Eurosurveillance最新文献

{"title":"Use of healthcare services preceding HIV diagnosis - missed opportunities for earlier diagnosis, Finland, 1996 to 2019.","authors":"Sanna Isosomppi, Mikaela Mutru, Jukka Ollgren, Henrikki Brummer-Korvenkontio, Kirsi Liitsola, Jussi Sutinen, Inka Aho, Pia Kivelä","doi":"10.2807/1560-7917.ES.2025.30.18.2400610","DOIUrl":"https://doi.org/10.2807/1560-7917.ES.2025.30.18.2400610","url":null,"abstract":"<p><p>BackgroundHIV testing based on indicator conditions is recommended to diagnose HIV earlier.AimOur aim was to assess opportunities for earlier diagnosis of HIV.MethodThis is a retrospective study on people living with HIV (PLWH) included in the national HIV register. We collected data on public primary outpatient healthcare (PHC) (2011-2019), secondary and tertiary outpatient healthcare (STHC), and all inpatient care (1996-2019) from the Care Register for Health Care from the presumed acquisition, estimated by CD4+ T-cell count at diagnosis, until the diagnosis of HIV.ResultsOf 907 PLWH diagnosed between 2011 and 2019, 522 (58%) had ≥ 1 healthcare contact at any level between HIV acquisition and > 30 days before diagnosis. At least one European Centre for Disease Prevention and Control (ECDC) indicator condition was recorded for 119 (23% of 522), and 112 (21%) were born in a high-prevalence country. In total, 384 of 907 (42%) had visited a PHC physician, and 58% of those with CD4+ T-cell count < 200 cells/μL at diagnosis. Of 2,082 PLWH diagnosed between 1996 and 2019, 869 (42%) had STHC outpatient contacts > 30 days before diagnosis, 18% with ≥ 1 ECDC indicator condition, and 367 (18%) had been hospitalised, 20% with ≥ 1 ECDC indicator condition. The most common ECDC indicator conditions > 30 days before diagnosis at all levels of healthcare were pneumonia, sexually transmitted infections, unexplained fever, herpes zoster, pregnancy and lymphadenopathy.ConclusionWe recommend enhancing indicator condition-based HIV testing by all healthcare providers, particularly for gonorrhoea, syphilis and, for persons younger than 50 years, also herpes zoster and lymphadenopathy.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 18","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human infections with Eurasian avian-like swine influenza virus detected by coincidence via routine respiratory surveillance systems, the Netherlands, 2020 to 2023.","authors":"Dirk Eggink, Annelies Kroneman, Jozef Dingemans, Gabriel Goderski, Sharon van den Brink, Mariam Bagheri, Pascal Lexmond, Mark Pronk, Erhard van der Vries, Evelien Germeraad, Diederik Brandwagt, Manon Houben, Mariëtte van Hooiveld, Joke van der Giessen, Rianne van Gageldonk-Lafeber, Ron Fouchier, Adam Meijer","doi":"10.2807/1560-7917.ES.2025.30.19.2400662","DOIUrl":"10.2807/1560-7917.ES.2025.30.19.2400662","url":null,"abstract":"<p><p>BackgroundZoonotic influenza, including infections with avian and swine influenza A viruses (swIAV), is a notifiable disease in the Netherlands. Human cases infected with swIAV have previously been rarely detected in the Netherlands.AimWe aimed to describe detection and characterisation of Eurasian avian-like swIAV infections in humans in the Netherlands 2020-2023.MethodsThe Dutch National Influenza Center coordinates different activities to monitor respiratory infections and circulating human influenza viruses. This monitoring includes sentinel surveillance in general practitioner practices, community participatory surveillance and characterisation of influenza viruses received from diagnostic laboratories. A subset of the specimens positive for influenza A virus from the monitoring activities are sent for further characterisation. We characterised swIAV from human patients using whole genome sequencing, tested the viruses for antiviral susceptibility and in haemagglutination inhibition assays for antigenic characterisation and compared them with previous detections from humans and pigs.ResultsAvian-like swine influenza virus was detected in three persons presenting with mild respiratory symptoms, and all recovered fully. Only one patient had close contact with pigs shortly before the start of symptoms. Sequence analyses of the viruses showed clustering with swAIV from pigs in a recently initiated surveillance system on pig farms.ConclusionsThese human cases show that swIAV viruses with zoonotic potential are enzootic in the Netherlands. Finding them by coincidence suggests human infections might occur more frequently than noticed.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 19","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Klebsiella aerogenes</i> ST117 causing folliculitis in men having sex with men, Belgium, February 2025.","authors":"Nicolas Yin, Jonathan Krygier, Célestin Mairesse, Agnès Libois, Sophie Quoilin, Delphine Martiny","doi":"10.2807/1560-7917.ES.2025.30.20.2500304","DOIUrl":"10.2807/1560-7917.ES.2025.30.20.2500304","url":null,"abstract":"<p><p><i>Klebsiella aerogenes</i> has recently been reported as a causative agent of folliculitis in men who have sex with men (MSM). We present four cases of folliculitis in MSM diagnosed in Brussels, Belgium. Patients were aged between 25 and 50 years, and all were infected by a single multilocus sequence type (ST117) strain. This strain carried the yersiniabactin siderophore genes. Following a preliminary treatment by sulfamethoxazole-trimethoprim for 7-14 days, all patients experienced a recurrence of symptoms, necessitating an extended therapeutic regimen.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 20","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Absence of cross-reactivity of the cobas WNV assay with human pegiviruses.","authors":"Paula Saá, Ke Chen, Ellen Ordinario","doi":"10.2807/1560-7917.ES.2025.30.21.2500316","DOIUrl":"10.2807/1560-7917.ES.2025.30.21.2500316","url":null,"abstract":"","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 21","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute flaccid myelitis in Europe between 2016 and 2023: indicating the need for better registration.","authors":"Jelte Helfferich, Cristina Calvo, Ekkehardt Alpeter, Cristina Andrés, Andrés Antón, Melodie Aubart, Stefania Maria Bova, Maria Cabrerizo, Karin von Eije, Stollar Fabiola, Ana Felipe, Ralitsa Iordanova, Marianne Kragh Thomsen, Per Kristian Knudsen, Freek van Loenen, Noemi Lopez, Audrey Mirand, Richard Molenkamp, Sofie Midgley, Raquel Neves, Lubomira Nikolaeva Glomb, Joakim Øverbø, Gülten Öztürk, Paula Palminha, Helle Cecilie Viekilde Pfeiffer, Birgit Prochazka, Carlos Ribeiro, Martine Rodesch, Isabelle Schuffenecker, Jay Shetty, Sandy Siegert, Silje Lae Solberg, Artur Sulik, Dilşad Türkdoğan, Olcay Ünver, Jaco Verweij, Jorgina Vila, Tytti Vuorinen, Ronny Wickström, Thea K Fischer, Heli Harvala, Kimberley S M Benschop","doi":"10.2807/1560-7917.ES.2025.30.21.2400579","DOIUrl":"10.2807/1560-7917.ES.2025.30.21.2400579","url":null,"abstract":"<p><p>BackgroundAcute flaccid myelitis (AFM) is a rare polio-like condition affecting mainly children and characterised by severe, often persistent, weakness. It is one of several causes of acute flaccid paralysis (AFP), which manifests as acute onset of limb weakness and reduced muscle tone. Some non-polio enteroviruses (EV), such as EV-D68 may cause AFM. Little is known about AFM incidence in Europe.AimWe aimed to better understand AFM incidence, aetiology and current surveillance policies in Europe.MethodsIn 28 countries, members of the European non-polio enterovirus network (ENPEN) and a newly established AFM network of clinicians under ENPEN received a survey asking them how AFM surveillance was performed in their countries in 2016-2023 and the numbers of AFM cases including those diagnosed with EV-D68 infection during this period.ResultsSurveillance information was obtained for 16 countries. In eight countries, AFP surveillance initiated for poliomyelitis eradication was still ongoing, while non-polio AFM cases were only systematically reported in Norway. The survey revealed 130 AFM cases for 14 countries, with 48 (37%) EV-D68-laboratory-confirmed. Among the AFM cases, 70% (n = 91) occurred in 2016, 2018 and 2022, when EV-D68 circulation increased.ConclusionsThis report provides some indication of AFM case numbers in Europe since 2016. However, as 15 of 16 countries with AFM monitoring information lacked structural AFM surveillance, numbers should be interpreted with caution. Knowing AFM incidence matters to determine its impact and detect future outbreaks. Thus, the newly established clinical network will develop a European AFM repository.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 21","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newly emerging metronidazole-resistant <i>Clostridioides difficile</i> PCR ribotype 955 identified in Poland, 2021 to 2023 but not in Czechia, 2012 to 2023 and Slovakia, 2015 to 2023.","authors":"Jaroslava Zikova, Klaudia Szarek, Monika Kabała, Dorota Wultańska, Natalia Frankowska, Adam Iwanicki, Krzysztof Hinc, Anna Mucha, Jolanta Komarnicka, Anna Jagielska, Ed Kuijper, Marcela Krutova, Hanna Pituch","doi":"10.2807/1560-7917.ES.2025.30.21.2400675","DOIUrl":"10.2807/1560-7917.ES.2025.30.21.2400675","url":null,"abstract":"<p><p>BackgroundOn 29 January 2024, the European Centre for Disease Prevention and Control distributed an alert about a metronidazole-resistant <i>Clostridioides difficile</i> outbreak of PCR ribotype (RT) 955 in England.AimWe aimed to investigate the presence of RT955 in Czech, Slovak and Polish <i>C. difficile</i> isolates and evaluate different culture media for detecting its metronidazole resistance.MethodsIsolates with binary toxin genes identified as 'unknown' by the WEBRIBO PCR ribotyping database up to 2023 were re-analysed after adding the RT955 profile to the database. The RT955 isolates were characterised by whole genome sequencing and tested for susceptibility to 15 antimicrobials.ResultsWe did not find RT955 in Czech (n = 6,661, 2012-2023) and Slovak (n = 776, 2015-2023) isolates, but identified 13 RT955 cases (n = 303, 2021-2023) in three hospitals in Poland. By whole genome multilocus sequence typing, 10 isolates clustered into one clonal complex including a sequence of United Kingdom strain ERR12670107, and shared similar antimicrobial resistance genes/mutations. All 13 isolates were resistant to ciprofloxacin/moxifloxacin, erythromycin/clindamycin and ceftazidime. All isolates had a mutation in the <i>nim</i>B gene promoter and in NimB (Tyr130Ser and Leu155Ile). The metronidazole resistance was detected in all isolates using brain-heart-infusion agar supplemented with haemin and Chocolate agar. Results were discrepant with the European Committee on Antimicrobial Susceptibility Testing-recommended Fastidious anaerobe agar and Brucella blood agar.ConclusionThe identification of clonally related haem-dependent metronidazole-resistant <i>C. difficile</i> RT955 in multiple hospitals indicates a need for prospective surveillance to estimate its prevalence in Europe.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 21","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of an updated methodology to estimate the burden of healthcare-associated infections in Italy, 2022.","authors":"Costanza Vicentini, Valerio Bordino, Luca Bresciano, Stefania Di Giacomo, Fortunato D'Ancona, Carla Maria Zotti","doi":"10.2807/1560-7917.ES.2025.30.18.2400812","DOIUrl":"https://doi.org/10.2807/1560-7917.ES.2025.30.18.2400812","url":null,"abstract":"<p><p>BackgroundAccurate burden estimates are necessary to inform priority setting and rational resource allocation. Weighting prevalence inversely proportional to time-at-risk has been proposed as a solution for length-biased sampling, an important limitation affecting prevalence to incidence conversion for healthcare-associated infections (HAIs).AimThis study aimed to update Italian burden estimates by calculating HAI incidence, attributable mortality and disability-adjusted life years (DALYs). Further, we describe an adapted methodology for burden estimations.MethodsWe used data from the latest European Centre for Disease Prevention and Control (ECDC) point prevalence survey (PPS) of HAIs, conducted in Italy in November 2022, to calculate the burden of five major HAIs at national level. We adapted the Burden of Communicable Diseases in Europe (BCoDE) methodology to include inverse probability weighting and compared results of naïve and weighted calculations.ResultsThe national sample included 18,397 patients. Overall, 564.8 DALYs per 100,000 general population resulted from weighted calculations (95% uncertainty interval (UI): 450.04-694.38), with an annual incidence of 685.42 cases per 100,000 general population (95% UI: 611.09-760.86) and 33.23 deaths per 100,000 general population per year (95% UI: 28.62-38.33). Concerning naïve estimates, overall 1,017.81 DALYs per 100,000 general population were calculated (95% UI: 855.16-1,190.59). In both calculations, healthcare-acquired bloodstream infections had the highest burden in terms of DALYs per 100,000 hospitalised and general population.ConclusionOur study confirmed the substantial burden of HAIs in Italy and renews the need to prioritise resources for infection prevention and control interventions.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 18","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, case-fatality rates and risk factors of bloodstream infections caused by <i>Escherichia coli</i>, <i>Klebsiella</i> species and <i>Pseudomonas aeruginosa</i>, England, April 2017 to March 2022.","authors":"Olisaeloka Nsonwu, Simon Thelwall, Sarah Gerver, Rebecca L Guy, Dimple Chudasama, Russell Hope","doi":"10.2807/1560-7917.ES.2025.30.17.2400430","DOIUrl":"https://doi.org/10.2807/1560-7917.ES.2025.30.17.2400430","url":null,"abstract":"<p><p>Background<i>Escherichia coli</i>, <i>Klebsiella</i> spp. and <i>Pseudomonas aeruginosa</i> are included in the mandatory surveillance of bloodstream infections (BSI) in England.AimWe aimed to investigate the epidemiology of these BSIs in England April 2017-March 2022.MethodsWe extracted data on <i>E. coli</i>, <i>Klebsiella</i> spp. and <i>P. aeruginosa</i> BSI, categorised BSIs as healthcare-associated (HA) or community-associated (CA) and linked to antimicrobial susceptibility and mortality data. We used multivariable logistic regression models to assess predictors of mortality.ResultsThe incidence rate of <i>E. coli</i> BSI was 71.8 per 100,000 population (95% confidence interval (CI): 71.5-72.1), <i>Klebsiella</i> spp. 19.1 (95% CI: 18.9-19.3) and <i>P. aeruginosa</i> 7.6 (95% CI: 7.5-7.7). Most (65,467/104,957) BSI episodes were CA. Case-fatality rate was 14.8% (95% CI: 14.6-14.9) in <i>E. coli</i>, 20.0% (95% CI: 19.6-20.3) in <i>Klebsiella</i> spp. and 25.8% (95% CI: 25.2-26.4) in <i>P. aeruginosa</i> BSI. Urinary tract infection (UTI) was the most reported primary infection for <i>E. coli</i> (56,961/100,834), <i>Klebsiella</i> spp. (9,098/22,827) and <i>P. aeruginosa</i> (3,204/8,484) BSI. Insertion or manipulation of urinary catheters was reported for 26.4% (16,136/61,043) of <i>E. coli</i>, 41.6% (4,470 /10,734) of <i>Klebsiella</i> spp. and 49.0% (2,127/4,341) of <i>P. aeruginosa</i> BSI. The adjusted odds ratio (OR) of death among hospital-onset HA-BSI compared to CA-BSI was 2.0 (95% CI: 1.9-2.2) for <i>E. coli</i>, 2.1 (95% CI: 2.0-2.3) for <i>Klebsiella</i> spp. and 1.7 (95% CI: 1.5-2.0) for <i>P. aeruginosa</i>.ConclusionsAppropriate management of UTIs and urinary catheterisation is essential for reduction of these BSIs.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 17","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From multiple measles genotype D8 introductions in 2024 to sustained B3 local transmission in and around Milan, northern Italy, January to April 2025.","authors":"Clara Fappani, Maria Gori, Silvia Bianchi, Lucia Tieghi, Daniela Colzani, Sabrina Senatore, Marino Faccini, Priscilla Pasutto, Luca Imeri, Luigi Vezzosi, Gabriele Del Castillo, Simone Villa, Danilo Cereda, Silvia Gioacchini, Paola Bucci, Raoul Fioravanti, Emilio D'Ugo, Melissa Baggieri, Fabio Magurano, Antonella Amendola","doi":"10.2807/1560-7917.ES.2025.30.20.2500315","DOIUrl":"10.2807/1560-7917.ES.2025.30.20.2500315","url":null,"abstract":"<p><p>An outbreak of measles virus genotype B3 is ongoing in Milan and surrounding areas since February 2025, with 27 cases identified in 32 laboratory-confirmed measles cases. Most cases were locally acquired and young adults. Phylogenetic analysis indicated the presence of a unique lineage closely related to strains circulating in Morocco. The lack of epidemiological links between several affected individuals suggests case numbers are being underestimated. The continuous transmission raises concerns about the potential re-establishment of endemic circulation in northern Italy.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 20","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spread of the novel vancomycin-resistant <i>Enterococcus faecium</i> strain ST1299/vanA from local level in Germany to cross-border level in Austria, 2018 to 2022.","authors":"Anca Rath, Bärbel Kieninger, Nilufarbayim Mirzaliyeva, Guido Werner, Jennifer K Bender, Martin A Fischer, Adriana Cabal-Rosel, Werner Ruppitsch, Helena Mb Seth-Smith, Adrian Egli, Milo Halabi, Anna Hörtenhuber, Yarub Salaheddin, Wolfgang Prammer, Heidrun Kerschner, Rainer Hartl, Martin Ehrenschwender, Andreas Ambrosch, Jörn Kalinowski, Levin Joe Klages, Christian Rückert-Reed, Tobias Busche, Alexander Kratzer, Aila Caplunik-Pratsch, Anja Eichner, Jürgen Fritsch, Wulf Schneider-Brachert","doi":"10.2807/1560-7917.ES.2025.30.20.2400389","DOIUrl":"10.2807/1560-7917.ES.2025.30.20.2400389","url":null,"abstract":"<p><p>IntroductionVancomycin-resistant <i>Enterococcus faecium</i> (VREfm) isolates of sequence type (ST)1299 were described recently in south-eastern German hospitals and rapidly expanded from local to cross-border level.AimWe 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.MethodsAt University Hospital Regensburg (UHoR), routine VREfm surveillance is whole genome sequencing-based (≥ 1 VREfm per <i>van</i>-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.ResultsWe identified 635 VREfm ST1299 isolates (100% <i>vanA</i>), 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.ConclusionSince their emergence in 2018, two highly transmissible subtypes of ST1299/<i>vanA</i> reached national, then cross-border scale. The observed outbreak tendency may explain the rapid and successful spread and the high clonality in our collection.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 20","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}