Whole-genome sequencing reveals transmission of vancomycin-resistant Enterococcus faecium in a healthcare network

• DOI: 10.1186/s13073-015-0259-7
• Publication Date: 2016-01-12T09:25:56Z
• Authors: Hayley J. Brodrick; Kathy E. Raven; Ewan M. Harrison; Beth Blane; Sandra Reuter; M. Estée Török; Julian Parkhill; Sharon J. Peacock
• Keywords: Enterococcus faecium; Vancomycin-resistant Enterococcus; Carriage

Background: Bacterial whole-genome sequencing (WGS) has the potential to identify reservoirs of multidrugresistant organisms and transmission these pathogens across healthcare networks.We used WGS define vancomycin-resistant enterococci (VRE) within a long-term care facility (LTCF), between this an acute hospital in United Kingdom (UK).Methods: A longitudinal prospective observational study faecal VRE carriage was conducted LTCF Cambridge, UK.Stool samples were collected at recruitment, then repeatedly until end period, discharge or death.Selective culture media isolate VRE, which subsequently sequenced analysed.We also analysed genomes 45 Enterococcus faecium bloodstream isolates Cambridge University Hospitals NHS Foundation Trust (CUH).Results: Forty-five residents recruited during 6-month period 2014, 693 stools frequency least 1 week apart.Fifty-one stool from 3/45 participants (7 %) positive for E. faecium.Two carried multiple lineages, one single lineage.Genome analyses based on nucleotide polymorphisms (SNPs) core genome indicated that by each three unrelated.Participants had extensive contact with local network.We found hospital-associated infection interspersed throughout phylogenetic tree, several instances closely related strains two settings.Conclusions: proportion are carriers VRE.Evidence genetic relatedness associated nearby indicate shared bacterial population.