TY - JOUR
T1 - Early identification of the nosocomial spread of vancomycin-resistant Enterococcus faecium by Fourier-transform infrared spectroscopy and performance comparison with PFGE and WGS
AU - Pitart, Cristina
AU - Piquet, Maria
AU - Burgwinkel, Tessa
AU - Arazo Del Pino, Rocío
AU - Rubio Bueno, Marc
AU - Aguilar, Mireia
AU - De Gea, Sergi
AU - Pulgarín, Andrea
AU - Campo, Irene
AU - Torralbo, Blanca
AU - Parejo, Romina
AU - Valls, Silvia
AU - Fortes, Isabel
AU - Santana, Gemina
AU - Rubio, Elisa
AU - Vilella, Anna
AU - Del Río, Ana
AU - Martínez, José Antonio
AU - Miró, Elisenda
AU - Navarro, Ferran
AU - Espasa, Mateu
AU - Casals-Pascual, Climent
AU - Vila Estapé, Jordi
AU - Higgins, Paul G.
AU - Roca, Ignasi
N1 - Publisher Copyright:
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group, on behalf of Shanghai Shangyixun Cultural Communication Co., Ltd.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - Fourier-transform infrared spectroscopy
KW - Vancomycin-resistance
KW - epidemiology
KW - outbreak
KW - strain typing
KW - Humans
KW - Gram-Positive Bacterial Infections/microbiology
KW - Vancomycin-Resistant Enterococci/genetics
KW - Anti-Bacterial Agents/pharmacology
KW - Cross Infection/microbiology
KW - Electrophoresis, Gel, Pulsed-Field
KW - Microbial Sensitivity Tests
KW - Spectroscopy, Fourier Transform Infrared/methods
KW - Carbon-Oxygen Ligases/genetics
KW - Bacterial Proteins/genetics
KW - Disease Outbreaks
KW - Whole Genome Sequencing/methods
KW - Enterococcus faecium/genetics
KW - Spain/epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85202087833&partnerID=8YFLogxK
U2 - 10.1080/22221751.2024.2392659
DO - 10.1080/22221751.2024.2392659
M3 - Article
C2 - 39137261
SN - 2222-1751
VL - 13
JO - Emerging Microbes and Infections
JF - Emerging Microbes and Infections
IS - 1
M1 - 2392659
ER -