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Unit 13: Nosocomial Pathogens and Antibiotic Resistances

Guido Werner
Franziska Layer-Nicolaou

We are primarily concerned with surveying and studying the emergence and spread of those bacterial nosocomial pathogens that can act as indicators of hospital hygiene efficacy and rational antibacterial chemotherapy. Although our work primarily focusses on aspects of MRSA and VRE, further analyses and studies of gram-negative bacteria (E.coli, Klebsiella spp., and others) with production of extended spectrum beta-lactamases (ESBL) and carbapenemases are also addressed in our group.

Of particular interest is the spread and evolution of newly emerging resistance characteristics, of multiresistant strains and of epidemic strain variants. Our studies are based on population-wide analysis of successful clonal lineages and on the identification of genetic determinants for antibiotic resistance and pathogenicity. In addition, we have targeted projects aimed at evaluating advanced diagnostic and typing methodologies. Since decades we serve the "One-health" approach by participating or coordinating various interdisciplinary research projects to identify and quantify agricultural and environmental reservoirs of antibiotic resistance.

Scientists of our unit are active members in various national and international societies and their corresponding working and study groups (German Society for Hygiene and Microbiology (DGHM), the Paul-Ehrlich Society (PEG), the European Society for Clinical Microbiology and Infectious Diseases (ESCMID)) and represent the institute at distinct national and international commissions and institutions, such as at the European Centre for Disease Prevention and Control (ECDC).

Scientists of our unit give lectures and are actively involved in students’ education at universities in neighbouring cities (Braunschweig, Magdeburg, Göttingen, Hanover). Regularly, bachelor, master and PhD students perform their experimental work as part of their studies in our laboratories and under supervision of our scientists.

The unit hosts the German National Reference Centre for Staphylococci and Enterococci.


  • Tracing the emergence and spread of bacterial pathogens (Staphylococcus spp., Enterococcus spp., Enterobacteriaceae) and their characteristic determinants (antibiotic resistance, pathogenicity)
  • Deducing important markers for successful and prevalent bacterial strain types
  • Analysing nosocomial staphylococcal, enterococcal and enterobacterial isolates based on various typing methods
  • evaluating diagnostic and typing assays based on a representative set of staphylococcal, enterococcal and enterobacterial reference and type strains
  • Supporting regulatory bodies and commissions in establishing recommendations for infection prevention and control regarding nosocomial pathogens (KRINKO)


  • BMG-funded project GÜCCI
  • EU-funded project COMPARE
  • BMBF-funded project IRMRESS/InfectControl2020
  • BMBF-funded project MedVetStaph
  • BMBF-funded project RESET
  • BMG-funded project on genome-based phylogeny and contact-network analysis of Klebsiella pneumoniae (IIA5-2513NIK006//321-4471-02/129)
    The project aims at quantifying the benefit of a combined epidemiological, modelling and whole-genome based approach in real-time analyses of outbreaks caused by carbapenemase-producing Klebsiella penumoniae isolates. We collaborate with Units FG37 and P4 of the RKI and the National Reference Centre for multiresistant Gram-negative bacteria, Bochum, Germany.
  • BMG-funded project on Transmission dynamics of nosocomial pathogens (IIA5-2512-FSB-726)
    The project aims at identifying factors other than antibiotic usage influencing emergence and transmission dynamics of multiresistant pathogens at German Intensive Care Units. We collaborate with the University Hospital Charité, Berlin and the National Reference Centre for multiresistant Gram-negative bacteria, Bochum, Germany.
  • BMG-funded project on the Introduction of multiresistant pathogens into hospitals
    The project aims at quantifying the introduction of multiresistant pathogens into German hospitals and Intensive Care Units. We collaborate with the University Hospital Charité, Berlin, and the National Reference Centre for multiresistant Gram-negative bacteria, Bochum, Germany.
  • BMG-funded Network project of National Reference Laboratories (with focus on antibiotic resistance)
    The project aims at analysing the benefit of whole-genome analysis in a network of clinical, public health and reference laboratories in real-time surveillance and outbreak situations. We collaborate with the University Hospital Homburg, the National Reference Centre for multiresistant Gram-negative bacteria, Bochum, Unit FG37, RKI, and the Federal Public Health Laboratory Saarland, Germany.

Date: 17.02.2020


  • Larsen J, Raisen CL, Ba X, Sadgrove NJ, Padilla-González GF, Simmonds MSJ, Loncaric I, Kerschner H, Apfalter P, Hartl R, Deplano A, Vandendriessche S, Černá Bolfíková B, Hulva P, Arendrup MC, Hare RK, Barnadas C, Stegger M, Sieber RN, Skov RL, Petersen A, Angen Ø, Rasmussen SL, Espinosa-Gongora C, Aarestrup FM, Lindholm LJ, Nykäsenoja SM, Laurent F, Becker K, Walther B, Kehrenberg C, Cuny C, Layer F, Werner G, Witte W et al. (2022): Emergence of methicillin resistance predates the clinical use of antibiotics.
    Nature: Epub Jan 5. doi: 10.1038/s41586-021-04265-w. more

  • Weber RE, Pietsch M, Frühauf A, Pfeifer Y, Martin M, Luft D, Gatermann S, Pfennigwerth N, Kaase M, Werner G, Fuchs S (2019): IS26-mediated transfer of blaNDM-1 as the main route of resistance transmission during a polyclonal, multispecies outbreak in a German hospital.
    Front. Microbiol. 10: 2817. Epub Dec 17. doi: 10.3389/fmicb.2019.02817. more

  • Neumann B, Prior K, Bender JK, Harmsen D, Klare I, Fuchs S, Bethe A, Zühlke D, Göhler A, Schwarz S, Schaffer K, Riedel K, Wieler LH, Werner G (2019): A core genome multilocus sequence typing (cgMLST) scheme for Enterococcus faecalis.
    J. Clin. Microbiol. 57 (3): e01686-18. Epub Jan 16. doi: 10.1128/JCM.01686-18. more

  • Cuny C, Layer F, Hansen S, Werner G, Witte W (2019): Nasal colonization of humans with occupational exposure to raw meat and to raw meat products with methicillin-susceptible and methicillin resistant Staphylococcus aureus.
    Toxins (Basel) 11 (4): pii: E190. Epub Mar 30. doi: 10.3390/toxins11040190. more

  • Steinig EJ, Duchene S, Robinson DA, Monecke S, Yokoyama M, Laabei M, Slickers P, Andersson P, Williamson D, Kearns A, Goering RV, Dickson E, Ehricht R, Ip M, O'Sullivan MVN, Coombs GW, Petersen A, Brennan G, Shore AC, Coleman DC, Pantosti A, de Lencastre H, Westh H, Kobayashi N, Heffernan H, Strommenger B, Layer F et al. (2019): Evolution and global transmission of a multidrug-resistant, community-associated Methicillin-resistant Staphylococcus aureus lineage from the Indian subcontinent.
    MBio 10 (6): 257. Epub Feb 25. doi: 10.1007/s15010-019-01281-x. more

  • Lee JYH, Monk IR, Gonçalves da Silva A, Seemann T, Chua KYL, Kearns A, Hill R, Woodford N, Bartels MD, Strommenger B et al. (2018): Global spread of three multidrug-resistant lineages of Staphylococcus epidermidis
    Nat. Microbiol. 3 (10): 1175–1185. Epub Sep 3. doi: 10.1038/s41564-018-0230-7. more

  • Weßels C, Strommenger B, Klare I, Bender JK, Messler S, Mattner F, Krakau M, Werner G, Layer F (2018): Emergence and control of linezolid-resistant Staphylococcus epidermidis in an ICU of a German hospital
    J. Antimicrob. Chemother. 73 (5): 1185-1193. Epub Feb 9. doi: 10.1093/jac/dky010. more

  • Bender JK, Cattoir V, Hegstadt K, Sadowy E, Coque TM, Westh H, Hammerum AM, Schaffer K, Burns K, Murchan S, Novais C, Freitas AR, Peixe L, Del Grosse M, Pantosti A, Werner G (2018): Update on prevalence and mechanisms of resistance to linezolid, tigecycline and daptomycin in enterococci in Europe: towards a common nomenclature
    Drug Resistance Updates 40 (2018): 25-39. Epub Nov 2. doi: 10.1016/j.drup.2018.10.002. more