Genomic analysis of inter-hospital transmission of vancomycin-resistant Enterococcus faecium sequence type 80 isolated during an outbreak in Hiroshima, Japan.

Autor:	Segawa T; Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan., Masuda K; Hiroshima Prefectural Center for Disease Control and Prevention, Hiroshima, Japan.; Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan., Hisatsune J; Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan.; Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan.; Department of Antimicrobial Resistance, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan., Ishida-Kuroki K; Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan., Sugawara Y; Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan., Kuwabara M; Hiroshima Prefectural Center for Disease Control and Prevention, Hiroshima, Japan., Nishikawa H; Hiroshima Prefectural Center for Disease Control and Prevention, Hiroshima, Japan., Hiratsuka T; Hiroshima Prefectural Technology Research Institute, Public Health and Environment Center, Hiroshima, Japan., Aota T; Hiroshima City Institute of Public Health, Hiroshima, Japan., Tao Y; Hiroshima City Public Health Center, Hiroshima, Japan., Iwahashi Y; Hiroshima City Public Health Center, Hiroshima, Japan., Ueda K; Hiroshima City Public Health Center, Hiroshima, Japan., Mae K; Hiroshima City Medical Association Clinical Laboratory, Hiroshima, Japan., Masumoto K; Hiroshima City Medical Association Clinical Laboratory, Hiroshima, Japan., Kitagawa H; Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan.; Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan., Komatsuzawa H; Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan.; Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan., Ohge H; Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan.; Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan., Sugai M; Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan.; Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan.; Department of Antimicrobial Resistance, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan.
Jazyk:	angličtina
Zdroj:	Antimicrobial agents and chemotherapy [Antimicrob Agents Chemother] 2024 May 02; Vol. 68 (5), pp. e0171623. Date of Electronic Publication: 2024 Mar 20.
DOI:	10.1128/aac.01716-23
Abstrakt:	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 Enterococcus faecium sequence type (ST) 80 carrying the vanA plasmid, which was derived from strain A10290 isolated in India. Of the 103 isolates, 93 were E. faecium ST80 transmitted across hospitals. The circular vanA plasmid of the Hiroshima isolates was similar to the vanA plasmid of strain A10290 and transferred from E. faecium ST80 to other STs of E. faecium and other Enterococcus 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. Competing Interests: The authors declare no conflict of interest.
Databáze:	MEDLINE
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