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SDG 3: Antimicrobial resistance

Abstract

Introduction

Vancomycin-resistant (VREfm) isolates of sequence type (ST)1299 were described recently in south-eastern German hospitals and rapidly expanded from local to cross-border level.

Aim

We describe the spread of the novel VREfm strain ST1299/vanA on a genetic, geographical and temporal level during the first 5 years after its detection.

Methods

At University Hospital Regensburg (UHoR), routine VREfm surveillance is whole genome sequencing-based (≥ 1 VREfm per -genotype, patient and year). In this observational cohort study, we analysed one VREfm ST1299 isolate from our database (2016–2022) per patient and year. Isolates were added from the Hospital of the Merciful Brothers Regensburg (MBR), the National Reference Centre for Staphylococci and Enterococci (NRC), and clinical isolates from Austria.

Results

We identified 635 VREfm ST1299 isolates (100% ), including 504 from Regensburg, and 113 blood cultures. ST1299 isolates were first detected in 2018 simultaneously in Regensburg (n = 2) and southern Bavaria (n = 2), with local (UHoR) and regional numbers increasing rapidly from 2020, shifting to national scale in the same year. Genome data, analysed by cgMLST, showed a predominance of ST1299/CT1903 (315/504 isolates, 62.5%) and ST1299/CT3109 (127/504 isolates, 25.2%) isolates from Regensburg. By 2021, ST1299/CT1903 reached Upper Austria causing hospital outbreaks (n = 5). Phylogeny analysis suggests common ancestors with VREfm ST80, ST18 and ST17.

Conclusion

Since their emergence in 2018, two highly transmissible subtypes of ST1299/ reached national, then cross-border scale. The observed outbreak tendency may explain the rapid and successful spread and the high clonality in our collection.

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Spread of the novel vancomycin-resistant Enterococcus faecium strain ST1299/vanA from local level in Germany to cross-border level in Austria, 2018 to 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Anca+Rath&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rath Anca</a>, <a href="/search?value1=B%C3%A4rbel+Kieninger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kieninger Bärbel</a>, <a href="/search?value1=Nilufarbayim+Mirzaliyeva&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mirzaliyeva Nilufarbayim</a>, <a href="/search?value1=Guido+Werner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Werner Guido</a>, <a href="/search?value1=Jennifer+K+Bender&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bender Jennifer K</a>, <a href="/search?value1=Martin+A+Fischer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fischer Martin A</a>, <a href="/search?value1=Adriana+Cabal-Rosel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cabal-Rosel Adriana</a>, <a href="/search?value1=Werner+Ruppitsch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ruppitsch Werner</a>, <a href="/search?value1=Helena+MB+Seth-Smith&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Seth-Smith Helena MB</a>, <a href="/search?value1=Adrian+Egli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Egli Adrian</a>, <a href="/search?value1=Milo+Halabi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Halabi Milo</a>, <a href="/search?value1=Anna+H%C3%B6rtenhuber&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hörtenhuber Anna</a>, <a href="/search?value1=Yarub+Salaheddin&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Salaheddin Yarub</a>, <a href="/search?value1=Wolfgang+Prammer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Prammer Wolfgang</a>, <a href="/search?value1=Heidrun+Kerschner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kerschner Heidrun</a>, <a href="/search?value1=Rainer+Hartl&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hartl Rainer</a>, <a href="/search?value1=Martin+Ehrenschwender&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ehrenschwender Martin</a>, <a href="/search?value1=Andreas+Ambrosch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ambrosch Andreas</a>, <a href="/search?value1=J%C3%B6rn+Kalinowski&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kalinowski Jörn</a>, <a href="/search?value1=Levin+Joe+Klages&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Klages Levin Joe</a>, <a href="/search?value1=Christian+R%C3%BCckert-Reed&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rückert-Reed Christian</a>, <a href="/search?value1=Tobias+Busche&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Busche Tobias</a>, <a href="/search?value1=Alexander+Kratzer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kratzer Alexander</a>, <a href="/search?value1=Aila+Caplunik-Pratsch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Caplunik-Pratsch Aila</a>, <a href="/search?value1=Anja+Eichner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Eichner Anja</a>, <a href="/search?value1=J%C3%BCrgen+Fritsch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fritsch Jürgen</a>, <a href="/search?value1=Wulf+Schneider-Brachert&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schneider-Brachert Wulf</a></span>. Spread of the novel vancomycin-resistant Enterococcus faecium strain ST1299/vanA from local level in Germany to cross-border level in Austria, 2018 to 2022. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(20):pii=2400389. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.20.2400389" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.20.2400389</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 17 Jun 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 18 Nov 2024 </span> </p>
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