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Therefore, our hospital employs a screening program whereby rectal swabs are screened for the presence of <jats:italic>vanA<\/jats:italic> and <jats:italic>vanB<\/jats:italic>, and only PCR-positive broths are cultured on VRE selection agar. Early November 2016, a clinical <jats:italic>vanA-<\/jats:italic>\/<jats:italic>vanB<\/jats:italic>-negative VRE isolate was detected in a <jats:italic>vanA\/vanB<\/jats:italic>-screening-negative patient, giving the possibility that an undetected VRE might be spreading within our hospital. Whole-genome-sequencing of the isolate showed that resistance was <jats:italic>vanD<\/jats:italic>-mediated and core genome multilocus sequence typing showed it was a rare type: ST17\/CT154. To determine the prevalence of <jats:italic>vanA\/B\/C\/D<\/jats:italic>-carrying enterococci, we designed a real-time PCR for <jats:italic>vanC1\/2\/3<\/jats:italic> and <jats:italic>vanD<\/jats:italic> and screened rectal swabs from 360 patients. <jats:italic>vanD<\/jats:italic> was found in 27.8% of the patients, yet culture demonstrated only <jats:italic>E<\/jats:italic>. <jats:italic>faecium<\/jats:italic> from <jats:italic>vanA<\/jats:italic>-positive broths and <jats:italic>E<\/jats:italic>. <jats:italic>gallinarum<\/jats:italic> from <jats:italic>vanC1<\/jats:italic>-positive broths. No <jats:italic>vanD<\/jats:italic>-positive VRE were found, limiting the possibility of nosocomial spread of this VRE. Moreover, the high prevalence of non-VRE <jats:italic>vanD<\/jats:italic> in rectal swabs makes it unfeasible to include the <jats:italic>vanD<\/jats:italic> PCR in our VRE screening. However, having validated the <jats:italic>vanC1\/2\/3<\/jats:italic> and <jats:italic>vanD<\/jats:italic> PCRs allows us to rapidly check future <jats:italic>vanA\/B<\/jats:italic>-negative VRE for the presence of <jats:italic>vanC<\/jats:italic> and <jats:italic>vanD<\/jats:italic> genes.<\/jats:p>","DOI":"10.1038\/s41598-019-42824-4","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T00:21:22Z","timestamp":1557188482000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Appearance of vanD-positive Enterococcus faecium in a tertiary hospital in the Netherlands: prevalence of vanC and vanD in hospitalized patients"],"prefix":"10.1038","volume":"9","author":[{"given":"Jacky","family":"Flipse","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian J. 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