VRE Transmission in Plain Sight: Why Genomics Matters

Vancomycin-resistant Enterococcus faecium (VRE) is a persistent problem in hospitals—but how do you know when it's spreading patient to patient versus sporadically appearing?

A new study published in Infection Control and Hospital Epidemiology used whole-genome sequencing (WGS) surveillance across five hospitals to answer that question. Investigators retrospectively sequenced 341 clinical VRE isolates over a 17-month period. The results?

• Nearly one-third (31%) of isolates were genetically linked to transmission clusters.

• Many clusters crossed units and were missed by traditional surveillance.

• The postanesthesia care unit (PACU) emerged as a previously under-recognized hub of transmission.

  
  

The authors found that despite strong infection control programs, real transmission was happening in places not typically scrutinized—like the PACU—reinforcing that conventional methods may overlook meaningful spread.

What’s particularly notable is that none of the 25 transmission clusters were identified in real time by traditional methods. It took WGS to uncover them.

This study continues to build the case for proactive, system-wide genomic surveillance—not just during known outbreaks. As hospitals look for ways to get ahead of transmission and improve patient safety, this paper highlights both the hidden risk and the actionable insights genomics can provide.

📄 Read the study: https://doi.org/10.1017/ice.2025.68