{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:28:06Z","timestamp":1787923686846,"version":"build-2784847793"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971988"],"award-info":[{"award-number":["81971988"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n This study investigated the clonal dissemination and molecular basis of linezolid-, tigecycline- and vancomycin-resistant E. faecium (LTVRE) isolates in a surgical intensive care unit (SICU) of a Chinese hospital.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Three LTVRE isolates collected from patients in the SICU were subjected to antimicrobial susceptibility testing and whole-genome sequencing analysis. S1 nuclease pulsed-field gel electrophoresis was performed to verify the topology of plasmids. Conjugation experiments were conducted to evaluate the transferability of resistance determinants.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n WGS analysis demonstrated that the three LTVRE belonged to the same clone (Sequence Type 78). The optrA and vanA genes were co-located on a transferable large linear plasmid (327.5\u2005kb in size) and contributed resistance to linezolid and vancomycin. A tet(M) variant carrying a phenylalanine-to-isoleucine substitution at Position 473 (F473I) was identified within a Tn916-like transposon. Although chromosomally encoded, this element retains the capacity for horizontal transfer to E. faecium BM4105RF and conferred tigecycline resistance.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our findings reveal a resistance dissemination strategy in which plasmid-borne and chromosomal mobile genetic elements independently or cooperatively drive the spread of resistance to last-line antibiotics and highlight the urgent need for enhanced surveillance of multidrug-resistant E. faecium, such as LTVRE.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/jac\/dkag292","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:16:22Z","timestamp":1786706182000},"source":"Crossref","is-referenced-by-count":0,"title":["Clonal spread of linezolid-, tigecycline-, and vancomycin-resistant\n Enterococcus faecium<\/i>\n isolates co-harbouring transferable\n optrA<\/i>\n ,\n vanA<\/i>\n and\n tet<\/i>\n (M) variant"],"prefix":"10.1093","volume":"81","author":[{"given":"Kaiqi","family":"Zeng","sequence":"first","affiliation":[{"name":"Clinical Microbiology Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University , Hangzhou 310009 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiyi","family":"Shen","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University , Hangzhou 310009 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9452-7118","authenticated-orcid":false,"given":"Jiachang","family":"Cai","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University , Hangzhou 310009 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