title: Polyclonal emergence of vanA vancomycin-resistant Enterococcus faecium in Australia.
abstract: To investigate the genetic context associated with the emergence of vanA VRE in Australia.
  
  
  
  The whole genomes of 18 randomly selected vanA -positive Enterococcus faecium patient isolates, collected between 2011 and 2013 from hospitals in four Australian capitals, were sequenced and analysed.
  
  
  
  In silico typing and transposon/plasmid assembly revealed that the sequenced isolates represented (in most cases) different hospital-adapted STs and were associated with a variety of different Tn 1546 variants and plasmid backbone structures.
  
  
  
  The recent emergence of vanA VRE in Australia was polyclonal and not associated with the dissemination of a single 'dominant' ST or vanA -encoding plasmid. Interestingly, the factors contributing to this epidemiological change are not known and future studies may need to consider investigation of potential community sources.
authors.affiliation: School of Medicine, Western Sydney University, Sydney, NSW, Australia.|Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors.forename: Sebastiaan J
authors.initials: SJ
authors.lastname: van Hal
authors.affiliation: School of Medicine, Western Sydney University, Sydney, NSW, Australia.|Antimicrobial Resistance and Mobile Elements Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.
authors.forename: Björn A
authors.initials: BA
authors.lastname: Espedido
authors.affiliation: School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia.|PathWest Laboratory Medicine, Fiona Stanley Hospital, Perth, WA, Australia.
authors.forename: Geoffrey W
authors.initials: GW
authors.lastname: Coombs
authors.affiliation: Austin Health, Melbourne, Vic., Australia.|Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Vic., Australia.
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Howden
authors.affiliation: Monash Hospital, Melbourne, Vic., Australia.
authors.forename: Tony M
authors.initials: TM
authors.lastname: Korman
authors.affiliation: Pathology Queensland, Brisbane, QLD, Australia.
authors.forename: Graeme R
authors.initials: GR
authors.lastname: Nimmo
authors.affiliation: School of Medicine, Western Sydney University, Sydney, NSW, Australia.|Antimicrobial Resistance and Mobile Elements Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.|Sydney South Western Pathology Service, NSW Pathology, Sydney, NSW, Australia.
authors.forename: Iain B
authors.initials: IB
authors.lastname: Gosbell
authors.affiliation: School of Medicine, Western Sydney University, Sydney, NSW, Australia.|Antimicrobial Resistance and Mobile Elements Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.
authors.forename: Slade O
authors.initials: SO
authors.lastname: Jensen
mesh_terms: D001315:Australia / Q000453:epidemiology; D001426:Bacterial Proteins / Q000235:genetics*; D019729:Carbon-Oxygen Ligases / Q000235:genetics*; D004251:DNA Transposable Elements; D016984:Enterococcus faecium / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D014644:Genetic Variation; D016680:Genome, Bacterial; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006761:Hospitals; D006801:Humans; D058889:Molecular Typing; D010957:Plasmids / Q000032:analysis; D017422:Sequence Analysis, DNA; D065507:Vancomycin-Resistant Enterococci / Q000145:classification* / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; D004251:DNA Transposable Elements; C071437:VanA ligase, Bacteria; D019729:Carbon-Oxygen Ligases