Publication

Enterococcus faecium: from evolutionary insights to practical interventions

Zhou, X. W., 2018, [Groningen]: Rijksuniversiteit Groningen. 179 p.

Research output: ThesisThesis fully internal (DIV)Academic

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Documents

  • Title and contents

    Final publisher's version, 147 KB, PDF-document

  • Chapter 1

    Final publisher's version, 123 KB, PDF-document

  • Chapter 2

    Final publisher's version, 779 KB, PDF-document

    Embargo ends: 19/12/2019

  • Chapter 3

    Final publisher's version, 537 KB, PDF-document

  • Chapter 4

    Final publisher's version, 335 KB, PDF-document

  • Chapter 5

    Final publisher's version, 409 KB, PDF-document

  • Chapter 6

    Final publisher's version, 280 KB, PDF-document

  • Chapter 7

    Final publisher's version, 683 KB, PDF-document

  • Chapter 8

    Final publisher's version, 148 KB, PDF-document

  • Chapter 9

    Final publisher's version, 168 KB, PDF-document

  • Complete thesis

    Final publisher's version, 2 MB, PDF-document

    Embargo ends: 19/12/2019

  • Propositions

    Final publisher's version, 12 KB, PDF-document

  • Xue Wei Zhou
Enterococcus faecium has rapidly become a successful nosocomial pathogen. Early in its evolution E. faecium already possessed traits such as high tenacity, resistance to antibiotics and environmental stresses which made it capable to survive in a hospital environment. In the antibiotic era, E. faecium acquired resistance and virulence genes and soon the success of E. faecium became clear in the hospitals. In European hospitals, infections caused by E. faecium started to rise around 2000, followed by an increase of vancomycin resistant E. faecium (VRE). In this thesis we aimed to gain insight in the evolution and epidemiology of E. faecium. From these insights, this thesis proceeds to interventions that have value for patient care. The rapid emergence of hospital lineages imposes challenges for controlling, detecting and typing of VRE. To overcome these challenges, antibiotic stewardship strategies and diagnostic innovations using molecular techniques are required. This thesis describes such interventions, including model-based antibiotic prescription guidance, tailor made diagnostic tools for (vancomycin resistant) E. faecium, targeted VRE infection prevention measures and highly discriminating typing methods in VRE outbreak investigations. Finally, since the evolution in E. faecium will never stop, it will be a challenge to withstand the spread of VRE in the upcoming years. Therefore, innovations in the fields of diagnostics, treatment, and eradication is necessary to tackle the ongoing success of E. faecium.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
Supervisors/Advisors
Award date19-Dec-2018
Place of Publication[Groningen]
Publisher
Print ISBNs978-94-034-1130-9
Electronic ISBNs978-94-034-1129-3
Publication statusPublished - 2018

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