Molecular Epidemiology of Enterococcus faecium Bacteraemia in a NSW Hospital

Project Summary

Previous studies have indicated sequential clonal expansion of Enterococcus faecium clones that begin as vancomycin -susceptible and then acquire VanB resistance de novo before onwards transmission. De novo generation of VanB VRE appears to occur readily although the causative factors are poorly understood.

In a NSW hospital with a long history of effective antimicrobial stewardship, particularly regarding the use of third generation cephalosporins VRE bacteraemia rates remained low until 2011. Following 2011 there was a significant increase in the rates of VanB E. faecium cases per annum. Worryingly VanA E. faecium isolates have also been increasingly detected and have caused a number of bloodstream infections. Interestingly,  several other NSW hospitals have also seen an increase in VanB E. faecium-mediated bloodstream infections since 2010, despite the rate of vancomycin-susceptible E. faecium- mediated bloodstream infections remaining largely unchanged over the same time period.

This project will use whole genome sequencing to examine the molecular epidemiology of VSE and VRE isolates associated bloodstream infections at this NSW hospital.

Project Partner

Austin Hospital

Project Team

Prof Paul Johnson

Dr John Ferguson

Dr Glen Carter

A/Prof Torsten Seemann

A/Prof Tim Stinear