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Review
. 2022 Jun;130(6):323-329.
doi: 10.1111/apm.13216. Epub 2022 Mar 31.

The use of core genome multilocus sequence typing to determine the duration of vancomycin-resistant Enterococcus faecium outbreaks

Maja Johanne Søndergaard Knudsen  1 , Ingrid Maria Cecilia Rubin  1   2 , Katrine Gisselø  1 , Sarah Mollerup  1 , Andreas Munk Petersen  1   2   3 , Mette Pinholt  1 , Henrik Westh  1   3 , Mette Damkjaer Bartels  1   3
Affiliations
Review

The use of core genome multilocus sequence typing to determine the duration of vancomycin-resistant Enterococcus faecium outbreaks

Maja Johanne Søndergaard Knudsen et al. APMIS. 2022 Jun.

Abstract

The prevalence of vancomycin-resistant Enterococcus faecium has increased rapidly, and in Denmark, we are facing an endemic outbreak situation in hospitals. The aim of this study was to use whole-genome sequencing (WGS) and core genome multilocus sequencing typing (cgMLST) to determine the duration of VREfm outbreaks and thereby evaluate the effect of our infection control strategies. We included all VREfm isolates from six hospitals in the Capital Region of Denmark that were sequenced between 2012 and 2020. Ward data were collected from our laboratory information system. A ward outbreak was defined as two patient samples from the same ward within a period of 30 days belonging to the same cgMLST cluster. cgMLST complex types were determined using Ridom SeqSphere v7.2.3, where a maximum of 20 allelic differences between isolates defines a cluster. We included 1690 patient isolates between 2012 and 2020. Our collection consisted of 45 unique clusters and 227 ward outbreaks. The median duration of outbreaks was 20 days. We reported a median outbreak duration of VREfm outbreaks based on WGS data to be 20 days, and thus concluded that our infection control precautions are adequate.

Keywords: VRE; WGS; cgMLST; clinical microbiology; infection control; outbreak duration.

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References

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