Retrospective genomic-epidemiology study of 309 vancomycin-resistant Enterococcus faecium (VRE) isolates collected in 32 Dutch hospitals (2012-2015), combining short-read and long-read whole-genome sequencing to determine whether vanA-type vancomycin resistance disseminated clonally or horizontally via plasmids and Tn1546 transposition. The study found that resistance spread through both modes, with plasmid-mediated horizontal transfer playing a substantial role.
Mode and dynamics of vanA-type vancomycin resistance dissemination in Dutch hospitals
Study: Mode and dynamics of vanA-type vancomycin resistance dissemination in Dutch hospitals
VRE-crossword, horizontal or vertical? Transmission of vancomycin-resistant Enterococcus faecium in Dutch hospitals