Whole-genome sequencing reveals transmission of @entity2176 -resistant XXXX in a healthcare network.

@entity1 @entity2176 @entity3013 @entity281 @entity6375 @entity580 @entity204
BACKGROUND: Bacterial whole-genome sequencing (WGS) has the potential to identify reservoirs of multidrug-resistant organisms and transmission of these pathogens across healthcare networks. We used WGS to define transmission of @entity2176 -resistant enterococci (VRE) within a long-term care facility (LTCF), and between this and an acute hospital in the United Kingdom (UK). METHODS: A longitudinal prospective observational study of @entity3013 was conducted in a LTCF in Cambridge, UK. Stool samples were collected at recruitment, and then repeatedly until the end of the study period, discharge or @entity204 . Selective culture media were used to isolate VRE, which were subsequently sequenced and analysed. We also analysed the genomes of 45 @entity6375 bloodstream isolates collected at Cambridge University Hospitals NHS Foundation Trust (CUH). RESULTS: Forty-five residents were recruited during a 6-month period in 2014, and 693 stools were collected at a frequency of at least 1 week apart. Fifty-one stool samples from 3/45 @entity1 (7 %) were positive for @entity2176 -resistant @entity6375 . Two residents carried multiple VRE lineages, and one carried a single VRE lineage. Genome analyses based on single nucleotide polymorphisms (SNPs) in the core genome indicated that VRE carried by each of the three residents were unrelated. @entity1 had extensive contact with the local healthcare network. We found that VRE genomes from LTCF residents and @entity580 were interspersed throughout the phylogenetic tree, with several instances of closely related VRE strains from the two settings. CONCLUSIONS: A proportion of LTCF residents are long-term carriers of VRE. Evidence for genetic relatedness between these and VRE associated with @entity281 in a nearby acute NHS Trust indicate a shared bacterial population.
