Early identification of the nosocomial spread of vancomycin-resistant Enterococcus faecium by Fourier-transform infrared spectroscopy and performance comparison with PFGE and WGS
Pitart, Cristina (Hospital Clínic i Provincial de Barcelona)
Piquet, Maria (Hospital Clínic i Provincial de Barcelona)
Burgwinkel, Tessa (University of Cologne)
Arazo Del Pino, Rocío (University of Cologne)
Rubio, Marc (Institut de Recerca Sant Pau)
Aguilar, Mireia (Hospital Clínic i Provincial de Barcelona)
De Gea, Sergi (Hospital Clínic i Provincial de Barcelona)
Pulgarín, Andrea (Hospital Clínic i Provincial de Barcelona)
Campo, Irene (Hospital Clínic i Provincial de Barcelona)
Torralbo, Blanca (Hospital Clínic i Provincial de Barcelona)
Parejo, Romina (Hospital Clínic i Provincial de Barcelona)
Valls, Silvia (Hospital Clínic i Provincial de Barcelona)
Fortes, Isabel (Hospital Clínic i Provincial de Barcelona)
Santana, Gemina (Hospital Clínic i Provincial de Barcelona)
Rubio, Elisa (Hospital Clínic i Provincial de Barcelona)
Vilella, Anna (Hospital Clínic i Provincial de Barcelona)
Del Río, Ana (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Martínez, José Antonio (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Miró, Elisenda (Institut de Recerca Sant Pau)
Navarro Risueño, Ferran (Institut de Recerca Sant Pau)
Espasa, Mateu (Hospital Clínic i Provincial de Barcelona)
Casals-Pascual, Climent (Hospital Clínic i Provincial de Barcelona)
Vila Estapé, Jordi (Hospital Clínic i Provincial de Barcelona)
Higgins, Paul G. (University of Cologne)
Roca, Ignasi (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Early detection of disseminating vancomycin-resistant Enterococcus faecium (VREfm) in ICU wards is crucial for outbreak identification and the implementation of prompt infection control measures. Genotypic methods like pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS) are costly and time-consuming, hindering rapid response due to batch dependency. Fourier-transform infrared spectroscopy (FT-IR) offers the potential for real-time outbreak detection and reliable strain typing. We utilized FT-IR to identify clonal VREfm dissemination and compared its performance to PFGE and WGS. Between February through October 2023, an unusually high number of VREfm were recovered at a tertiary hospital in Barcelona. Isolates were examined for antimicrobial susceptibility, carriage of vanA/vanB genes and clonality was also studied using FT-IR, PFGE, and WGS. Routine FT-IR inspections revealed recurring VREfm clustering during the outbreak's initial weeks. In total, 104 isolates were recovered from 75 patients and from multiple wards. However, only one isolate was recovered from an environmental sample, suggesting the absence of environmental reservoirs. An ST80 vancomycin-resistant (vanA) E. faecium strain was the main strain responsible for the outbreak, although a few additional VREfm strains were also identified, all belonging to CC17. PFGE and cgMLST (WGS) yielded identical clustering results to FT-IR, and WGS confirmed vanA/vanB gene carriage in all VREfm isolates. Infection control measures led to a rapid decline in VREfm isolates, with no isolates detected in November. FT-IR spectroscopy offers rapid turnaround times, sensitivity, and reproducibility, comparable to standard typing methods. It proved as an effective tool for monitoring VREfm dissemination and early outbreak detection.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Epidemiology ; Fourier-transform infrared spectroscopy ; Outbreak ; Strain typing ; Vancomycin-resistance
Publicat a:	Emerging microbes & infections, Vol. 13 Núm. 1 (2024) , p. 2392659, ISSN 2222-1751

DOI: 10.1080/22221751.2024.2392659
PMID: 39137261

13 p, 2.0 MB

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