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Emergence of vancomycin-resistant Enterococcus faecium vanA ST612 with reduced daptomycin susceptibility, Switzerland, 2018 to 2024
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Danielle Vuichard-Gysin1,2,*
,
Andrea C Büchler1,3,*
,
Dominique S Blanc3,4
,
Peter M Keller5
,
Pascal Schläpfer6
,
Andreas Kronenberg7
,
Vanja Piezzi8
,
Patrice Nordmann4,9
,
Laurence Senn1,3
,
Stephan Harbarth1,10
,
Sarah Tschudin-Sutter1,11
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View Affiliations Hide AffiliationsAffiliations: 1 Swiss National Centre for Infection Prevention, Swissnoso, Bern, Switzerland 2 Department of Infectious Diseases and Infection Prevention, Thurgau Hospital Group, Frauenfeld and Münsterlingen, Switzerland 3 Infection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland 4 National Reference Centre for Emerging Antibiotic Resistance (NARA), Fribourg, Switzerland 5 Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland 6 Laboratory Medicine, University Hospital Basel, Basel, Switzerland 7 Institute for Infectious Diseases, University of Bern, Bern, Switzerland 8 Federal Office of Public Health, Bern, Switzerland 9 Medical and Molecular Microbiology, University of Fribourg, Fribourg, Switzerland 10 Infection Control Programme, Geneva University Hospitals and Faculty of Medicine, WHO Collaborating Center, Geneva, Switzerland 11 Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland* These authors contributed equally to this work and share first authorship.Correspondence:Danielle Vuichard-Gysindanielle.vuichard-gysin swissnoso.ch
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Citation style for this article: Vuichard-Gysin Danielle, Büchler Andrea C, Blanc Dominique S, Keller Peter M, Schläpfer Pascal, Kronenberg Andreas, Piezzi Vanja, Nordmann Patrice, Senn Laurence, Harbarth Stephan, Tschudin-Sutter Sarah. Emergence of vancomycin-resistant Enterococcus faecium vanA ST612 with reduced daptomycin susceptibility, Switzerland, 2018 to 2024. Euro Surveill. 2025;30(45):pii=2500227. https://doi.org/10.2807/1560-7917.ES.2025.30.45.2500227 Received: 30 Mar 2025; Accepted: 17 Jul 2025
Abstract
We describe the emergence of vancomycin-resistant Enterococcus faecium (VREfm) vanA ST612 in Switzerland from 2018 to 2024 that resulted in a national outbreak investigation. This clone has predisposing genetic alterations associated with reduced daptomycin susceptibility. The National Nosocomial Outbreak Investigation Center was commissioned to assess the temporospatial distribution of this clone in Switzerland and evaluate its clinical impact. Core genome multi-locus sequence typing (cgMLST) revealed five separate VREfm vanA ST612 clusters of different sizes across different healthcare regions, but predominantly in the German-speaking part. The broad geographic dissemination and temporal variation in detection suggests multiple introductions to the healthcare system. One of these cgMLST clusters (n = 79 cases) with an infection rate of 12.8% was ongoing, mainly affecting patients with extensive contact to the Swiss healthcare system or prior antibiotic exposure. The detection of daptomycin non-susceptibility in patients without prior daptomycin exposure suggests ongoing E. faecium adaptation due to external pressures. Future prevention efforts should emphasise assessing barriers for active surveillance cultures, developing a national standard for cost-effective sequencing methods and promoting the sharing of sequencing results together with epidemiological metadata. Our report intends to raise awareness as this sequence type might already be spreading undetected in European countries.
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