Vancomycin-Resistant Enterococcus faecium: A current perspective on resilience, adaptation, and the urgent need for novel strategies

Journal of Global Antimicrobial Resistance, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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Promiscuous, persistent and problematic: insights into current enterococcal genomics to guide therapeutic strategy

BMC Microbiology, Journal Year: 2024, Volume and Issue: 24(1)

Published: March 28, 2024

Abstract Vancomycin-resistant enterococci (VRE) are major opportunistic pathogens and the causative agents of serious diseases, such as urinary tract infections endocarditis. VRE strains mainly include species Enterococcus faecium E. faecalis which can colonise gastrointestinal (GIT) patients and, following growth persistence in gut, transfer to blood resulting systemic dissemination body. Advancements genomics have revealed that hospital-associated characterised by increased numbers mobile genetic elements, higher antibiotic resistance genes often lack active CRISPR-Cas systems. Additionally, comparative our understanding routes among healthcare workers. Since efficiency currently available antibiotics is rapidly declining, new measures control infection these persistent urgently needed. These approaches combinatory administration antibiotics, strengthening colonisation gut microbiota reduce proliferation through commensals or probiotic bacteria, switching non-antibiotic bacterial killers, bacteriophages bacteriocins. In this review, we discuss current knowledge isolates state-of-the-art therapeutic advances against infections.

Language: Английский

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HAIviz: an interactive dashboard for visualising and integrating healthcare-associated genomic epidemiological data

Microbial Genomics, Journal Year: 2024, Volume and Issue: 10(2)

Published: Feb. 15, 2024

Existing tools for phylogeographic and epidemiological visualisation primarily provide a macro-geographic view of epidemic pandemic transmission events but offer little support detailed investigation outbreaks in healthcare settings. Here, we present HAIviz, an interactive web-based application designed integrating visualising genomic information to improve the tracking healthcare-associated infections (HAIs). HAIviz displays links outbreak timeline, building map, phylogenetic tree, patient bed movements, network on single dashboard. has been developed bacterial investigations can be utilised general focused built environments which customised maps is required. This paper describes demonstrates HAI investigations.

Language: Английский

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Genomic sequencing surveillance of patients colonized with vancomycin-resistantEnterococcus(VRE) improves detection of hospital-associated transmission

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: May 3, 2024

ABSTRACT Background Vancomycin-resistant enterococcal (VRE) infections pose significant challenges in healthcare. Transmission dynamics of VRE are complex, often involving patient colonization and subsequent transmission through various healthcare-associated vectors. We utilized a whole genome sequencing (WGS) surveillance program at our institution to better understand the contribution clinical colonizing isolates transmission. Methods performed on 352 collected over 34 months 891 rectal screening 9-month nested period, used single nucleotide polymorphisms assess relatedness. then geo-temporal analysis considering both compared with alone, calculated 30-day outcomes patients. Results carriage constituted 87.3% acquisition, an average monthly acquisition rate 7.6 per 1000 days. identified 185 genetically related clusters containing 2-42 encompassing 69.6% all dataset. The inclusion swab increased detection isolate (from 53% 67%, P<0.01). Geo-temporal hotspot locations Patients that were closely previously sampled experienced ICU admission (17.5%), hospital readmission (9.2%), death (13.3%). Conclusions Our findings describe high burden shed light importance using WGS this pathogen. This study highlights potential utility incorporating into routine practice for improving infection prevention safety.

Language: Английский

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High-Risk VREfm Clones and Resistance Determinants in a Thai Hospital

Antibiotics, Journal Year: 2025, Volume and Issue: 14(3), P. 229 - 229

Published: Feb. 24, 2025

Background/Objective: Vancomycin-resistant enterococci (VRE), particularly Enterococcus faecium (VREfm), are significant healthcare-associated infections, especially bloodstream infections (BSIs). Method: This study explored the genotypic and phenotypic characteristics of 29 VREfm isolates causing BSIs in Thailand. Bacterial species, sequence types (STs), virulence genes, vancomycin antimicrobial-resistance genes were identified by multiplex PCR, multilocus typing, whole-genome sequencing (WGS). Antibiotic susceptibility was determined disk diffusion, while an E-test or broth microdilution used for daptomycin, teicoplanin, linezolid, tigecycline. Biofilm formation assessed using a microtiter plate assay. Results: All harbored vanA gene exhibited resistance to ampicillin, erythromycin, norfloxacin, vancomycin, rifampin. Resistance ciprofloxacin, tigecycline, nitrofurantoin widespread as well. remained susceptible chloramphenicol linezolid. The majority belonged clonal complex 17, with ST17 being predominant (21/29, 72.4%), followed ST80 (6/29, 20.7%), ST761 (1/29, 3.4%), ST117 3.4%). WGS analysis confirmed presence various antimicrobial including aac(6′)-Ii, ant-Ia, erm(B), vanA. Additionally, such acm (collagen adhesin) esp (enterococcal surface protein), which involved biofilm formation, detected. Conclusion: provides insights into genomic dissemination invasive Thailand, is crucial infection control public health surveillance.

Language: Английский

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Solu – a Cloud Platform for Real-Time Genomic Pathogen Surveillance

bioRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: June 2, 2024

Background: Genomic surveillance is extensively used for tracking public health outbreaks and healthcare-associated pathogens. Despite advancements in bioinformatics pipelines, there are still significant challenges terms of infrastructure, expertise, security when it comes to continuous surveillance. The existing pipelines often require the user set up manage their own infrastructure not designed that demands integration new regularly generated sequencing data with previous analyses. Additionally, academic projects do meet privacy requirements healthcare providers. Results: We present Solu, a cloud-based platform integrates genomic into real-time, privacy-focused system. Evaluation: Solu's accuracy taxonomy assignment, antimicrobial resistance genes, phylogenetics, was comparable established pathogen pipelines. In some cases, Solu identified genes were previously undetected. Together, these findings demonstrate efficacy our platform. Conclusions: By enabling reliable, user-friendly, surveillance, has potential bridge gap between cutting-edge research practical, widespread application settings. available free use at platform.solugenomics.com.

Language: Английский

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Epidemiology of vancomycin-resistant enterococci in the United Arab Emirates: a retrospective analysis of 12 years of national AMR surveillance data

Frontiers in Public Health, Journal Year: 2023, Volume and Issue: 11

Published: Nov. 27, 2023

Introduction Enterococci are usually low pathogenic, but can cause invasive disease under certain circumstances, including urinary tract infections, bacteremia, endocarditis, and meningitis, associated with peritonitis intra-abdominal abscesses. Increasing resistance of enterococci to glycopeptides fluoroquinolones, high-level aminoglycosides is a concern. National antimicrobial (AMR) surveillance data for from the Middle East North Africa (MENA) Gulf region scarce. Methods A retrospective 12-year analysis N = 37,909 non-duplicate diagnostic Enterococcus spp. isolates United Arab Emirates (UAE) was conducted. Data generated by routine patient care during 2010–2021, collected trained personnel reported participating sites UAE AMR Surveillance program. conducted WHONET. Results faecalis most commonly species (81.5%), followed faecium (8.5%), other (4.8%). Phenotypically vancomycin-resistant (VRE) were found in 1.8% isolates. Prevalence VRE (%VRE) highest E. (8.1%), (0.9%). significant level these two has been observed majority years [ (0–2.2%), 2010: 0%, 2021: 0.6%] (0–14.2%, 5.8%). Resistance fluoroquinolones between 17 29% ( ) higher (between 42 83%). mortality (RR: 2.97), admission intensive units 2.25), increased length stay (six excess inpatient days per case), as compared vancomycin-susceptible Discussion Published on particular VRE-infections, MENA Our demonstrates that VRE-enterococci relatively rare UAE, however showing an increasing trend several clinically important antibiotic classes, causing concern treatment serious infections caused enterococci. This study also mortality, unit rates, longer hospitalization, thus poorer clinical outcome costs UAE. We recommend expansion current techniques (e.g., local screening), stricter infection prevention control strategies, better stewardship interventions. Further studies molecular epidemiology needed.

Language: Английский

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Analysis of molecular epidemiological characteristics and antimicrobial susceptibility of vancomycin-resistant and linezolid-resistant Enterococcus in China

BMC Medical Genomics, Journal Year: 2024, Volume and Issue: 17(1)

Published: July 1, 2024

Abstract Background This study investigates the distribution and characteristics of linezolid vancomycin susceptibilities among Enterococcus faecalis ( E. ) faecium explores underlying resistance mechanisms. Methods A total 2842 clinical isolates from patients were retrospectively collected, their data further analyzed. The minimum inhibitory concentrations (MICs) validated by broth dilution method. genes optr A, cfr , van B M investigated using polymerase chain reaction (PCR). Housekeeping obtianed through whole-genome sequencing (WGS). Results Of isolates, 88.5% (2516) originated urine, with accounted for 60.1% these. gene was identified in 27/28 resistant (VRE) 4 which carried both genes. remaining strain positive. all (LRE). showed a higher multiple antibiotic index (MAR index) compared to faecalis. multi-locus sequence typing (MLST) type mainly belongs clonal complex (CC) 17, nearly analyzed differentiated into 7 types (STs), ST16 CC16 major lineage. Conclusion Urine primary source VRE LRE this study. levels . Optr detected 91.6% LRE, could explain resistance, strains, while key mechanism

Language: Английский

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