{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:41:06Z","timestamp":1792510866614,"version":"4.5.0"},"reference-count":49,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The rise of vancomycin-resistant\n                      <jats:italic toggle=\"yes\">Enterococcus faecium<\/jats:italic>\n                      (VREfm) poses a growing global health threat. This study aimed to characterize the molecular features and resistance mechanisms of clinical VREfm isolates from a Chinese tertiary hospital. Eighteen VREfm isolates were identified using matrix-assisted laser desorption\/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and whole-genome sequencing (WGS). Antimicrobial susceptibility testing was performed via the broth microdilution method. Resistance mechanisms and molecular epidemiology were analyzed using WGS and bioinformatics tools. Additionally, plasmid-mediated transfer of vancomycin resistance genes was evaluated through conjugation assays. Among the 18 VREfm isolates, 13 carried only the\n                      <jats:italic toggle=\"yes\">vanHAX<\/jats:italic>\n                      gene cluster, while 5 harbored both the\n                      <jats:italic toggle=\"yes\">vanHAX<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">vanHMX<\/jats:italic>\n                      gene clusters. Notably, two VREfm strains\u2014EFM250320 and EFM250826\u2014were isolated from the same patient but from specimens of the same type collected at different time points. Strain EFM250320 carried both the\n                      <jats:italic toggle=\"yes\">vanHAX<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">vanHMX<\/jats:italic>\n                      gene clusters, whereas strain EFM250826 carried not only the\n                      <jats:italic toggle=\"yes\">vanHAX<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">vanHMX<\/jats:italic>\n                      gene clusters, but also a G2505A mutation in the 23S rRNA gene associated with linezolid resistance. Five distinct sequence types (STs) were identified, with ST80 (44.4%, 8\/18) being the predominant type.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        This study reveals notable drug resistance patterns in vancomycin-resistant\n                        <jats:italic toggle=\"yes\">Enterococcus faecium<\/jats:italic>\n                        (VREfm) bacteria at our hospital, with multiple resistance genes identified in the isolates. Notably, one strain was found to concurrently harbor both the\n                        <jats:italic toggle=\"yes\">vanHAX<\/jats:italic>\n                        and\n                        <jats:italic toggle=\"yes\">vanHMX<\/jats:italic>\n                        gene clusters, along with a G2505A mutation in the 23S rRNA gene that confers resistance to linezolid. The dissemination of the dominant ST80 clone suggests potential intra-hospital transmission. These findings underscore the necessity for enhanced surveillance and stringent infection control measures to curb the spread of such hazardous multidrug-resistant pathogens.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.00014-26","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:00:20Z","timestamp":1787662820000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Molecular characterization of vancomycin-resistant\n                    <i>Enterococcus faecium<\/i>\n                    and identification of a clinical strain co-harboring the G2505A mutation associated with linezolid resistance from a tertiary hospital in China"],"prefix":"10.1128","volume":"14","author":[{"given":"Ni","family":"Suo","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056swr059","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]},{"id":[{"id":"https:\/\/ror.org\/01wfgh551","id-type":"ROR","asserted-by":"publisher"}],"name":"The First Clinical Medical College of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujing","family":"Wang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01wfgh551","id-type":"ROR","asserted-by":"publisher"}],"name":"The First Clinical Medical College of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunguang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Sixth People\u2019s Hospital of Zhengzhou City","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijun","family":"Li","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056swr059","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]},{"id":[{"id":"https:\/\/ror.org\/01wfgh551","id-type":"ROR","asserted-by":"publisher"}],"name":"The First Clinical Medical College of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Yi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/056swr059","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, 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