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Vancomycin resistance can be plasmid encoded; however, as the analysis of plasmids is challenging, so far only a few reports have provided a detailed characterization of plasmids in nosocomial VREfm transmission. Here we describe a nosocomial VREfm outbreak caused by a\n                      <jats:italic>vanA<\/jats:italic>\n                      positive ST80 isolate.\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmid sequence data was used to distinguish outbreak-associated isolates from sporadic VREfm cases and to investigate the spread of this plasmid within the local VREfm population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      446 VREfm isolates were collected from routine surveillance between 01\/2022 and 02\/2024 and analyzed using long-read whole genome sequencing (lrWGS). Genetic relatedness of isolates was evaluated based on core genome multilocus sequence typing (cgMLST). Genetically similar\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmids were identified using a Mash based approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      30 genetically similar VREfm isolates were identified in patients\u2019 screening and environmental samples. Infection control evaluation confirmed transmission through shared hospital rooms. All outbreak-related VREfm isolates, including environmental samples, carried a highly similar\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmid (Mash distance of\u2009&lt;\u20090.001) with an identical replicon type. After enhanced infection control measures were established, no new transmissions were detected. Comparison with additional VREfm isolates from the respective department showed no evidence for further plasmid transmission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our study illustrates how\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmid analysis can support the evaluation of VREfm transmission in hospitals. The outbreak-associated\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmids were genetically highly similar, but could be clearly distinguished from other\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmids in the local hospital population. Taken together, detailed analysis of hospital-associated\n                      <jats:italic>vanA<\/jats:italic>\n                      plasmids can improve our understanding of VREfm transmission and epidemiology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-025-04058-5","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T23:19:35Z","timestamp":1748387975000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Characterization of vanA-harboring plasmids supports differentiation of outbreak-related and sporadic vancomycin-resistant Enterococcus faecium isolates in a tertiary care hospital"],"prefix":"10.1186","volume":"25","author":[{"given":"A.","family":"Sobkowiak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Scherff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"van Almsick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Schuler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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Am J Infect Control. 2024;52:801\u20136. https:\/\/doi.org\/10.1016\/j.ajic.2024.02.013.","journal-title":"Am J Infect Control"}],"container-title":["BMC Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-025-04058-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12866-025-04058-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-025-04058-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T23:19:39Z","timestamp":1748387979000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmicrobiol.biomedcentral.com\/articles\/10.1186\/s12866-025-04058-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4058"],"URL":"https:\/\/doi.org\/10.1186\/s12866-025-04058-5","relation":{},"ISSN":["1471-2180"],"issn-type":[{"value":"1471-2180","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,28]]},"assertion":[{"value":"25 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This investigation was part of routine surveillance carried out in accordance with the national guidelines of the Robert Koch-Institute, Germany [\n                      \n                      ] No additional patient data or material were collected. No ethics approval or informed consent was necessary according to national guidelines [\n                      \n                      ] and the German Protection against Infection Act (Infektionsschutzgesetz, IfSG) \u00a723. As the investigation was no clinical trial, no trial registration number is necessary.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Similar to the ethics approval and consent to participate, no formal consent was required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"NS is a part-time employee of Ridom GmbH (M\u00fcnster, Germany), which developed the software SeqSphere\u2009+\u2009. All other authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"337"}}