Abstract
We describe clonal shifts in vanA Enterococcus faecium isolates from clinical samples obtained from patients in Denmark from 2015 to the first quarter (Q1) of 2019. During Q1 2019, the vancomycin-variable enterococci (VVE) ST1421-CT1134 vanA E. faecium became the most dominant vanA E. faecium clone and has spread to all five regions in Denmark. Among 174 E. faecium isolates with vanA, vanB or vanA/vanB genes in Q1 2019, 44% belonged to this type.
Highlights
We describe clonal shifts in vanA Enterococcus faecium isolates from clinical samples obtained from patients in Denmark from 2015 to the first quarter (Q1) of 2019
We describe the clonal shift for vanA Enterococcus faecium during the last 4 years and the national spread of a vancomycin-variable vanA E. faecium ST1421-CT1134 clone in Denmark
This study shows that predominating clones shifted over time and, importantly, the emergence of a vancomycinvariable clone, ST1421-CT1134 vanA E. faecium, that has spread to all the five Danish regions in 2019
Summary
Surveillance of vancomycin-resistant enterococci reveals shift in dominating clones and national spread of a vancomycin-variable vanA Enterococcus faecium ST1421-CT1134 clone, Denmark, 2015 to March 2019. During Q1 2019, the vancomycin-variable enterococci (VVE) ST1421-CT1134 vanA E. faecium became the most dominant vanA E. faecium clone and has spread to all five regions in Denmark. Different clones of VVE have caused nosocomial outbreaks and development of vancomycin-resistant revertant mutants in vitro and in vivo has been described [1,3,4,5] This makes the detection of VVE highly important in clinical samples in order to assure relevant antibiotic treatment and in screening samples to avoid nosocomial spread. In ST1421-CT1134 isolates resistant to vancomycin, resistance could be attributed to changes in ddl disrupting
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