Vancomycin-resistant enterococci in Spanish hospitals: the experience of official network for the surveillance of resistant microorganisms RedLabRA, 2023–2024

Objectives RedLabRA is a network of microbiology laboratories for the genomic surveillance of antibiotic resistance. The aim of this study was to describe the actions undertaken by RedLabRA in response to an increase of vancomycin-resistant enterococci (VRE) in some Spanish regions. Methods RedLabRA designed a VRE surveillance organized in two phases: (1) a questionnaire to assess risk perception of VRE among the network’s Level 2 laboratories (LN2), and (2) collection of cases detected between April 2023 and March 2024, followed by WGS of a sample of vancomycin-resistant Enterococcus faecium (VREfm) isolates to investigate interregional dissemination. WGS was performed using the Illumina platform; MLST ( PubMLST.org scheme), cgMLST and phylogenetic relationships (Ridom SeqSphere+ v3.5.0), and resistome (Resfinder 4.7.2) were analysed. Results Nine of the 17 autonomous communities defined a priority scenario of VRE. 31 LN2 reported 1,958 VRE cases from 86 hospitals across 12 autonomous communities and the autonomous city Ceuta. The predominant species was E. faecium (97.1%). 317 VREfm isolates were included for WGS: 211 (66.6%) carried the van A gene, 90 (28.4%) van B, and 16 (5%) both genes. ST117 (34.7%), ST80 (27.1%), or ST1421 (25.6%) predominated. Using cgMLST (1,423 genes, cutoff of 5 alleles), 45 VREfm clusters were identified, of which eight involved at least three hospitals and were inter-regional. 51 (16.1%) isolates carried linezolid resistance mechanisms, mainly optr A+ cfr D. Conclusion VREfm had a highly uneven impact across Spanish regions. The inter-regional presence of VREfm isolates with high genetic similarity belonging to ST1421, ST117, and ST80 clones was detected. The emergence of E. faecium isolates carrying genes conferring resistance to vancomycin and linezolid requires ongoing surveillance.

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Journal
Frontiers in Public Health
Published
2026-10-29
DOI
https://doi.org/10.3389/fpubh.2026.1966902
Primary Topic
Antibiotic Resistance in Bacteria
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article
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article

Vancomycin-resistant enterococci in Spanish hospitals: the experience of official network for the surveillance of resistant microorganisms RedLabRA, 2023–2024

Julia Serrano‐Lobo, Ana Isabel López‐Calleja, Luis López-Urrutia, Fernando Gónzález‐Candelas et al.
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Frontiers in Public Health
Antibiotic Resistance in Bacteria
article

Vancomycin-resistant enterococci in Spanish hospitals: the experience of official network for the surveillance of resistant microorganisms RedLabRA, 2023–2024

Julia Serrano‐Lobo, Ana Isabel López‐Calleja, Luis López-Urrutia, Fernando Gónzález‐Candelas, Jordi Cámara, Fernando Lázaro‐Perona, Sara Pérez de Madrid, Paloma Merino Amador, Ignasi Roca, Jesús Oteo, Lorena López‐Cerero, Marta Hernández-García, Maria Dolores Pérez-Vázquez, María del Pilar Ortega-Lafont, Javier E. Cañada-García, María Dolores Tirado-Balaguer, Cristina Seral, Ferran Navarro, Estela Giménez Quiles, Nieves Larrosa-Escartín, Esther Viedma-Moreno, the Spanish RedLabRA Network Study Group, Diego García Martínez-de-Artola
article en

Abstract

Objectives RedLabRA is a network of microbiology laboratories for the genomic surveillance of antibiotic resistance. The aim of this study was to describe the actions undertaken by RedLabRA in response to an increase of vancomycin-resistant enterococci (VRE) in some Spanish regions. Methods RedLabRA designed a VRE surveillance organized in two phases: (1) a questionnaire to assess risk perception of VRE among the network’s Level 2 laboratories (LN2), and (2) collection of cases detected between April 2023 and March 2024, followed by WGS of a sample of vancomycin-resistant Enterococcus faecium (VREfm) isolates to investigate interregional dissemination. WGS was performed using the Illumina platform; MLST ( PubMLST.org scheme), cgMLST and phylogenetic relationships (Ridom SeqSphere+ v3.5.0), and resistome (Resfinder 4.7.2) were analysed. Results Nine of the 17 autonomous communities defined a priority scenario of VRE. 31 LN2 reported 1,958 VRE cases from 86 hospitals across 12 autonomous communities and the autonomous city Ceuta. The predominant species was E. faecium (97.1%). 317 VREfm isolates were included for WGS: 211 (66.6%) carried the van A gene, 90 (28.4%) van B, and 16 (5%) both genes. ST117 (34.7%), ST80 (27.1%), or ST1421 (25.6%) predominated. Using cgMLST (1,423 genes, cutoff of 5 alleles), 45 VREfm clusters were identified, of which eight involved at least three hospitals and were inter-regional. 51 (16.1%) isolates carried linezolid resistance mechanisms, mainly optr A+ cfr D. Conclusion VREfm had a highly uneven impact across Spanish regions. The inter-regional presence of VREfm isolates with high genetic similarity belonging to ST1421, ST117, and ST80 clones was detected. The emergence of E. faecium isolates carrying genes conferring resistance to vancomycin and linezolid requires ongoing surveillance.

Frontiers in Public HealthVol. 14
Universitat de València (ES), Hospital Universitario La Paz (ES), Instituto de Salud Carlos III (ES), Hospital de Sant Pau (ES), Bellvitge University Hospital (ES), Hospital General Universitario Gregorio Marañón (ES), Hospital Clínico San Carlos (ES), Institut d'Investigació Biomédica de Bellvitge (ES), Hospital Universitario Nuestra Señora de Candelaria (ES), Hospital Universitario Virgen Macarena (ES), Hospital Universitario de Guadalajara (ES), Hospital Clínico Universitario de Valencia (ES), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (ES), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (ES), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES), Hospital Universitario 12 De Octubre (ES), Centro Nacional de Microbiologia (ES), Hospital Universitario Miguel Servet (ES), Centro de Investigación Biomédica en Red (ES), Hospital Clínic de Barcelona (ES), Hospital General Universitari de Castelló (ES), Vall d'Hebron Hospital Universitari (ES), Hospital Clínico Universitario Lozano Blesa (ES), Instituto de Investigación Sanitaria Aragón (ES), Institute for Integrative Systems Biology (ES), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES), Hospital Universitario Río Hortega (ES), Hospital Universitario Ramón y Cajal (ES), Centro de Investigación Biomédica en Red Enfermedades Infecciosas (ES)
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Antibiotic Resistance in Bacteria
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