Investigating pathways of vancomycin-resistant Enterococcus (VRE) contamination and transmission in intensive care units: a prospective genomic surveillance study

Genomic surveillance in ICU patients and their environments detected VRE in 6.22% of occupant-stays, with non-patient sampling increasing detection from 6 to 20.

• Why it matters: ICU infection prevention needs clearer maps of how VRE moves between patients, yet most studies rely mainly on patient isolates, leaving indirect transmission pathways undercharacterized.
• What they did: Across 13 weeks in two hospitals, daily sampling (N = 6848) from patients, HCP hands, patient rooms, and shared surfaces was cultured and sequenced; genomic clustering thresholds defined related isolate groups.
• The result: Two VREfm spread patterns emerged—outbreak-like low heterogeneity with observed transmission, and high heterogeneity with movement between occupant-stays without observed events—while adding non-patient isolates increased multi-isolate clusters 7-fold.

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