{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T11:36:54Z","timestamp":1793101014346,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["MicrobiologyOpen"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      A significant increase of vancomycin\u2010resistant\n                      <jats:italic>Enterococcus faecium<\/jats:italic>\n                      (VREfm) infections was observed in South\u2010Eastern Austria since 2024. The prolonged outbreak is caused by a novel\n                      <jats:italic>vanB\u2010<\/jats:italic>\n                      VREfm clone (ST117\/CT7799, \u201cVREfm\n                      <jats:sub>styr<\/jats:sub>\n                      \u201d). This study characterizes the atypical difficult\u2010to\u2010detect resistance phenotype and assesses the genomic relatedness of the isolates. Patient and outbreak characteristics were investigated including whole genome sequencing of the isolates. Sensitivity of broth microdilution (BMD), gradient tests (GT), disk diffusion (DD), and automated susceptibility testing (VITEK2) was compared. The performance of commercial screening media was evaluated. From sporadic detections in early 2024 case numbers began to rise during the year. In 30\/31 (97%) of all cases, intra\u2010hospital transmission was considered likely and an association with invasive procedures was identified in most cases. Core genome multilocus sequence typing revealed only six allelic differences between VREfm\n                      <jats:sub>styr<\/jats:sub>\n                      isolates collected in a 12\u2010month period, all belonging to the\n                      <jats:italic>E. faecium<\/jats:italic>\n                      ST117\/CT7799 lineage. BMD detected vancomycin resistance (MIC\u2009&gt;\u20094\u2009mg\/L) in no more than 16\/31 (52%) of isolates after 24\u2009h incubation, while GT and DD misclassified all isolates. Only prolonged incubation improved the performance of these assays. VITEK2 analysis, however, correctly classified all 31 isolates. Of four commercially available VRE\u2010screening agars, only one was capable of detecting VREfm\n                      <jats:sub>styr<\/jats:sub>\n                      after 24\u2009h incubation. The emergence and clonal dissemination of VREfm ST117\/CT7799 reveals a serious diagnostic gap as commonly used diagnostic algorithms fail to reliably detect this resistance phenotype. Our findings should help to further evaluate the true geographical distribution and clinical significance of this novel VREfm clone.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mbo3.70393","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T12:06:26Z","timestamp":1788177986000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergence of a Novel, Phenotypically Difficult\u2010to\u2010Detect Vancomycin\u2010Resistant\n                    <i>Enterococcus faecium<\/i>\n                    Clone (ST117\/CT7799)"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5768-6523","authenticated-orcid":false,"given":"Patrick","family":"Forstner","sequence":"first","affiliation":[{"name":"Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2065-5836","authenticated-orcid":false,"given":"Christine","family":"Uitz","sequence":"additional","affiliation":[{"name":"Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2800-3659","authenticated-orcid":false,"given":"Johanna","family":"Dabernig\u2010Heinz","sequence":"additional","affiliation":[{"name":"Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5704-3955","authenticated-orcid":false,"given":"Gabriel E.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Bender","sequence":"additional","affiliation":[{"name":"Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases Robert Koch Institute Wernigerode Germany"},{"name":"German National Reference Centre for Staphylococci and Enterococci Wernigerode Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9319-3862","authenticated-orcid":false,"given":"Martin","family":"Fischer","sequence":"additional","affiliation":[{"name":"Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases Robert Koch Institute Wernigerode Germany"},{"name":"German National Reference Centre for Staphylococci and Enterococci Wernigerode 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