{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:52:15Z","timestamp":1785466335421,"version":"3.56.0"},"reference-count":14,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Bavarian State Ministry of Health and Care","award":["G54g-G8110.3-2018\/23-14"],"award-info":[{"award-number":["G54g-G8110.3-2018\/23-14"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2023,12,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Since 2019, we have observed a remarkable rise of vancomycin resistance among invasive strains of\n            <jats:italic>Enterococcus (E.) faecium<\/jats:italic>\n            at the University Hospital Erlangen (UKER), a tertiary-care hospital in Germany. Here, we analyzed the genetic diversity of\n            <jats:italic>E. faecium<\/jats:italic>\n            isolated from blood cultures of in-patients by core genome multilocus sequence typing to see whether the occurrence of vancomycin resistance was associated with the spread of new clonal lineages. Between January and December 2022, 37 consecutive non-duplicate isolates were included in this study. Resistance to vancomycin was detected in 15 isolates (40.5%). The affected patients had a median age of 65 years, and 26 of them (70.3%) were males. Patients with bloodstream infection caused by vancomycin-resistant\n            <jats:italic>E. faecium<\/jats:italic>\n            (VREfm) or vancomycin-susceptible\n            <jats:italic>E. faecium<\/jats:italic>\n            (VSEfm) showed a similar in-hospital mortality rate (33.3% vs 27.3%,\n            <jats:italic>P<\/jats:italic>\n            = 0.692), indicating that VREfm were not more virulent than VSEfm. In contrast, the genetic diversity was higher in VSEfm (15 clonal lineages) than in VREfm isolates (seven clonal lineages). The majority of VREfm isolates (73.2%) belonged to only three clonal lineages: ST117\/CT71\n            <jats:italic>vanB<\/jats:italic>\n            (\n            <jats:italic>n<\/jats:italic>\n            = 4), which is the most commonly detected vancomycin-resistant lineage in Germany, and two novel ST1299\n            <jats:italic>vanA<\/jats:italic>\n            lineages classified as CT3109 (\n            <jats:italic>n<\/jats:italic>\n            = 4) and CT1903 (\n            <jats:italic>n<\/jats:italic>\n            = 3). We conclude that the high rate of vancomycin resistance among invasive\n            <jats:italic>E. faecium<\/jats:italic>\n            isolates at UKER could be associated with the emergence of novel ST1299\n            <jats:italic>vanA<\/jats:italic>\n            lineages, which is likely to be relevant also for other hospitals and countries. Future studies will focus on the prevalence of ST1299\n            <jats:italic>vanA<\/jats:italic>\n            in the general population.\n          <\/jats:p>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>\n              The proportion of VREfm among all\n              <jats:italic>Enterococcus faecium<\/jats:italic>\n              isolated from blood cultures in German hospitals has increased in the period 2015\u20132020 from 11.9% to 22.3% with a country-wide spread of the clonal lineage ST117\/CT71\n              <jats:italic>vanB<\/jats:italic>\n              . In this study, we provided useful information about the genetic diversity of invasive strains of\n              <jats:italic>E. faecium<\/jats:italic>\n              . Moreover, our findings confirm the nosocomial spread of novel ST1299\n              <jats:italic>vanA<\/jats:italic>\n              lineages, which recently had a rapid expansion in Austria and the south-eastern part of Germany.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.02962-23","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T13:01:59Z","timestamp":1698757319000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":6,"title":["Emergence of novel ST1299\n            <i>vanA<\/i>\n            lineages as possible cause for the striking rise of vancomycin resistance among invasive strains of\n            <i>Enterococcus faecium<\/i>\n            at a German university hospital"],"prefix":"10.1128","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9342-4388","authenticated-orcid":false,"given":"Giuseppe","family":"Valenza","sequence":"first","affiliation":[{"name":"Mikrobiologisches Institut \u2013 Klinische Mikrobiologie, Immunologie und Hygiene, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t (FAU) Erlangen-N\u00fcrnberg , Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Eisenberger","sequence":"additional","affiliation":[{"name":"Bayerisches Landesamt f\u00fcr Gesundheit und Lebensmittelsicherheit , Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Voigtl\u00e4nder","sequence":"additional","affiliation":[{"name":"Bayerisches Landesamt f\u00fcr Gesundheit und Lebensmittelsicherheit , Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayya","family":"Alsalameh","sequence":"additional","affiliation":[{"name":"Mikrobiologisches Institut \u2013 Klinische Mikrobiologie, Immunologie und Hygiene, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t (FAU) Erlangen-N\u00fcrnberg , Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Gerlach","sequence":"additional","affiliation":[{"name":"Mikrobiologisches Institut \u2013 Klinische Mikrobiologie, Immunologie und Hygiene, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t (FAU) Erlangen-N\u00fcrnberg , Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Koch","sequence":"additional","affiliation":[{"name":"Apotheke des Universit\u00e4tsklinikums Erlangen , Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Kunz","sequence":"additional","affiliation":[{"name":"Mikrobiologisches Institut \u2013 Klinische Mikrobiologie, Immunologie und Hygiene, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t (FAU) Erlangen-N\u00fcrnberg , Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1130-9727","authenticated-orcid":true,"given":"J\u00fcrgen","family":"Held","sequence":"additional","affiliation":[{"name":"Mikrobiologisches Institut \u2013 Klinische Mikrobiologie, Immunologie und Hygiene, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t (FAU) Erlangen-N\u00fcrnberg , Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Bogdan","sequence":"additional","affiliation":[{"name":"Mikrobiologisches Institut \u2013 Klinische Mikrobiologie, Immunologie und Hygiene, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-Universit\u00e4t (FAU) Erlangen-N\u00fcrnberg , Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","unstructured":"WHO\/ECDC report: Antimicrobial resistance surveillance in Europe\n. 2022. Antimicrobial resistance surveillance in Europe 2022 - 2020 data (europa.eu)."},{"key":"e_1_3_4_3_2","volume-title":"30th European Congress of clinical Microbiology and infectious diseases, abstract book","author":"Neumann B","year":"2020","unstructured":"Neumann B , Kresken M , Werner G . 2020. Genome-based surveillance of clinical vancomycin-resistant Enterococcus faecium reveals increased prevalence of vanB-type isolates of St117\/Ct71 in German hospitals, 2010-2016, . In 30th European Congress of clinical Microbiology and infectious diseases, abstract book. Vol. 1735"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.25646\/8710"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2020.100732"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01946-15"},{"key":"e_1_3_4_7_2","unstructured":"Technical University of Denmark\n. ResFinder 4.1. Available from: https:\/\/cge.cbs.dtu.dk\/services\/ResFinder\/"},{"key":"e_1_3_4_8_2","unstructured":"Institute of Pathogen Biology CAMS & PUMC\n. Virulence factor database (VFDB). Available from: http:\/\/www.mgc.ac.cn\/VFs\/main.htm"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gky1080"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.12688\/wellcomeopenres.14826.1"},{"key":"e_1_3_4_11_2","volume-title":"33rd European Congress of Clinical Microbiology & Infectious Diseases (ECCMID)","author":"Rath A","year":"2023","unstructured":"Rath A , Kieninger B , Mirzaliyeva N , Werner G , Bender J , Fischer M , Cabal A , Ruppitsch W , Halabi M , H\u00f6rtenhuber A , Prammer W , Salaheddin Y , Kerscher H , Hartl R , Caplunik-Pratsch A , Eichner A , Fritsch J , Schneider-Brachert W . 2023. ST1299\/vanA is the new kid on the block! Analysis of the explosive regional expansion of a new strain of vancomycin-resistant Enterococcus faecium. Abstr. P0816. 33rd European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), Copenhagen, Denmark"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.13.4.686"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-018-0419-9"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2761"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa271"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.02962-23","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.02962-23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T13:19:27Z","timestamp":1702387167000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.02962-23"}},"subtitle":[],"editor":[{"given":"Cezar M.","family":"Khursigara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,12,12]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12,12]]}},"alternative-id":["10.1128\/spectrum.02962-23"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.02962-23","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,12]]},"assertion":[{"value":"2023-09-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e02962-23"}}