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Objective <p>Whole-genome sequencing (WGS) has improved our understanding on epidemiology and transmission of vancomycin-resistant <i>Enterococcus faecium</i> (VRE). However, regional differences in strain distribution patterns remain poorly reported. In this narrative review, we summarize current evidence in Germany.</p> Methods <p>A systematic PubMed search was conducted for studies describing WGS-based typing of VRE in Germany published between 2015 and 2025 (<i>n</i> = 39). A relevant national surveillance report was included additionally.</p> Results <p>Data availability varies regionally, with highest reporting rates in north-western and south-eastern Germany. The German VRE population is predominantly composed of six major lineages: <i>vanB</i>-positive sequence types (ST) 80, 117, 192, and 203, and <i>vanA</i>-positive ST78 and ST1299. While ST192, ST203, and ST78 declined over time, ST80 and ST117 and their sub-lineages are nationally endemic. Core genome analyses demonstrate stable distribution of regionally specific complex types (CT) including ST80/CT1065/<i>vanB</i> and ST1299/CT1903/<i>vanA</i> in southern Germany, and ST117/CT71/<i>vanB</i> and ST80/CT1470/<i>vanA</i> in the north-west. Notably, ST80 exhibits greater CT diversity than ST117, reflecting its wider evolutionary plasticity.</p> Conclusion <p>Although unevenly reported, persistent regional differences in dominant lineages are evident, underscoring the necessity and value of high-resolution genomic surveillance beyond national-level reporting. Ultimately, this strategy could improve transmissions and outbreak analysis, and facilitate identification of lineage-specific virulence determinants.</p>

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Limited, outbreak-biased and unevenly reported: genomic insights into vancomycin-resistant Enterococcus faecium in Germany as reported between 2015 and 2025

  • 期刊论文

  • 发表日期：

    2026年7月30日

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  • Anca Rath,
  • Wulf Schneider-Brachert

摘要

Objective

Whole-genome sequencing (WGS) has improved our understanding on epidemiology and transmission of vancomycin-resistant Enterococcus faecium (VRE). However, regional differences in strain distribution patterns remain poorly reported. In this narrative review, we summarize current evidence in Germany.

Methods

A systematic PubMed search was conducted for studies describing WGS-based typing of VRE in Germany published between 2015 and 2025 (n = 39). A relevant national surveillance report was included additionally.

Results

Data availability varies regionally, with highest reporting rates in north-western and south-eastern Germany. The German VRE population is predominantly composed of six major lineages: vanB-positive sequence types (ST) 80, 117, 192, and 203, and vanA-positive ST78 and ST1299. While ST192, ST203, and ST78 declined over time, ST80 and ST117 and their sub-lineages are nationally endemic. Core genome analyses demonstrate stable distribution of regionally specific complex types (CT) including ST80/CT1065/vanB and ST1299/CT1903/vanA in southern Germany, and ST117/CT71/vanB and ST80/CT1470/vanA in the north-west. Notably, ST80 exhibits greater CT diversity than ST117, reflecting its wider evolutionary plasticity.

Conclusion

Although unevenly reported, persistent regional differences in dominant lineages are evident, underscoring the necessity and value of high-resolution genomic surveillance beyond national-level reporting. Ultimately, this strategy could improve transmissions and outbreak analysis, and facilitate identification of lineage-specific virulence determinants.