract
objectiveWhole-genome sequencing (WGS) has improved our understanding on epidemiology and transmission of vancomycin-resistant Enterococcus faecium (VRE). However, regional differences in strain distribution patterns remain poorly reported. In this narrative review, we summarize current evidence in Germany.
methodsA systematic PubMed search was conducted for studies describing WGS-based typing of VRE in Germany published between 2015 and 2025 (n = 39). A relevant national surveillance report was included additionally.
resultsData availability varies regionally, with highest reporting rates in north-western and south-eastern Germany. The German VRE population is predominantly composed of six major lineages: vanB-positive sequence types (ST) 80, 117, 192, and 203, and vanA-positive ST78 and ST1299. While ST192, ST203, and ST78 declined over time, ST80 and ST117 and their sub-lineages are nationally endemic. Core genome analyses demonstrate stable distribution of regionally specific complex types (CT) including ST80/CT1065/vanB and ST1299/CT1903/vanA in southern Germany, and ST117/CT71/vanB and ST80/CT1470/vanA in the north-west. Notably, ST80 exhibits greater CT diversity than ST117, reflecting its wider evolutionary plasticity.
conclusionAlthough unevenly reported, persistent regional differences in dominant lineages are evident, underscoring the necessity and value of high-resolution genomic surveillance beyond national-level reporting. Ultimately, this strategy could improve transmissions and outbreak analysis, and facilitate identification of lineage-specific virulence determinants.
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