Genomic characterization of vancomycin-resistant Enterococcus faecium and van-carrying mobile genetic elements in a tertiary hospital in northeastern China

Background: (VREfm) poses a significant healthcare challenge due to its multidrug resistance and genomic plasticity. Vancomycin resistance is commonly mediated by van gene clusters located on transposons, which are often associated with plasmids. Methods: 19 VREfm isolates were collected from different departments of the First Hospital of Jilin University between 2019 and 2024. Whole-genome sequencing (WGS) was performed on the strains for comprehensive genomic analysis. Multilocus sequence typing (MLST) was used to determine the sequence types of the strains. Plasmids were grouped based on Mash distance, and plasmid content was analyzed using the MOB-suite tool. Genome-wide comparisons and average nucleotide identity (ANI) analysis were conducted using FastANI. The TnCentral database was used to analyze resistance-associated transposons. The objective was to characterize the genomic diversity of VREfm isolates and the genetic contexts of van-carrying plasmids and transposons. Results: -associated mobile genetic elements across different plasmid and clonal backgrounds. Conclusion: This study provides genomic insights into the diversity and relatedness of VREfm isolates in a tertiary hospital over a 5-year period. The findings describe the diversity of sequence types, plasmid backbones, and van-associated mobile genetic elements within this hospital collection.