{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T12:47:32Z","timestamp":1793364452889,"version":"4.5.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:p>\n                    A notable increase in the incidence of vancomycin-resistant\n                    <jats:italic toggle=\"yes\">Enterococcus faecium<\/jats:italic>\n                    (VREfm) was observed at a hospital in Guangzhou, China, during 2022\u20132023. We conducted a retrospective cross-sectional study from January 1, 2022, to August 31, 2023, to investigate the clinical and genomic characteristics of VREfm. Clinical data were extracted from electronic medical records, and infection control measures were reviewed from the relevant department. VREfm confirmation was performed using antimicrobial susceptibility testing. Genomic characteristics were analyzed via the whole-genome sequencing. The prevalence of VREfm among\n                    <jats:italic toggle=\"yes\">E. faecium<\/jats:italic>\n                    isolates rose significantly from 13.3% (10\/75) in 2022 to 26.4% (40\/151) by August 2023 (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001). Concurrently, usage of third-generation cephalosporins increased by 8.4% (22.47 to 24.36 defined daily doses per 100 patient days), carbapenems by 34% (51.47\u201368.97), and vancomycin by 18% (21.15\u201324.97) (all\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2264 0.001). Molecular analysis revealed ST80\/CC17 (78%, 39\/50) as the dominant clone, carrying\n                    <jats:italic toggle=\"yes\">vanA<\/jats:italic>\n                    and virulence genes (\n                    <jats:italic toggle=\"yes\">scm<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">acm,<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">fss3<\/jats:italic>\n                    ), suggesting clonal expansion of a lineage rarely reported in Guangzhou. Our study documented an outbreak of ST80\/CC17\n                    <jats:italic toggle=\"yes\">vanA<\/jats:italic>\n                    -positive VREfm, characterized by virulence genes (\n                    <jats:italic toggle=\"yes\">scm<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">acm,<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">fss3<\/jats:italic>\n                    ) and clonal dominance (78%, 39\/50). The temporal association between reduced sodium hypochlorite disinfection (2.7-fold decline,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.002), increased antibiotic selective pressure, and pathogen transmission highlights multifactorial drivers of this epidemic. These findings underscore the complex multifactorial nature of pathogen transmission, including the role of antibiotic use, infection control measures, and environmental factors in the spread of multidrug-resistant clones. Strengthened infection control strategies\u2014integrating targeted disinfection, antibiotic stewardship, and genomic surveillance\u2014are imperative to curb the spread of such multidrug-resistant clones.\n                  <\/jats:p>","DOI":"10.1177\/10766294251361345","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T17:09:57Z","timestamp":1759943397000},"page":"269-278","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["An Outbreak of ST80 Vancomycin-Resistant\n                    <i>Enterococcus faecium<\/i>\n                    in a Hospital in Guangzhou, China: Clinical and Genomic Epidemiology Study from 2022 to 2023"],"prefix":"10.1177","volume":"31","author":[{"given":"Yawen","family":"Deng","sequence":"first","affiliation":[{"name":"Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Xie","sequence":"additional","affiliation":[{"name":"The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baiji","family":"Chen","sequence":"additional","affiliation":[{"name":"Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaoni","family":"Lan","sequence":"additional","affiliation":[{"name":"School of Medical Technology, Guangdong Medical University, Dongguan, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Luan","sequence":"additional","affiliation":[{"name":"Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanhua","family":"Rao","sequence":"additional","affiliation":[{"name":"Genskey Medical Technology Co., Ltd, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Han","sequence":"additional","affiliation":[{"name":"Genskey Medical Technology Co., Ltd, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaohui","family":"Duan","sequence":"additional","affiliation":[{"name":"Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"issue":"4","key":"e_1_3_6_2_2","first-page":"mgen001008","article-title":"Taking hospital pathogen surveillance to the next level","volume":"9","author":"Werner G","year":"2023","unstructured":"Werner G, , Couto N, , Feil EJ, et al. Taking hospital pathogen surveillance to the next level. Microb Genom., 2023; 9(4):mgen001008; doi: 10.1099\/mgen.0.001008","journal-title":"Microb Genom."},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2024.107412"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2024.2361030"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01716-23"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-6-130"},{"key":"e_1_3_6_7_2","volume-title":"Guidelines for the Prevention and Control of Carbapenem-resistant Enterobacteriaceae, Acinetobacter Baumannii and Pseudomonas Aeruginosa in Health Care Facilities","author":"World Health Organization","year":"2017","unstructured":"World Health Organization. Guidelines for the Prevention and Control of Carbapenem-resistant Enterobacteriaceae, Acinetobacter Baumannii and Pseudomonas Aeruginosa in Health Care Facilities. 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