{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:14:52Z","timestamp":1790554492703,"version":"4.1.0"},"reference-count":21,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X22000071_as1\"><jats:title>Objective:<\/jats:title><jats:p>To analyze the spread of a novel sequence type (ST1478) of vancomycin-resistant <jats:italic>Enterococcus faecium<\/jats:italic> across Canadian hospitals.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000071_as2\"><jats:title>Design:<\/jats:title><jats:p>Retrospective chart review of patients identified as having ST1478 VRE bloodstream infection.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000071_as3\"><jats:title>Setting:<\/jats:title><jats:p>Canadian hospitals that participate in the Canadian Nosocomial Infection Surveillance Program (CNISP).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000071_as4\"><jats:title>Methods:<\/jats:title><jats:p>From 2013 to 2018, VRE bloodstream isolates collected from participating CNISP hospitals were sent to the National Microbiology Laboratory (NML). ST1478 isolates were identified using multilocus sequence typing, and whole-genome sequencing was performed. Patient characteristics and location data were collected for patients with ST1478 bloodstream infection (BSI). The sequence and patient location information were used to generate clusters of infections and assess for intrahospital and interhospital spread.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000071_as5\"><jats:title>Results:<\/jats:title><jats:p>ST1478 VRE BSI occurred predominantly in a small number of hospitals in central and western Canada. Within these hospitals, infections were clustered on certain wards, and isolates often had &lt;20 single-nucleotide variants (SNV) differences from one another, suggesting a large component of intrahospital spread. Furthermore, some patients with bloodstream infections were identified as moving from one hospital to another, potentially having led to interhospital spread. Genomic analysis of all isolates revealed close relatedness between isolates at multiple different hospitals (&lt;20 SNV) not predicted from our epidemiologic data.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X22000071_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>Both intrahospital and regional interhospital spread have contributed to the emergence of VRE ST1478 infections across Canada. Whole-genome sequencing provides evidence of spread that might be missed with epidemiologic investigation alone.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2022.7","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T06:42:37Z","timestamp":1646894557000},"page":"17-23","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":9,"title":["Vancomycin-resistant <i>Enterococcus<\/i> sequence type 1478 spread across hospitals participating in the Canadian Nosocomial Infection Surveillance Program from 2013 to 2018"],"prefix":"10.1017","volume":"44","author":[{"given":"David R.","family":"Kleinman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"McCracken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3911-7033","authenticated-orcid":false,"given":"Susy S.","family":"Hota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George R.","family":"Golding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"CNISP VRE Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4910-0083","authenticated-orcid":false,"given":"Stephanie W.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"S0899823X22000071_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-019-0466-x"},{"key":"S0899823X22000071_ref17","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00534-13"},{"key":"S0899823X22000071_ref6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0218185"},{"key":"S0899823X22000071_ref2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2609.201576"},{"key":"S0899823X22000071_ref20","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.228"},{"key":"S0899823X22000071_ref18","first-page":"e000048","article-title":"Evolutionary dynamics of Enterococcus faecium reveals complex genomic relationships between isolates with independent emergence of vancomycin resistance","volume":"2","author":"van Hal","year":"2016","journal-title":"Microb Genom"},{"key":"S0899823X22000071_ref14","first-page":"e000116","article-title":"SNVPhyl: a single nucleotide variant phylogenomics pipeline for microbial genomic epidemiology","volume":"3","author":"Petkau","year":"2017","journal-title":"Microb Genom"},{"key":"S0899823X22000071_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv142"},{"key":"S0899823X22000071_ref19","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00102-19"},{"key":"S0899823X22000071_ref3","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20160121"},{"key":"S0899823X22000071_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.07.014"},{"key":"S0899823X22000071_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2018.05.003"},{"key":"S0899823X22000071_ref11","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-48436-2"},{"key":"S0899823X22000071_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky074"},{"key":"S0899823X22000071_ref16","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00412-13"},{"key":"S0899823X22000071_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky308"},{"key":"S0899823X22000071_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa122"},{"key":"S0899823X22000071_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw314"},{"key":"S0899823X22000071_ref13","volume-title":"Canadian Nosocomial Infection Surveillance Program (CNISP) Surveillance of Vancomycin Resistant Enterococci Bloodstream Infections in CNISP Hospitals","author":"Smith","year":"2018."},{"key":"S0899823X22000071_ref8","doi-asserted-by":"publisher","DOI":"10.1101\/gr.204024.116"},{"key":"S0899823X22000071_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-019-03524-z"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X22000071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T10:14:37Z","timestamp":1674036877000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X22000071\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,10]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["S0899823X22000071"],"URL":"https:\/\/doi.org\/10.1017\/ice.2022.7","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,10]]},"assertion":[{"value":"\u00a9 The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}