Abstract: OBJECTIVE To explore the clinical characteristics of patients with vancomycin-resistant Enterococcus faecium (VR-Efm) infection/colonization and observe the related contamination of their surroundings so as to provide bases for prevention and control of health care-associated infections (HAIs). METHODS The clinical data were collected from 9 patients who were detected with VR-Efm in the Fifth Affiliated Hospital Sun Yat-sen University from Jul. 2024 to Oct. 2024. The environmental hygiene surveillance was carried for the body surfaces and highly frequent contact surfaces of the patients, and the status of implementation of the control and prevention measures was evaluated. RESULTS Among the 9 patients, urine specimens were collected from 6 cases, ascites from 2 cases, abdominal drainage fluid from 1 case. There were 4 cases of community-acquired infections, 4 cases of community-associated colonization, and 1 case of HAIs. The age was 71.00(57.50,77.50) years old, and the length of hospital stay was 22.00(11.00,44.50)days. All of the 9 VR-Efm isolates were resistant to vancomycin, teicoplanin, ampicillin, penicillin and levofloxacin, while the strains were sensitive to linezolid and teicoplanin. The synergy test showed that 8 strains were resistant to high concentration of gentamycin. A total of 10 VR-Efm isolates were detected in the body surface colonization screening (detection rate 45.45%), of which 7 were from perianal swabs. The detection rate was higher from the perianal swabs than from the nasal and pharyngeal swabs (P=0.008). Totally 6 VR-Efm isolates were detected on environmental surfaces (detection rate 6.98%, 6/86). Contamination was concentrated on bedside tables and bedside chairs of the bedridden patients, and on toilet door handles and toilet buttons of the ambulatory patients. The contamination rate of the highly frequent contact surfaces (bedside areas plus bathroom facilities) was significantly higher than that on the low-frequency contact surfaces (P=0.033). No VR-Efm was detected on hand surface specimens, but opportunistic pathogens were detected on the hands of cleaning staff. CONCLUSIONS VR-Efm is predominantly community-derived, with VanA as the dominant resistance phenotype and the intestinal tract as the main colonization site. The distribution of environmental contamination is closely associated with the patient mobility. It is recommended to implement a differentiated disinfection strategy, strengthen the bed unit disinfection for the bedridden patients and enhance the bathroom area disinfection for the ambulatory patients.