{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:56:45Z","timestamp":1787702205090,"version":"build-2784847793"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T00:00:00Z","timestamp":1636329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Irish Health Research Board","award":["ILP-POR-2019-010"],"award-info":[{"award-number":["ILP-POR-2019-010"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vancomycin-resistant Enterococcus faecium (VREfm) cause a wide range of hospital infections. Ireland has had one of the highest invasive VREfm infection rates in Europe over the last decade, yet little is known about Irish VREfm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the population structure of Irish VREfm, explore diversity by analysing the vanA transposon region and compare Irish, Danish and global isolates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>E. faecium (n\u200a=\u200a648) from five Irish hospitals were investigated, including VREfm [547 rectal screening and 53 bloodstream infection (BSI)] isolates and 48 vancomycin-susceptible (VSEfm) BSI isolates recovered between June 2017 and December 2019. WGS and core-genome MLST (cgMLST) were used to assess population structure. Genetic environments surrounding vanA were resolved by hybrid assembly of short-read (Illumina) and long-read (Oxford Nanopore Technologies) sequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All isolates belonged to hospital-adapted clade A1 and the majority (435\/648) belonged to MLST ST80. The population structure was highly polyclonal; cgMLST segregated 603\/648 isolates into 51 clusters containing mixtures of screening and BSI isolates, isolates from different hospitals, and VREfm and VSEfm. Isolates within clusters were closely related (mean average \u226416 allelic differences). The majority (96.5%) of VREfm harboured highly similar vanA regions located on circular or linear plasmids with multiple IS1216E insertions, variable organization of vanA operon genes and 78.6% harboured a truncated tnpA transposase. Comparison of 648 Irish isolates with 846 global E. faecium from 30 countries using cgMLST revealed little overlap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Irish VREfm are polyclonal, yet harbour a characteristic plasmid-located vanA region with multiple IS1216E insertions that may facilitate spread.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkab393","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T15:26:50Z","timestamp":1633706810000},"page":"320-330","source":"Crossref","is-referenced-by-count":62,"title":["Genomic analysis of 600 vancomycin-resistant\n                    <i>Enterococcus faecium<\/i>\n                    reveals a high prevalence of ST80 and spread of similar\n                    <i>vanA<\/i>\n                    regions via IS\n                    <i>1216E<\/i>\n                    and plasmid transfer in diverse genetic lineages in Ireland"],"prefix":"10.1093","volume":"77","author":[{"given":"Sarah A.","family":"Egan","sequence":"first","affiliation":[{"name":"Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College, Lincoln Place, Dublin 2, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole L.","family":"Kavanagh","sequence":"additional","affiliation":[{"name":"Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College, Lincoln Place, Dublin 2, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna C.","family":"Shore","sequence":"additional","affiliation":[{"name":"Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College, Lincoln Place, Dublin 2, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Mollerup","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hvidovre University Hospital, Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 A.","family":"Samaniego Castruita","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hvidovre University Hospital, Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"O\u2019Connell","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, School of Medicine, University of Dublin, Trinity College Dublin, St. James\u2019s Hospital, Dublin 8, Ireland"},{"name":"National MRSA Reference Laboratory, St. James\u2019s Hospital, James\u2019s Street, Dublin 8, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3969-054X","authenticated-orcid":false,"given":"Brenda A.","family":"McManus","sequence":"additional","affiliation":[{"name":"Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College, Lincoln Place, Dublin 2, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grainne I.","family":"Brennan","sequence":"additional","affiliation":[{"name":"National MRSA Reference Laboratory, St. James\u2019s Hospital, James\u2019s Street, Dublin 8, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Pinholt","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hvidovre University Hospital, Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Westh","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Hvidovre University Hospital, Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1797-2888","authenticated-orcid":false,"given":"David C.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College, Lincoln Place, Dublin 2, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,8]]},"reference":[{"key":"2022021008034495500_dkab393-B1","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1038\/nrmicro2761","article-title":"The rise of the Enterococcus: beyond vancomycin 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