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This study investigated the molecular epidemiology of linezolid-resistant Enterococcusfaecalis strains and the genetic environment of linezolid-resistance genes, in immunocompromised patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This study investigated two linezolid-resistant E. faecalis strains (minimal inhibitory concentration\u00a0=\u00a016\u00a0mg\/l). These colonizing strains were isolated from patients at Tunisia\u2019s National Bone Marrow Transplant Center. Both strains exhibited a multidrug resistant phenotype. Whole-genome sequencing revealed the co-occurrence of optrA and fexA resistance genes, for the first time, in ST300 and ST861 E. faecalis. Concerning the ST300 strain, optrA and fexA were located on a novel plasmid pS1987-optrA sharing high similarity with plasmids from clinical isolates in Japan and the Netherlands. Comparative genomics highlighted genetic diversity in the optrA region among geographically linked isolates, suggesting plasmid-mediated spread.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study reported, for the first time, the co-occurrence of optrA and fexA genes in linezolid-resistant E. faecalis ST300 and ST861, harbored by a novel plasmid in the ST300 strain.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jambio\/lxaf248","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T13:18:38Z","timestamp":1759756718000},"source":"Crossref","is-referenced-by-count":1,"title":["Linezolid resistance in immunocompromised patients: Co-occurrence of <i>optrA<\/i> and <i>fexA<\/i> genes harbored by a novel plasmid in <i>Enterocococus faecalis<\/i> 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