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However, regional differences in strain distribution patterns remain poorly reported. In this narrative review, we summarize current evidence in Germany.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic PubMed search was conducted for studies describing WGS-based typing of VRE in Germany published between 2015 and 2025 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200939). A relevant national surveillance report was included additionally.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data availability varies regionally, with highest reporting rates in north-western and south-eastern Germany. The German VRE population is predominantly composed of six major lineages:\n                      <jats:italic>vanB<\/jats:italic>\n                      -positive sequence types (ST) 80, 117, 192, and 203, and\n                      <jats:italic>vanA<\/jats:italic>\n                      -positive ST78 and ST1299. While ST192, ST203, and ST78 declined over time, ST80 and ST117 and their sub-lineages are nationally endemic. Core genome analyses demonstrate stable distribution of regionally specific complex types (CT) including ST80\/CT1065\/\n                      <jats:italic>vanB<\/jats:italic>\n                      and ST1299\/CT1903\/\n                      <jats:italic>vanA<\/jats:italic>\n                      in southern Germany, and ST117\/CT71\/\n                      <jats:italic>vanB<\/jats:italic>\n                      and ST80\/CT1470\/\n                      <jats:italic>vanA<\/jats:italic>\n                      in the north-west. Notably, ST80 exhibits greater CT diversity than ST117, reflecting its wider evolutionary plasticity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although unevenly reported, persistent regional differences in dominant lineages are evident, underscoring the necessity and value of high-resolution genomic surveillance beyond national-level reporting. Ultimately, this strategy could improve transmissions and outbreak analysis, and facilitate identification of lineage-specific virulence determinants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02890-z","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:35:06Z","timestamp":1785425706000},"page":"2333-2345","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Limited, outbreak-biased and unevenly reported: genomic insights into vancomycin-resistant Enterococcus faecium in Germany as reported between 2015 and 2025"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1992-1897","authenticated-orcid":false,"given":"Anca","family":"Rath","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wulf","family":"Schneider-Brachert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"2890_CR1","volume-title":"Antimicrobial resistance - Annual Epidemiological Report - Country summaries\u2009\u2013\u20092024 data","author":"European Centre for Disease Prevention and Control","year":"2025","unstructured":"European Centre for Disease Prevention and Control. 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