TABLE 1.

Strain characteristics and WGS sequence statistics

Strain	Resistance classificationa	Hospital	Patient	Age (yrs)	Underlying disease	Isolation date (mo-day-yr)	Isolation site	Antibiotic use	Interval vancomycin treatment and VanDb	MICs (mg/liter)			Variation in Ddlc	Variation in VanSc	Size of genomic island (bp)
										Vancomycin	Teicoplanin	Ampicillin
E7962	VRE	1	A	73	Acute myeloid leukemia	11-25-2013	Rectum	Vancomycin cotrimoxazole, ciprofloxacin	Unknown	16	<1	>256	S185F	S57R, K169E, T170P, V280L	185,412
E8043	VRE	2	B	57	Acute lymphoid leukemia	3-24-2014	Rectum	vancomycin	Unknown	16	<1	>256	Insertion 2 aa at pos. 280	S57R, A165V, V280L	168,512
E9242	VRE	2	C	18	Acute lymphoid leukemia	3-31-2016	Rectum	Cotrimoxazole, ciprofloxacin	Unknown	256	4	>256	Δ2 bp at pos. 319	K308Q	144,229
E9352d	ARE					12-9-2012	Blood	Amoxicillin-clavulanic acid, cefotaxime, ciprofloxacin, metronidazole, vancomycin	NA	<1	<1	>256	Normal	NA
E9353d	ARE	3	D	65	Cardiovascular disease, cholangitis	12-27-2012	Blood		NA	<1	<1	>256	Normal	NA
E8429d	VRE					1-22-2013	Rectum		43 days	256	2	>256	Δ1 bp at pos. 165	S57R, A68V, K308Q, V280L	120,918
E9354d	VRE					1-27-2013	Rectum		48 days	256	2	>256	Δ4 aa at pos. 280	S57R, A68V, K308Q, V280L	120,844
E9641	VRE	4	E	63	Non-Hodgkin lymphoma	2-27-2017	Rectum	Ciprofloxacin, ceftazidime, piperacillin-tazobactam, vancomycin	4 mo	8	<0.5	>256	S185F	S57R, V280L	168,541

^aVRE, vancomycin-resistant E. faecium; ARE, ampicillin-resistant E. faecium.

^bNA, not available.

^cIndicated positions are based on amino acid (aa) sequence for Ddl (d-Ala-d-Ala ligase) and VanS (vancomycin sensor protein).

^dThese four strains were isolated from the same patient at different time points.