Limited, outbreak-biased and unevenly reported: genomic insights into vancomycin-resistant Enterococcus faecium in Germany as reported between 2015 and 2025
- 1Department of Infection Prevention and Infectious Diseases, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
- 2University of Regensburg, Regensburg, Germany
Abstract
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.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02890-z.
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BibTeX
@article{rath2026limited,
title = {{Limited, outbreak-biased and unevenly reported: genomic insights into vancomycin-resistant Enterococcus faecium in Germany as reported between 2015 and 2025}},
author = {Anca Rath and Wulf Schneider-Brachert},
journal = {Infection},
year = {2026},
month = jul,
doi = {10.1007/s15010-026-02890-z},
url = {https://doi.org/10.1007/s15010-026-02890-z},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Limited, outbreak-biased and unevenly reported: genomic insights into vancomycin-resistant Enterococcus faecium in Germany as reported between 2015 and 2025
AU - Anca Rath
AU - Wulf Schneider-Brachert
PY - 2026
DA - 2026/07/30
JO - Infection
DO - 10.1007/s15010-026-02890-z
UR - https://doi.org/10.1007/s15010-026-02890-z
AB - 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. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02890-z.
SN - 0300-8126
SN - 1439-0973
ER -