Temporal trends of enterococcal and vancomycin-resistant Enterococcus faecium bacteraemia in the northern Dutch-German cross-border region: a ten-year multicentre analysis (2013-2022)

OBJECTIVES: To analyse the trends in occurrence of enterococcal and vancomycin-resistant Enterococcus faecium (VREfm) bacteraemia in the northern Dutch-German cross-border region.

METHODS: A retrospective cross-sectional study was conducted using positive blood culture results from two university hospitals, the University Medical Centre Groningen (UMCG) and the Klinikum Oldenburg (KOL) between1 January 2013 to 31 December 2022.

RESULTS: Over the ten-year period, 738 enterococcal bacteraemia episodes were observed at KOL and 1091 at UMCG, involving 685 and 999 patients, respectively. E. faecium was the predominant species in both institutions (60.3% at KOL and 60.8% at UMCG). The median age of patients with enterococcal, E. faecium, E. faecalis, and VREfm bacteraemia was consistently higher at KOL than at UMCG (p = 0.029). In both institutions, over half of the enterococcal bacteraemia cases (53.4% at KOL, 55.8% at UMCG) were observed in intensive care units and haematology/oncology wards. From 2018 to 2022, UMCG had higher overall incidence rates of E. faecium, and E. faecalis bacteraemia, while KOL had a significantly higher incidence of VREfm (0.56 vs. 0.05 per 10,000 patient-days, p < 0.0001). There was a significant upward trend in VREfm bacteraemia cases (p = 0.01) and in the proportion of VREfm among bacteraemia caused by E. faecium (p = 0.027) at KOL, with no such trend observed at UMCG during the study period.

CONCLUSIONS: The results reveal a significant difference in VREfm bacteraemia occurrences between a German and Dutch hospital in a cross-border region, reflecting national trends yet showing regional variation.