{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T21:29:03Z","timestamp":1781040543971,"version":"3.54.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100002918","name":"Copenhagen University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002918","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Daptomycin is a cyclic lipopeptide used in the treatment of vancomycin-resistant Enterococcus faecium (VREfm). However, the development of daptomycin-resistant VREfm challenges the treatment of nosocomial VREfm infections. Resistance mechanisms of daptomycin are not fully understood. Here, we analyzed the genomic changes leading to a daptomycin-susceptible VREfm isolate becoming resistant after 50 days of daptomycin and linezolid combination therapy. A total of seven isogenic VREfm isolates from the same patient (daptomycin-susceptible and daptomycin-resistant) were analyzed using Illumina whole genome sequencing, and two isolates were further characterized with Nanopore sequencing. One nonsynonymous SNP in the rpoC gene previously shown to harbor mutations in daptomycin-resistant VREfm was identified in the daptomycin-resistant isolates. Whole genome comparative analysis identified the loss of a 46.5 kb fragment, duplication of a 29.7 kb fragment, and integration of two plasmids upon acquisition of daptomycin resistance. Transmission electron microscopy showed similar alterations in cell morphology and cell wall structure as have previously been described in daptomycin-resistant E. faecalis.<\/jats:p>","DOI":"10.1093\/femsle\/fnac063","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:49:07Z","timestamp":1659574147000},"source":"Crossref","is-referenced-by-count":12,"title":["Rapid <i>in vivo<\/i> development of resistance to daptomycin in vancomycin-resistant <i>Enterococcus faecium<\/i> due to genomic alterations"],"prefix":"10.1093","volume":"369","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2429-4018","authenticated-orcid":false,"given":"Sarah","family":"Mollerup","sequence":"first","affiliation":[{"name":"Department of Clinical Microbiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre Hospital , Ketteg\u00e5rd Alle 30, DK2650 Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Elmeskov","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre Hospital , Ketteg\u00e5rd Alle 30, DK2650 Hvidovre, Denmark"},{"name":"Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen , Stigb\u00f8jlen 4, 1870 Frederiksberg C, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Pinholt","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre Hospital , Ketteg\u00e5rd Alle 30, DK2650 Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias S","family":"Sejersen","sequence":"additional","affiliation":[{"name":"Core Facility for Integrated Microscopy, Faculty of Health and Medical Sciences, University of Copenhagen , Blegdamsvej 3, 2200 Copenhagen N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin S","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre Hospital , Ketteg\u00e5rd Alle 30, DK2650 Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peder","family":"Worning","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre Hospital , Ketteg\u00e5rd Alle 30, DK2650 Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorte","family":"Frees","sequence":"additional","affiliation":[{"name":"Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen , Stigb\u00f8jlen 4, 1870 Frederiksberg C, 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