{"id":"https://openalex.org/W7225821504","doi":"https://doi.org/10.64898/2026.11.10.765572","title":"Rise and Fall of a Superbug: Analyzing the epidemic success of a distinct clone of vancomycin-resistant Enterococcus faecium ST117/CT71 in Germany, 2017 - 2024.","display_name":"Rise and Fall of a Superbug: Analyzing the epidemic success of a distinct clone of vancomycin-resistant Enterococcus faecium ST117/CT71 in Germany, 2017 - 2024.","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7225821504","doi":"https://doi.org/10.64898/2026.11.10.765572"},"language":"en","primary_location":{"id":"doi:10.64898/2026.11.10.765572","doi":"https://doi.org/10.64898/2026.11.10.765572","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.10.765572","pdf_url":null,"source":{"id":"https://openalex.org/S4306402567","display_name":"bioRxiv (Cold Spring Harbor Laboratory)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2750212522","host_organization_name":"Cold Spring Harbor Laboratory","host_organization_lineage":["https://openalex.org/I2750212522"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"bioRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.64898/2026.11.10.765572","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5052016000","display_name":"Robert E. Weber","orcid":"https://orcid.org/0000-0001-6957-8327","observed_orcids":["https://orcid.org/0000-0001-6957-8327","https://orcid.org/0000-0002-5988-5216"]},"institutions":[{"id":"https://openalex.org/I24359323","display_name":"Robert Koch Institute","ror":"https://ror.org/01k5qnb77","country_code":"DE","type":"government","lineage":["https://openalex.org/I24359323"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Robert E. Weber","raw_affiliation_strings":["Robert Koch-Institut, Germany;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Robert Koch-Institut, Germany;","institution_ids":["https://openalex.org/I24359323"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5070392787","display_name":"Guido Werner","orcid":"https://orcid.org/0000-0002-5081-151X","observed_orcids":["https://orcid.org/0000-0002-5081-151X"]},"institutions":[{"id":"https://openalex.org/I24359323","display_name":"Robert Koch Institute","ror":"https://ror.org/01k5qnb77","country_code":"DE","type":"government","lineage":["https://openalex.org/I24359323"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Guido Werner","raw_affiliation_strings":["Robert Koch Institut, Germany;"],"raw_orcid":"https://orcid.org/0000-0002-5081-151X","affiliations":[{"raw_affiliation_string":"Robert Koch Institut, Germany;","institution_ids":["https://openalex.org/I24359323"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5029125902","display_name":"Jennifer K. Bender","orcid":"https://orcid.org/0000-0001-5167-3836","observed_orcids":["https://orcid.org/0000-0001-5167-3836"]},"institutions":[{"id":"https://openalex.org/I24359323","display_name":"Robert Koch Institute","ror":"https://ror.org/01k5qnb77","country_code":"DE","type":"government","lineage":["https://openalex.org/I24359323"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Jennifer Karin Bender","raw_affiliation_strings":["Robert Koch Institut, Germany;"],"raw_orcid":"https://orcid.org/0000-0001-5167-3836","affiliations":[{"raw_affiliation_string":"Robert Koch Institut, Germany;","institution_ids":["https://openalex.org/I24359323"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5029689989","display_name":"Berit Haldemann","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I24359323","display_name":"Robert Koch Institute","ror":"https://ror.org/01k5qnb77","country_code":"DE","type":"government","lineage":["https://openalex.org/I24359323"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Berit Haldemann","raw_affiliation_strings":["Robert Koch Institut, Germany;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Robert Koch Institut, Germany;","institution_ids":["https://openalex.org/I24359323"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5057806915","display_name":"Oliver Drechsel","orcid":"https://orcid.org/0000-0002-7661-2535","observed_orcids":["https://orcid.org/0000-0002-7661-2535"]},"institutions":[{"id":"https://openalex.org/I24359323","display_name":"Robert Koch Institute","ror":"https://ror.org/01k5qnb77","country_code":"DE","type":"government","lineage":["https://openalex.org/I24359323"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Oliver Drechsel","raw_affiliation_strings":["Robert Koch Institute, Germany"],"raw_orcid":"https://orcid.org/0000-0002-7661-2535","affiliations":[{"raw_affiliation_string":"Robert Koch Institute, Germany","institution_ids":["https://openalex.org/I24359323"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5006144218","display_name":"Martin Alexander Fischer","orcid":"https://orcid.org/0000-0002-9319-3862","observed_orcids":["https://orcid.org/0000-0002-9319-3862"]},"institutions":[{"id":"https://openalex.org/I24359323","display_name":"Robert Koch Institute","ror":"https://ror.org/01k5qnb77","country_code":"DE","type":"government","lineage":["https://openalex.org/I24359323"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Martin A. Fischer","raw_affiliation_strings":["Robert Koch Institut, Germany;"],"raw_orcid":"https://orcid.org/0000-0002-9319-3862","affiliations":[{"raw_affiliation_string":"Robert Koch Institut, Germany;","institution_ids":["https://openalex.org/I24359323"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I24359323"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10195","display_name":"Antimicrobial Resistance in Staphylococcus","score":0.7426999807357788,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10195","display_name":"Antimicrobial Resistance in Staphylococcus","score":0.7426999807357788,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10147","display_name":"Antibiotic Resistance in Bacteria","score":0.2207999974489212,"subfield":{"id":"https://openalex.org/subfields/2726","display_name":"Microbiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10943","display_name":"Escherichia coli research studies","score":0.004800000227987766,"subfield":{"id":"https://openalex.org/subfields/2404","display_name":"Microbiology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.7784000039100647},{"id":"https://openalex.org/C77434933","wikidata":"https://www.wikidata.org/wiki/Q4043440","display_name":"Multilocus sequence typing","level":4,"score":0.6638000011444092},{"id":"https://openalex.org/C2777677444","wikidata":"https://www.wikidata.org/wiki/Q140010","display_name":"Enterococcus faecium","level":3,"score":0.6330000162124634},{"id":"https://openalex.org/C54355233","wikidata":"https://www.wikidata.org/wiki/Q7162","display_name":"Genetics","level":1,"score":0.609000027179718},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.5412999987602234},{"id":"https://openalex.org/C2781209916","wikidata":"https://www.wikidata.org/wiki/Q3215756","display_name":"Typing","level":2,"score":0.531000018119812},{"id":"https://openalex.org/C81977670","wikidata":"https://www.wikidata.org/wiki/Q585259","display_name":"Genetic diversity","level":3,"score":0.5131000280380249},{"id":"https://openalex.org/C141231307","wikidata":"https://www.wikidata.org/wiki/Q7020","display_name":"Genome","level":3,"score":0.5006999969482422},{"id":"https://openalex.org/C180754005","wikidata":"https://www.wikidata.org/wiki/Q80726","display_name":"Allele","level":3,"score":0.4894999861717224},{"id":"https://openalex.org/C116675565","wikidata":"https://www.wikidata.org/wiki/Q3241045","display_name":"Outbreak","level":2,"score":0.4668000042438507},{"id":"https://openalex.org/C78458016","wikidata":"https://www.wikidata.org/wiki/Q840400","display_name":"Evolutionary biology","level":1,"score":0.3955000042915344},{"id":"https://openalex.org/C135763542","wikidata":"https://www.wikidata.org/wiki/Q106016","display_name":"Genotype","level":3,"score":0.39329999685287476},{"id":"https://openalex.org/C2983611323","wikidata":"https://www.wikidata.org/wiki/Q7229822","display_name":"Population structure","level":3,"score":0.3790000081062317},{"id":"https://openalex.org/C97669555","wikidata":"https://www.wikidata.org/wiki/Q4118435","display_name":"Molecular epidemiology","level":4,"score":0.3783999979496002},{"id":"https://openalex.org/C61053724","wikidata":"https://www.wikidata.org/wiki/Q1154615","display_name":"Sequence analysis","level":3,"score":0.37369999289512634},{"id":"https://openalex.org/C106934330","wikidata":"https://www.wikidata.org/wiki/Q1971873","display_name":"Trait","level":2,"score":0.36010000109672546},{"id":"https://openalex.org/C68873052","wikidata":"https://www.wikidata.org/wiki/Q349856","display_name":"Genetic variation","level":3,"score":0.3529999852180481},{"id":"https://openalex.org/C2776817793","wikidata":"https://www.wikidata.org/wiki/Q6553369","display_name":"Lineage (genetic)","level":3,"score":0.3370000123977661},{"id":"https://openalex.org/C4918238","wikidata":"https://www.wikidata.org/wiki/Q121438","display_name":"Transposable element","level":4,"score":0.3352999985218048},{"id":"https://openalex.org/C81089528","wikidata":"https://www.wikidata.org/wiki/Q5134986","display_name":"clone (Java method)","level":3,"score":0.32170000672340393},{"id":"https://openalex.org/C761482","wikidata":"https://www.wikidata.org/wiki/Q118093","display_name":"Transmission (telecommunications)","level":2,"score":0.30250000953674316},{"id":"https://openalex.org/C2780585763","wikidata":"https://www.wikidata.org/wiki/Q517258","display_name":"Enterococcus","level":3,"score":0.28220000863075256},{"id":"https://openalex.org/C186413461","wikidata":"https://www.wikidata.org/wiki/Q744727","display_name":"Genetic association","level":5,"score":0.2793999910354614},{"id":"https://openalex.org/C2778112365","wikidata":"https://www.wikidata.org/wiki/Q3511065","display_name":"Sequence (biology)","level":2,"score":0.2759999930858612},{"id":"https://openalex.org/C24432333","wikidata":"https://www.wikidata.org/wiki/Q2068526","display_name":"Whole genome sequencing","level":4,"score":0.2621000111103058},{"id":"https://openalex.org/C2776116246","wikidata":"https://www.wikidata.org/wiki/Q21067469","display_name":"Runs of Homozygosity","level":5,"score":0.26100000739097595},{"id":"https://openalex.org/C106208931","wikidata":"https://www.wikidata.org/wiki/Q1098876","display_name":"Genome-wide association study","level":5,"score":0.2581999897956848},{"id":"https://openalex.org/C184898388","wikidata":"https://www.wikidata.org/wiki/Q1435712","display_name":"Pairwise comparison","level":2,"score":0.25290000438690186}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.11.10.765572","doi":"https://doi.org/10.64898/2026.11.10.765572","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.10.765572","pdf_url":null,"source":{"id":"https://openalex.org/S4306402567","display_name":"bioRxiv (Cold Spring Harbor Laboratory)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2750212522","host_organization_name":"Cold Spring Harbor Laboratory","host_organization_lineage":["https://openalex.org/I2750212522"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"bioRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.11.10.765572","doi":"https://doi.org/10.64898/2026.11.10.765572","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.10.765572","pdf_url":null,"source":{"id":"https://openalex.org/S4306402567","display_name":"bioRxiv (Cold Spring Harbor Laboratory)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2750212522","host_organization_name":"Cold Spring Harbor Laboratory","host_organization_lineage":["https://openalex.org/I2750212522"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"bioRxiv","raw_type":"posted-content"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Vancomycin-resistant":[0],"Enterococcus":[1],"faecium":[2,114],"(VR":[3],"Efm":[4],")":[5],"is":[6,28,157],"a":[7,46,105,109,158],"major":[8],"cause":[9],"of":[10,23,86,112,123,135,204,243],"healthcare-associated":[11],"infections,":[12],"yet":[13],"outbreak":[14,187],"analysis":[15,91],"remains":[16,59],"challenging,":[17],"particularly":[18,60],"for":[19,93,239],"prevalent":[20],"lineages.":[21],"One":[22],"the":[24,29,83,119,212,232],"most":[25],"striking":[26],"examples":[27],"Sequence":[30,66],"Type":[31,34],"(ST)":[32],"117/Complex":[33],"(CT)":[35],"71/":[36],"vanB":[37],"lineage,":[38],"whose":[39],"rapid":[40],"expansion":[41],"across":[42],"Germany":[43],"coincided":[44],"with":[45,148,202],"sharp":[47],"rise":[48],"in":[49],"VRE":[50],"prevalence":[51],"observed":[52],"around":[53],"2019.":[54],"Defining":[55],"reliable":[56],"genomic":[57,219],"thresholds":[58],"difficult,":[61],"as":[62,252],"current":[63],"core-genome":[64,102,155],"Multi-Locus":[65],"Typing":[67],"(cgMLST)":[68],"cutoffs":[69],"are":[70],"based":[71],"largely":[72],"on":[73,226],"expert":[74],"consensus":[75],"or":[76,108],"limited":[77,154],"case":[78],"series.":[79],"Here,":[80],"we":[81,184,229],"evaluate":[82],"discriminatory":[84],"performance":[85],"cgMLST":[87,117,233],"and":[88,98,221],"split":[89],"k-mer":[90],"(SKA)":[92],"resolving":[94],"relatedness":[95,220],"within":[96,180,208],"ST117/CT71":[97,140,170],"investigate":[99],"whether":[100],"low":[101],"diversity":[103,156],"represents":[104],"lineage-specific":[106],"trait":[107],"population-wide":[110],"property":[111],"E.":[113],".":[115],"While":[116],"captures":[118],"overall":[120],"population":[121,160],"structure":[122],"ST117/CT71,":[124],"SKA":[125],"provided":[126],"higher":[127],"resolution,":[128],"distinguishing":[129],"isolates":[130,193],"identical":[131],"by":[132,247],"cgMLST.":[133],"Analysis":[134],"2,505":[136],"genomes":[137],"showed":[138,194],"that":[139,153],"does":[141],"not":[142],"exhibit":[143],"reduced":[144],"allelic":[145,178,197],"variability":[146],"compared":[147],"other":[149],"hospital-adapted":[150],"lineages,":[151],"suggesting":[152],"broader":[159],"characteristic.":[161],"Complementary":[162],"transposon":[163],"analyses":[164,250],"further":[165],"identified":[166],"two":[167],"temporally":[168],"distinct":[169],"sublineages":[171],"carrying":[172],"different":[173],"Tn1549-like":[174],"structures.":[175],"To":[176],"assess":[177],"variation":[179],"confirmed":[181],"transmission":[182],"events,":[183],"analyzed":[185],"138":[186],"clusters":[188],"from":[189],"96":[190],"hospitals.":[191],"Outbreak-associated":[192],"sharply":[195],"compressed":[196],"differences":[198],"(median":[199],"=":[200],"1),":[201],"90%":[203],"pairwise":[205],"comparisons":[206],"falling":[207],"\u22649":[209,237],"alleles.":[210],"Thus,":[211],"commonly":[213],"applied":[214],"\u226420-allele":[215],"threshold":[216,235],"risks":[217],"overestimating":[218],"grouping":[222],"unrelated":[223],"isolates.":[224],"Based":[225],"these":[227],"data,":[228],"propose":[230],"lowering":[231],"alert":[234],"to":[236],"alleles":[238],"initial":[240],"cluster":[241],"detection":[242],"local":[244],"outbreaks,":[245],"followed":[246],"confirmatory":[248],"high-resolution":[249],"such":[251],"SKA.":[253]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-11-12T00:00:00"}
