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Abstract：
Healthcare-associated infections caused by vancomycin-resistant Enterococcus faecium (VREFM) pose a significant threat to healthcare. Confirming the relatedness of the bacterial isolates from different patients is challenging. We aimed to assess the efficacy of IR-Biotyper, multilocus sequencing typing (MLST), and core-genome MLST (cgMLST) in comparison with whole-genome sequencing (WGS) for outbreak confirmation in the neonatal intensive care unit (NICU). Twenty VREFM isolates from four neonates and ten control isolates from unrelated patients were analyzed. Genomic DNA extraction, MLST, cgMLST, and WGS were performed. An IR-Biotyper was used with colonies obtained after 24 h of incubation on tryptic soy agar supplemented with 5% sheep blood. The optimal clustering cutoff for the IR-Biotyper was determined by comparing the results with WGS. Clustering concordance was assessed using the adjusted Rand and Wallace indices. MLST and cgMLST identified sequence types (ST) and complex types (CT), revealing suspected outbreak isolates with a predominance of ST17 and CT6553, were confirmed by WGS. For the IR-Biotyper, the proposed optimal clustering cut-off range was 0.106-0.111. Despite lower within-run precision, of the IR-Biotyper, the clustering concordance with WGS was favorable, meeting the criteria for real-time screening. This study confirmed a nosocomial outbreak of VREFM in the NICU using an IR-Biotyper, showing promising results compared to MLST. Although within-run precision requires improvement, the IR-Biotyper demonstrated high discriminatory power and clustering concordance with WGS. These findings suggest its potential as a real-time screening tool for the detection of VREFM-related nosocomial outbreaks.
OBJECTIVE: In this study, we evaluated the performance of the IR-Biotyper in detecting nosocomial outbreaks caused by vancomycin-resistant Enterococcus faecium, comparing it with MLST, cgMLST, and WGS. We proposed a cutoff that showed the highest concordance compared to WGS and assessed the within-run precision of the IR-Biotyper by evaluating the consistency in genetically identical strain when repeated in the same run.
OBJECTIVE: In this study, we evaluated the performance of the IR-Biotyper in detecting nosocomial outbreaks caused by vancomycin-resistant Enterococcus faecium, comparing it with MLST, cgMLST, and WGS. We proposed a cutoff that showed the highest concordance compared to WGS and assessed the within-run precision of the IR-Biotyper by evaluating the consistency in genetically identical strain when repeated in the same run.
摘要：
由耐万古霉素屎肠球菌（VREFM）引起的医疗保健相关感染对医疗保健构成了重大威胁。确认来自不同患者的细菌分离物的相关性是具有挑战性的。我们旨在评估IR-Biotyper的疗效，多位点测序分型（MLST），和核心基因组MLST（cgMLST）与全基因组测序（WGS）相比，用于新生儿重症监护病房（NICU）的暴发确认。分析了来自四个新生儿的20个VREFM分离株和来自无关患者的10个对照分离株。基因组DNA提取,MLST,cgMLST,进行了WGS。IR-Biotyper与在补充有5%绵羊血的胰蛋白酶大豆琼脂上孵育24小时后获得的菌落一起使用。通过将结果与WGS进行比较来确定IR-Biotyper的最佳聚类截止值。使用调整后的Rand和Wallace指数评估聚类一致性。MLST和cgMLST识别序列类型（ST）和复杂类型（CT），WGS证实了以ST17和CT6553为主的疑似暴发分离株.对于IR-Biotyper，提出的最佳聚类截止范围为0.106-0.111。尽管运行内精度较低，IR-Biotyper，与WGS的聚类一致性是有利的，符合实时筛选的标准。这项研究证实了使用IR-Biotyper的NICU中VREFM的医院爆发，与MLST相比，显示出有希望的结果。尽管运行中的精度需要改进，IR-Biotyper显示出较高的辨别能力和与WGS的聚类一致性。这些发现表明其作为检测VREFM相关医院暴发的实时筛查工具的潜力。
目的：在本研究中，我们评估了IR-Biotyper在检测由耐万古霉素的屎肠球菌引起的医院内爆发中的性能，与MLST相比，cgMLST,WGS。我们提出了与WGS相比具有最高一致性的截止值，并通过评估在同一运行中重复时遗传相同菌株的一致性来评估IR-Biotyper的运行内精度。
目的：在本研究中，我们评估了IR-Biotyper在检测由耐万古霉素的屎肠球菌引起的医院内爆发中的性能，与MLST相比，cgMLST,WGS。我们提出了与WGS相比具有最高一致性的截止值，并通过评估在同一运行中重复时遗传相同菌株的一致性来评估IR-Biotyper的运行内精度。
