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One-hundred twenty-five clinical isolates of VR<jats:italic>Efs<\/jats:italic>-VanA collected between 2004 and 2016 were studied by phenotypic assays, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), PCR detection of plasmid-specific genes, and Tn<jats:italic>1546<\/jats:italic> structure and localization mapping. Selected isolates were subjected to PFGE-S1, Southern hybridization, genomic sequencing and conjugation experiments. The majority of isolates (97.6%) belonged to clonal complexes CC2 and CC87 of <jats:italic>E. faecalis<\/jats:italic>. All isolates were resistant to vancomycin and teicoplanin, and resistance to ciprofloxacin and aminoglycosides (high level) was very prevalent in this group. VanA phenotype was associated with 16 types of Tn<jats:italic>1546<\/jats:italic>, carrying insertion sequences IS<jats:italic>1216<\/jats:italic>, IS<jats:italic>Efa4<\/jats:italic>, IS<jats:italic>1251<\/jats:italic> and IS<jats:italic>1542,<\/jats:italic> located on <jats:italic>repUS1<\/jats:italic><jats:sub>pVEF1<\/jats:sub>, <jats:italic>rep1<\/jats:italic><jats:sub>pIP501<\/jats:sub>, <jats:italic>rep2<\/jats:italic><jats:sub>pRE25<\/jats:sub>, <jats:italic>rep9<\/jats:italic><jats:sub>pAD1\/pTEF2\/pCF10<\/jats:sub> and <jats:italic>rep6<\/jats:italic><jats:sub>pS86<\/jats:sub> replicons. The most common Tn<jats:italic>1546<\/jats:italic> B- and BB-type transposons, harbouring one or two copies of IS<jats:italic>1216<\/jats:italic>, were inserted between <jats:italic>rep18a<\/jats:italic><jats:sub>p200B<\/jats:sub> and <jats:italic>repUS1<\/jats:italic><jats:sub>pVEF1<\/jats:sub> genes and located on\u2009~\u200920\u00a0kb and 150\u2013200\u00a0kb plasmids. VR<jats:italic>Efs-<\/jats:italic>VanA in Poland represent a polyclonal group, indicating a number of acquisitions of the <jats:italic>vanA<\/jats:italic> determinant. The <jats:italic>repUS1<\/jats:italic><jats:sub>pVEF1<\/jats:sub>-<jats:italic>vanA<\/jats:italic> plasmids, unique for Poland, were the main factor beyond the acquisition of vancomycin resistance by <jats:italic>E. faecalis,<\/jats:italic> circulating in Polish hospitals.<\/jats:p>","DOI":"10.1007\/s10096-022-04479-4","type":"journal-article","created":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T16:02:40Z","timestamp":1662220960000},"page":"1245-1261","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["VanA-Enterococcus faecalis in Poland: hospital population clonal structure and vanA mobilome"],"prefix":"10.1007","volume":"41","author":[{"given":"Ewa","family":"Wardal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorota","family":"\u017babicka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleria","family":"Hryniewicz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0284-6440","authenticated-orcid":false,"given":"Ewa","family":"Sadowy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,3]]},"reference":[{"key":"4479_CR1","unstructured":"European Centre for Disease Prevention and Control (2020) Antimicrobial resistance in the EU\/EEA (EARS-Net) - Annual Epidemiological Report 2019. 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