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Article

Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay

1
Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany
2
Institute of Medical Microbiology, University Hospital Münster, Domagkstraße 10, 48149 Münster, Germany
*
Author to whom correspondence should be addressed.
Received: 19 December 2019 / Revised: 27 January 2020 / Accepted: 30 January 2020 / Published: 31 January 2020
(This article belongs to the Special Issue Safety Aspects of Lactic Acid Bacteria)
Vancomycin-resistant enterococci (VRE) are relevant nosocomial pathogens with an increasing incidence in the last decades. Their transmission is optimal in the hospital setting, as it offers two potential, large reservoirs that are closely related: susceptible patients and their environment. Here we investigate the role of the hospital environment in the nosocomial transmission of VRE by establishing concrete links between contaminated surfaces and colonized/infected patients in outbreak and non-outbreak settings. Environmental and patient VRE isolates were collected between 2013 and 2019 and analyzed by whole-genome sequencing (WGS), subsequent multilocus sequence typing (MLST), and core genome (cg) MLST. Pairs of isolates differing in <3 alleles were rated as closely related, making a transmission likely. Fifty-three environmental VRE isolates were analyzed. MLST sequence types (ST) ST203 (50.0%), ST192 (21.3%), ST117 (17.3%), ST721 (8.8%), ST80 (2%), and ST1489 (0.7%) were detected, carrying the resistance determinants vanA (72.7%), vanB (24%), or both (3.3%). Of the 53 environmental isolates, 51 were found to form five clusters with genetically related patient isolates (n = 97 isolates). WGS confirms the role of the environment in the transmission dynamics of VRE in both the outbreak and non-outbreak settings, highlighting the importance of prevention and control of VRE spread. View Full-Text
Keywords: VRE; environment; contamination; infection; transmission; whole-genome sequencing VRE; environment; contamination; infection; transmission; whole-genome sequencing
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MDPI and ACS Style

Correa-Martinez, C.L.; Tönnies, H.; Froböse, N.J.; Mellmann, A.; Kampmeier, S. Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay. Microorganisms 2020, 8, 203. https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms8020203

AMA Style

Correa-Martinez CL, Tönnies H, Froböse NJ, Mellmann A, Kampmeier S. Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay. Microorganisms. 2020; 8(2):203. https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms8020203

Chicago/Turabian Style

Correa-Martinez, Carlos L., Hauke Tönnies, Neele J. Froböse, Alexander Mellmann, and Stefanie Kampmeier. 2020. "Transmission of Vancomycin-Resistant Enterococci in the Hospital Setting: Uncovering the Patient–Environment Interplay" Microorganisms 8, no. 2: 203. https://0-doi-org.brum.beds.ac.uk/10.3390/microorganisms8020203

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