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In this study, we describe epidemiological relatedness of vancomycin-resistant\n                    <jats:italic>Enterococcus faecium<\/jats:italic>\n                    isolated during an outbreak at a Norwegian hospital in 2012\u20132013. During the outbreak, 9454 fecal samples were screened for VRE by culture and\/or PCR. Isolates from 86 patients carrying the\n                    <jats:italic>vanA<\/jats:italic>\n                    resistance gene were characterized using pulsed-field gel electrophoresis (PFGE), MALDI-TOF mass spectrometry and single nucleotide polymorphism typing. PFGE revealed two main clusters, the first comprised 56 isolates related to an initial outbreak strain, and the second comprised 21 isolates originating from a later introduced strain, together causing two partly overlapping outbreaks. Nine isolates, including the index case were not related to the two outbreak clusters. In conclusion, the epidemiological analyses show that the outbreak was discovered by coincidence, and that infection control measures were successful. All typing methods identified the two outbreak clusters, and the experiment congruence between the MALDI-TOF and the PFGE clustering was 63.2%, with a strong correlation (r\u2009=\u200972.4%). Despite lower resolution compared to PFGE, MALDI-TOF may provide an efficient mean for real-time monitoring spread of infection.\n                  <\/jats:p>","DOI":"10.1038\/s41598-019-48436-2","type":"journal-article","created":{"date-parts":[[2019,8,15]],"date-time":"2019-08-15T06:02:31Z","timestamp":1565848951000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Molecular analysis and epidemiological typing of Vancomycin-resistant Enterococcus outbreak strains"],"prefix":"10.1038","volume":"9","author":[{"given":"Anbj\u00f8rg","family":"Rangberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astri Lervik","family":"Larsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Kacelnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne Skarpodde","family":"S\u00e6ther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marthe","family":"Bj\u00f8rland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jetmund","family":"Ringstad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine Monceyron","family":"Jonassen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,8,15]]},"reference":[{"key":"48436_CR1","doi-asserted-by":"publisher","first-page":"1749","DOI":"10.1099\/mic.0.026385-0","volume":"155","author":"K Fisher","year":"2009","unstructured":"Fisher, K. & Phillips, C. 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