{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T02:54:38Z","timestamp":1788836078073,"version":"build-2803163510"},"reference-count":44,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"crossref","award":["22fk0108604j0002"],"award-info":[{"award-number":["22fk0108604j0002"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Health and Labor Sciences Research Grant","award":["21KA1004"],"award-info":[{"award-number":["21KA1004"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2024,5,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Outbreaks caused by vancomycin-resistant enterococci that transcend jurisdictional boundaries are occurring worldwide. This study focused on a vancomycin-resistant enterococcus outbreak that occurred between 2018 and 2021 across two cities in Hiroshima, Japan. The study involved genetic and phylogenetic analyses using whole-genome sequencing of 103 isolates of vancomycin-resistant enterococci to identify the source and transmission routes of the outbreak. Phylogenetic analysis was performed using core genome multilocus sequence typing and core single-nucleotide polymorphisms; infection routes between hospitals were inferred using BadTrIP. The outbreak was caused by\n                      <jats:italic>Enterococcus faecium<\/jats:italic>\n                      sequence type (ST) 80 carrying the\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmid, which was derived from strain A10290 isolated in India. Of the 103 isolates, 93 were\n                      <jats:italic>E. faecium<\/jats:italic>\n                      ST80 transmitted across hospitals. The circular\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmid of the Hiroshima isolates was similar to the\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmid of strain A10290 and transferred from\n                      <jats:italic>E. faecium<\/jats:italic>\n                      ST80 to other STs of\n                      <jats:italic>E. faecium<\/jats:italic>\n                      and other\n                      <jats:italic>Enterococcus<\/jats:italic>\n                      species by conjugation. The inferred transmission routes across hospitals suggest the existence of a central hospital serving as a hub, propagating vancomycin-resistant enterococci to multiple hospitals. Our study highlights the importance of early intervention at the key central hospital to prevent the spread of the infection to small medical facilities, such as nursing homes, with limited medical resources and a high number of vulnerable individuals.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01716-23","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T09:04:35Z","timestamp":1710925475000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":17,"title":["Genomic analysis of inter-hospital transmission of vancomycin-resistant\n                    <i>Enterococcus faecium<\/i>\n                    sequence type 80 isolated during an outbreak in Hiroshima, Japan"],"prefix":"10.1128","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0248-7690","authenticated-orcid":true,"given":"Takaya","family":"Segawa","sequence":"first","affiliation":[{"name":"Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3164-7163","authenticated-orcid":false,"given":"Kanako","family":"Masuda","sequence":"additional","affiliation":[{"name":"Hiroshima Prefectural Center for Disease Control and Prevention, Hiroshima, Japan"},{"name":"Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9330-4203","authenticated-orcid":true,"given":"Junzo","family":"Hisatsune","sequence":"additional","affiliation":[{"name":"Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan"},{"name":"Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan"},{"name":"Department of Antimicrobial Resistance, Hiroshima University Graduate School of Biomedical &amp; 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