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Volume 15
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10.3390/pathogens15020143
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Article

Phenotypic and Molecular Characterization of Clinical Isolates of Vancomycin-Resistant Enterococcus faecium in the Health District of Bolzano (Italy) During 2021–2023

by
Angela Maria Di Pierro
1,*,
Richard Aschbacher
1,
Maria Del Grosso
2,
Monica Monaco
2 and
Elisabetta Pagani
1
1
Laboratory of Microbiology and Virology, Provincial Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University (PMU), 39100 Bolzano-Bozen, Italy
2
Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
*
Author to whom correspondence should be addressed.
Pathogens 2026, 15(2), 143; https://doi.org/10.3390/pathogens15020143
Submission received: 5 December 2025 / Revised: 24 December 2025 / Accepted: 31 December 2025 / Published: 28 January 2026
(This article belongs to the Special Issue Advances in the Epidemiology of Human Infectious Diseases)
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Abstract

Vancomycin-resistant Enterococcus faecium (VREfm) is an emerging pathogen responsible for healthcare-associated infections. For this reason, 44 VREfm isolates collected during 2021–2023 were characterized using phenotypic and genomic approaches. VREfm isolates were identified by MALDI-TOF and antimicrobial susceptibility tests were performed with Vitek 2, Sensititre, or E-test. Sequence type (ST), antibiotic resistance genes, virulence factors and genetic relatedness were determined using Next Generation Sequencing. Forty-three isolates had a VanA phenotype and vanHAX genotype and one had a VanB phenotype and vanHBX genotype. Isolates showed high antibiotic resistance to various antibiotics, but generally remained susceptible to quinupristin/dalfopristin, tigecycline and eravacycline. Two isolates were resistant to linezolid, showing the chromosomal mutation G2576T in domain V of the 23S rRNA gene in one isolate, and the transferable linezolid resistance genes cfr(D) and optrA in the other. Thirty-eight isolates belonged to ST80, one to ST17 (ST80 and ST17 are included in CC17) and one to ST697. Genomic analysis of the ST80 isolates showed that nearly all of them belonged to a single cluster. To prevent further spread of VREfm in the nosocomial environment, in addition to the application of up-to-date infection control strategies and antibiotic stewardship programs, the implementation of genomic surveillance is recommended.
Keywords: VanA; VanB; sequence type; NGS; antimicrobial resistance genes VanA; VanB; sequence type; NGS; antimicrobial resistance genes

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MDPI and ACS Style

Di Pierro, A.M.; Aschbacher, R.; Del Grosso, M.; Monaco, M.; Pagani, E. Phenotypic and Molecular Characterization of Clinical Isolates of Vancomycin-Resistant Enterococcus faecium in the Health District of Bolzano (Italy) During 2021–2023. Pathogens 2026, 15, 143. https://doi.org/10.3390/pathogens15020143

AMA Style

Di Pierro AM, Aschbacher R, Del Grosso M, Monaco M, Pagani E. Phenotypic and Molecular Characterization of Clinical Isolates of Vancomycin-Resistant Enterococcus faecium in the Health District of Bolzano (Italy) During 2021–2023. Pathogens. 2026; 15(2):143. https://doi.org/10.3390/pathogens15020143

Chicago/Turabian Style

Di Pierro, Angela Maria, Richard Aschbacher, Maria Del Grosso, Monica Monaco, and Elisabetta Pagani. 2026. "Phenotypic and Molecular Characterization of Clinical Isolates of Vancomycin-Resistant Enterococcus faecium in the Health District of Bolzano (Italy) During 2021–2023" Pathogens 15, no. 2: 143. https://doi.org/10.3390/pathogens15020143

APA Style

Di Pierro, A. M., Aschbacher, R., Del Grosso, M., Monaco, M., & Pagani, E. (2026). Phenotypic and Molecular Characterization of Clinical Isolates of Vancomycin-Resistant Enterococcus faecium in the Health District of Bolzano (Italy) During 2021–2023. Pathogens, 15(2), 143. https://doi.org/10.3390/pathogens15020143

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