Comprehensive integrated NGS-based surveillance and contact-network modeling unravels transmission dynamics of vancomycin-resistant enterococci in a high-risk population within a tertiary care hospital

• DOI: 10.1371/journal.pone.0235160
• Publication Date: 2020-06-24T17:41:56Z
• Authors: Bernd Neumann; Jennifer K. Bender; Benjamin F. Maier; Alice Wittig; Stephan Fuchs; Dirk Brockmann; Torsten Semmler; Hermann Einsele; Sabrina Kraus; Lothar H. Wieler; Ulrich Vogel; Guido Werner
• Keywords: Enterococcus faecium

Vancomycin-resistant E. faecium (VRE) are an important cause of nosocomial infections, which rapidly transmitted in hospitals. To identify possible transmission routes, we applied combined genomics and contact-network modeling to retrospectively evaluate routine VRE screening data generated by the infection control program a hemato-oncology unit. Over 1 year, total 111 isolates from patients were collected anal swabs tertiary care hospital Southern Germany. All isolated whole-genome sequenced, followed different in-depth bioinformatics analyses including genotyping determination phylogenetic relations, aiming standardized workflow. Patient movement used overlay sequencing infer events strain dynamics over time. A predominant clone harboring vanB exhibiting genotype ST117/CT469 (n = 67) was identified. Our comprehensive suggested intra-hospital spread, especially ST117/CT469, despite extensive screening, single room placement, contact isolation. new interactive tool visualize these complex designed. Furthermore, patient-contact network-modeling approach developed, indicates both periodic import into its spread within due patient movements. The analyzed most likely placement same prior positivity screening. We successfully demonstrated added value for this strategy extract well-founded knowledge interdisciplinary sources. combination high-resolution typing unraveled department and, additionally, constant influx