Genomics of vancomycin-resistant Enterococcus faecium

Abstract

Vancomycin-resistant Enterococcus faecium (VREfm) is a globally significant public health threat and was listed on the World Health Organization's 2017 list of high-priority pathogens for which new treatments are urgently needed. Treatment options for invasive VREfm infections are very limited, and outcomes are often poor. Whole-genome sequencing is providing important new insights into VREfm evolution, drug resistance and hospital adaptation, and is increasingly being used to track VREfm transmission within hospitals to detect outbreaks and inform infection control practices. This mini-review provides an overview of recent data on the use of genomics to understand and respond to the global problem of VREfm.

Keywords: Enterococcus faecium; antibiotic resistance; whole-genome sequencing.

Fig. 1.

Rates of invasive VREfm worldwide. Map adapted from The Centre for Disease Dynamics, Economics and Policy (CCDEP), Resistance Map: Antibiotic Resistance, accessed 11 January 2019, at https://resistancemap.cddep.org/AntibioticResistance.php. Data include aggregated resistance rates for isolates (includes intermediate resistance) from blood and cerebrospinal fluid (i.e. invasive) from inpatients of all ages. Because of differences in the scope of collections and testing methods, caution should be exercised in comparing across countries.