{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:28:37Z","timestamp":1760059717362,"version":"build-2065373602"},"reference-count":70,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Advisory No. 26 of the Faculty of Chemical Sciences at the Autonomous University of San Luis Potosi"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background:Enterococcus spp. is the third leading cause of healthcare-associated infections in the American continent, often because of the virulence factors that protect the bacterium against host defenses and facilitate tissue attachment and genetic material exchange. In addition, vancomycin, considered a last-resort treatment, has shown reduced efficacy in Enterococcus spp. strains. However, the relationship between bacterial resistance and virulence factors remains unclear. This study intends to evaluate the prevalence of glycopeptide-resistant genotypes and virulence factors in Enterococcus spp. strains. Methods: Over six months, 159 Enterococcus spp. strains causing nosocomial infections were analyzed. Multiplex PCR was performed to identify species, glycopeptide-resistant genotypes, and 12 virulence factors. Results: The most abundant species identified were Enterococcus faecalis and E. faecium. Vancomycin resistance was observed in 10.7% of the isolates, and the vanA genotype was present in 47% of resistant samples. The main virulence factors detected were acm (54%), which is related to cell adhesion; gel E (66%), a metalloproteinase linked to tissue damage; and the sex pheromones cpd (64%) and ccf (84%), which are involved in horizontal gene transfer. A significant association was found between the prevalence of acm, ccf, and cpd in VRE isolates, indicating the potential dissemination of genes to emerging strains via horizontal gene transfer. In addition, a new E. faecium, which displayed five virulence factors and harbored the vanA sequence type, was identified and registered as ST2700. Conclusions:Enterococcus faecalis and E. faecium are clinically critical due to multidrug resistance and virulence factors like acm, which aids host colonization. Genes ccf and cpd promote resistance spread via horizontal transfer, while the emerging ST2700 strain requires urgent monitoring to curb its virulent, drug-resistant spread.<\/jats:p>","DOI":"10.3390\/antibiotics14070663","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T07:42:06Z","timestamp":1751355726000},"page":"663","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Molecular Characterization of Vancomycin-Resistant Enterococcus spp. from Clinical Samples and Identification of a Novel Sequence Type in Mexico"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9963-3652","authenticated-orcid":false,"given":"Ra\u00fal Alejandro","family":"Atriano Briano","sequence":"first","affiliation":[{"name":"Laboratory of Hematology, Faculty of Chemical Sciences, Autonomous University of San Luis Potosi, San Luis Potosi 78240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4837-6536","authenticated-orcid":false,"given":"Nallely S.","family":"Badillo-Larios","sequence":"additional","affiliation":[{"name":"Center of Research in Health Sciences and Biomedicine, Faculty of Medicine, Autonomous University of San Luis Potosi, San Luis Potosi 78210, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perla","family":"Ni\u00f1o-Moreno","sequence":"additional","affiliation":[{"name":"Center of Research in Health Sciences and Biomedicine, Faculty of Medicine, Autonomous University of San Luis Potosi, San Luis Potosi 78210, Mexico"},{"name":"Genetics Laboratory, Faculty of Chemical Sciences, Autonomous University of San Luis Potosi, San Luis Potosi 78240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Fernando","family":"P\u00e9rez-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Autonomous University of San Luis Potosi, San Luis Potosi 78240, Mexico"},{"name":"High Specialty Regional Hospital \u201cDr. Ignacio Morones Prieto\u201d, San Luis Potosi 78240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9028-442X","authenticated-orcid":false,"given":"Edgar A.","family":"Turrubiartes-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Laboratory of Hematology, Faculty of Chemical Sciences, Autonomous University of San Luis Potosi, San Luis Potosi 78240, Mexico"},{"name":"Center of Research in Health Sciences and Biomedicine, Faculty of Medicine, Autonomous University of San Luis Potosi, San Luis Potosi 78210, Mexico"},{"name":"Genetics Laboratory, Faculty of Chemical Sciences, Autonomous University of San Luis Potosi, San Luis Potosi 78240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/j.idc.2020.08.004","article-title":"Resistance in Vancomycin-Resistant Enterococci","volume":"34","author":"Miller","year":"2020","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_2","unstructured":"ECDC (2024, August 14). Antimicrobial Resistance Surveillance in Europe, 2022\u20132020 Data. Available online: https:\/\/atlas.ecdc.europa.eu\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2001628","DOI":"10.2807\/1560-7917.ES.2021.26.45.2001628","article-title":"Hospital-acquired infections caused by enterococci: A systematic review and meta-analysis, who european region, 1 January 2010 to 4 February 2020","volume":"26","author":"Brinkwirth","year":"2021","journal-title":"Eurosurveillance"},{"key":"ref_4","first-page":"56","article-title":"Susceptibilidad antimicrobiana de Enterococcus faecalis y faecium en un hospital de tercer nivel","volume":"31","author":"Flores","year":"2018","journal-title":"Infectol. Pedi\u00e1tr."},{"key":"ref_5","unstructured":"Weaver, K.E. (2024, August 14). Enterococcal Genetics. Available online: https:\/\/journals.asm.org\/journal\/spectrum."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e00058-18","DOI":"10.1128\/CMR.00058-18","article-title":"The enterococcus: A model of adaptability to its environment","volume":"32","author":"Rice","year":"2019","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Garza-Gonz\u00e1lez, E., Morf\u00edn-Otero, R., Mendoza-Olazar\u00e1n, S., Bocanegra-Ibarias, P., Flores-Trevi\u00f1o, S., Rodr\u00edguez-Noriega, E., Ponce-De-Le\u00f3n, A., Sanchez-Francia, D., Franco-Cendejas, R., and Arroyo-Escalante, S. (2019). A snapshot of antimicrobial resistance in Mexico. Results from 47 centers from 20 states during a six-month period. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0209865"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Santajit, S., and Indrawattana, N. (2016). Mechanisms of Antimicrobial Resistance in ESKAPE Pathogens. BioMed Res. Int., 2016.","DOI":"10.1155\/2016\/2475067"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.jgar.2022.10.010","article-title":"A molecular study regarding the spread of vanA vancomycin-resistant Enterococcus faecium in a tertiary hospital in China","volume":"31","author":"Liu","year":"2022","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"O\u2019Toole, R.F., Leong, K.W.C., Cumming, V., and Van Hal, S.J. (2023). Vancomycin-resistant Enterococcus faecium and the emergence of new sequence types associated with hospital infection. Res. Microbiol., 174.","DOI":"10.1016\/j.resmic.2023.104046"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Rios, R., Reyes, J., Carvajal, L.P., Rincon, S., Panesso, D., Echeverri, A.M., Dinh, A., Kolokotronis, S.-O., Narechania, A., and Tran, T.T. (2020). Genomic Epidemiology of Vancomycin-Resistant Enterococcus faecium (VREfm) in Latin America: Revisiting the Global VRE Population Structure. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-62371-7"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"949","DOI":"10.2147\/IDR.S247569","article-title":"Emergence of vanA-Type Vancomycin-Resistant Enterococcus faecium ST 78 Strain with a rep2-Type Plasmid Carrying a Tn1546-Like Element Isolated from a Urinary Tract Infection in China","volume":"13","author":"Sun","year":"2020","journal-title":"Infect. Drug Resist."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"100732","DOI":"10.1016\/j.drup.2020.100732","article-title":"Thirty years of VRE in Germany\u2014\u201cexpect the unexpected\u201d: The view from the National Reference Centre for Staphylococci and Enterococci","volume":"53","author":"Werner","year":"2020","journal-title":"Drug Resist. Updates"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"104519","DOI":"10.1016\/j.meegid.2020.104519","article-title":"Emergence of high-risk multidrug-resistant Enterococcus faecalis CC2 (ST181) and CC87 (ST28) causing healthcare-associated infections in India","volume":"85","author":"Rao","year":"2020","journal-title":"Infect. Genet. Evol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Aung, M.S., Urushibara, N., Kawaguchiya, M., Ohashi, N., Hirose, M., Kudo, K., Tsukamoto, N., Ito, M., and Kobayashi, N. (2023). Antimicrobial Resistance, Virulence Factors, and Genotypes of Enterococcus faecalis and Enterococcus faecium Clinical Isolates in Northern Japan: Identification of optrA in ST480 E. Faecalis Antibiot., 12.","DOI":"10.3390\/antibiotics12010108"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"634","DOI":"10.4161\/viru.28998","article-title":"Correlation between biofilm formation and gelE, esp, and agg genes in Enterococcus spp. clinical isolates","volume":"5","author":"Soares","year":"2014","journal-title":"Virulence"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"301","DOI":"10.4103\/0255-0857.55437","article-title":"Review of virulence factors of enterococcus: An emerging nosocomial pathogen","volume":"27","author":"Upadhyaya","year":"2009","journal-title":"Indian J. Med. Microbiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Van Tyne, D., and Gilmore, M.S. (2014). Friend Turned Foe: Evolution of Enterococcal Virulence and Antibiotic Resistance. Annu. Rev. Microbiol., 68.","DOI":"10.1146\/annurev-micro-091213-113003"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.bjid.2015.11.011","article-title":"Incidence of virulence determinants in clinical Enterococcus faecalis and Enterococcus faecium isolates collected in Bulgaria","volume":"20","author":"Strateva","year":"2016","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_20","first-page":"e00037-18","article-title":"Enterococcus faecalis Sex Pheromone cCF10 Enhances Conjugative Plasmid Transfer In Vivo","volume":"9","author":"Hirt","year":"2018","journal-title":"Am. Soc. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13104-017-3088-5","article-title":"Antimicrobial resistance patterns and virulence factors of enterococci isolates in hospitalized burn patients","volume":"11","author":"Shokoohizadeh","year":"2018","journal-title":"BMC Res. Notes"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Zou, J., Tang, Z., Yan, J., Liu, H., Chen, Y., Zhang, D., Zhao, J., Tang, Y., Zhang, J., and Xia, Y. (2020). Dissemination of Linezolid Resistance Through Sex Pheromone Plasmid Transfer in Enterococcus faecalis. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.01185"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1111\/j.1469-0691.2010.03226.x","article-title":"Mobile genetic elements and their contribution to the emergence of antimicrobial resistant Enterococcus faecalis and Enterococcus faecium","volume":"16","author":"Hegstad","year":"2010","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"877","DOI":"10.3906\/sag-1412-86","article-title":"Determination of virulence and multidrug resistance genes with polymerase chain reaction method in vancomycin-sensitive and-resistant enterococci isolated from clinical samples","volume":"46","year":"2016","journal-title":"Turk. J. Med. Sci."},{"key":"ref_25","first-page":"156","article-title":"Virulence factors, biofilm formation and antibiotic resistance pattern in Enterococcus faecalis and Enterococcus faecium isolated from clinical and commensal human samples in Isfahan, Iran","volume":"31","author":"Ghaziasgar","year":"2019","journal-title":"Ann. Ig."},{"key":"ref_26","first-page":"264","article-title":"Virulence Determinants and Antimicrobial Resistance Patterns of Vancomycin-resistant Enterococcus faecium Isolated from Different Sources in Southwest Iran","volume":"47","author":"Arshadi","year":"2018","journal-title":"Iran. J. Public Health"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Guzman Prieto, A.M., van Schaik, W., Rogers, M.R.C., Coque, T.M., Baquero, F., Corander, J., and Willems, R.J. (2016). Global Emergence and Dissemination of Enterococci as Nosocomial Pathogens: Attack of the Clones?. Front. Microbiol., 7.","DOI":"10.3389\/fmicb.2016.00788"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Hashem, Y.A., Amin, H.M., Essam, T.M., Yassin, A.S., and Aziz, R.K. (2017). Biofilm formation in enterococci: Genotype-phenotype correlations and inhibition by vancomycin. Sci. Rep., 7.","DOI":"10.1038\/s41598-017-05901-0"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.eimc.2015.09.011","article-title":"Phenotypic and genotypic characterization of vancomycin-resistant Enterococcus faecium clinical isolates from two hospitals in Mexico: First detection of VanB phenotype-vanA genotype","volume":"34","year":"2016","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Faron, M.L., Ledeboer, N.A., and Buchan, B.W. (2016). Resistance Mechanisms, Epidemiology, and Approaches to Screening for Vancomycin-Resistant Enterococcus in the Health Care Setting. J. Clin. Microbiol., 54.","DOI":"10.1128\/JCM.00211-16"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"51","DOI":"10.3947\/ic.2017.49.1.51","article-title":"High Incidence of Virulence Factors Among Clinical Enterococcus faecalis Isolates in Southwestern Iran","volume":"49","author":"Heidari","year":"2017","journal-title":"Infect. Chemother."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1089\/mdr.2017.0049","article-title":"Occurrence of Enterococcus faecalis and Enterococcus faecium in Various Clinical Infections: Detection of Their Drug Resistance and Virulence Determinants","volume":"24","author":"Jahansepas","year":"2018","journal-title":"Microb. Drug Resist."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Farsi, S., Salama, I., Escalante-Alderete, E., and Cervantes, J. (2023). Multidrug-Resistant Enterococcal Infection in Surgical Patients, What Surgeons Need to Know. Microorganisms, 11.","DOI":"10.3390\/microorganisms11020238"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1089\/sur.2020.057","article-title":"Treatment with Ceftriaxone in Complicated Diverticulitis Increases the Incidence of Intra-Abdominal Enterococcus faecium Detection","volume":"22","author":"Pochhammer","year":"2021","journal-title":"Surg. Infect."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e12856","DOI":"10.1111\/tid.12856","article-title":"Comparison of risk factors and outcomes of daptomycin-susceptible and -nonsusceptible vancomycin-resistant Enterococcus faecium infections in liver transplant recipients","volume":"20","author":"Lewis","year":"2018","journal-title":"Transpl. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Urban-Chmiel, R., Marek, A., St\u0119pie\u0144-Py\u015bniak, D., Wieczorek, K., Dec, M., Nowaczek, A., and Osek, J. (2022). Antibiotic Resistance in Bacteria\u2014A Review. Antibiotics, 11.","DOI":"10.3390\/antibiotics11081079"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.jgar.2018.02.022","article-title":"Distribution, genetic diversity and antimicrobial resistance of clinically important bacteria from the environment of a tertiary hospital in Malaysia","volume":"14","author":"Phoon","year":"2018","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s13756-019-0508-4","article-title":"Genomic analysis of multidrug-resistant clinical Enterococcus faecalis isolates for antimicrobial resistance genes and virulence factors from the western region of Saudi Arabia","volume":"8","author":"Farman","year":"2019","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1055\/s-0042-1750085","article-title":"Antibiogram Pattern and Virulence Trait Characterization of Enterococcus Species Clinical Isolates in Eastern India: A Recent Analysis","volume":"14","author":"Mohanty","year":"2022","journal-title":"J. Lab. Physicians"},{"key":"ref_40","first-page":"68","article-title":"Estudio multic\u00e9ntrico de resistencias bacterianas nosocomiales en M\u00e9xico","volume":"30","author":"Granillo","year":"2017","journal-title":"Rev. Latin. Infect. Pediatr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1128\/JCM.02526-09","article-title":"Molecular epidemiology of vancomycin-resistant Enterococcus faecium: A prospective, multicenter study in South American hospitals","volume":"48","author":"Panesso","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.jgar.2020.01.010","article-title":"Risk factors and outcome associated with the acquisition of linezolid-resistant Enterococcus faecalis","volume":"21","year":"2020","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_43","first-page":"3129439","article-title":"Determination of Enterococcus faecalis and Enterococcus faecium Antimicrobial Resistance and Virulence Factors and Their Association with Clinical and Demographic Factors in Kenya","volume":"2022","author":"Georges","year":"2022","journal-title":"J. Pathog."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1089\/mdr.2017.0380","article-title":"Molecular Epidemiology of Vancomycin\u2013Resistant Enterococcus faecalis and Enterococcus faecium Isolated from Clinical Specimens in the Northwest of Iran","volume":"24","author":"Jahansepas","year":"2018","journal-title":"Microb. Drug Resist."},{"key":"ref_45","unstructured":"U.S. Department of Health & Human Services (2024, August 14). Antibiotic Resistance Threats in the United States, 2019, Available online: https:\/\/stacks.cdc.gov\/view\/cdc\/82532."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"17","DOI":"10.46234\/ccdcw2021.277","article-title":"Antimicrobial-Resistant Evolution and Global Spread of Enterococcus faecium Clonal Complex (CC) 17: Progressive Change from Gut Colonization to Hospital-Adapted Pathogen","volume":"4","author":"Peng","year":"2022","journal-title":"China CDC Wkly."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jgar.2018.08.016","article-title":"Antimicrobial-resistant CC17 Enterococcus faecium: The past, the present and the future","volume":"16","author":"Lee","year":"2019","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Valenza, G., Eisenberger, D., Voigtl\u00e4nder, S., Alsalameh, R., Gerlach, R., Koch, S., Kunz, B., Held, J., and Bogdan, C. (2023). Emergence of novel ST1299 vanA lineages as possible cause for the striking rise of vancomycin resistance among invasive strains of Enterococcus faecium at a German university hospital. Microbiol. Spectr., 11.","DOI":"10.1128\/spectrum.02962-23"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.meegid.2015.05.012","article-title":"Molecular characterization of resistance, virulence and clonality in vancomycin-resistant Enterococcus faecium and Enterococcus faecalis: A hospital-based study in Beijing, China","volume":"33","author":"Yang","year":"2015","journal-title":"Infect. Genet. Evol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"4315","DOI":"10.1128\/AAC.00384-15","article-title":"Epidemiology of vancomycin-resistant enterococci in Canadian hospitals (CANWARD study, 2007 to 2013)","volume":"59","author":"Simner","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.jgar.2015.12.002","article-title":"Clinical epidemiology of vancomycin-resistant Enterococcus gallinarum and Enterococcus casseliflavus bloodstream infections","volume":"5","author":"Britt","year":"2016","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1093\/jac\/dkab408","article-title":"Linezolid-resistant Enterococcus gallinarum isolate of swine origin carrying cfr, optrA and poxtA genes","volume":"77","author":"Coccitto","year":"2022","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1590\/S0074-02762012000100008","article-title":"Risk factors for vancomycin-resistant enterococci colonisation in critically ill patients","volume":"107","author":"Ribas","year":"2012","journal-title":"Mem. Inst. Oswaldo Cruz"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jiac.2018.01.001","article-title":"Clinical management of non- faecium non- faecalis vancomycin- resistant enterococci infection. Focus on Enterococcus gallinarum and Enterococcus casseliflavus\/flavescens","volume":"24","author":"Monticelli","year":"2018","journal-title":"J. Infect. Chemother."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1099\/jmm.0.45654-0","article-title":"Occurrence of virulence-associated genes in clinical Enterococcus faecalis strains isolated in Londrina, Brazil","volume":"53","author":"Suzart","year":"2004","journal-title":"J. Med. Microbiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1590\/S0074-02762013000500009","article-title":"Presence of virulence factors in Enterococcus faecalis and Enterococcus faecium susceptible and resistant to vancomycin","volume":"108","author":"Comerlato","year":"2013","journal-title":"Mem. Inst. Oswaldo Cruz"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"16","DOI":"10.4103\/0974-777X.176141","article-title":"Molecular Characterization of Virulence Genes in Vancomycin-Resistant and Vancomycin-Sensitive Enterococci","volume":"8","author":"Biswas","year":"2016","journal-title":"J. Glob. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1080\/09603123.2018.1497777","article-title":"Prevalence of virulence determinants and antibiotic resistance patterns of Enterococcus faecalis strains in patients with community-acquired urinary tract infections in Iran","volume":"28","author":"Karimi","year":"2018","journal-title":"Int. J. Environ. Health Res."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Doss Susai backiam, A., Duraisamy, S., Karuppaiya, P., Balakrishnan, S., Chandrasekaran, B., Kumarasamy, A., and Raju, A. (2023). Antibiotic Susceptibility Patterns and Virulence-Associated Factors of Vancomycin-Resistant Enterococcal Isolates from Tertiary Care Hospitals. Antibiotics, 12.","DOI":"10.3390\/antibiotics12060981"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Igbinosa, E.O., and Beshiru, A. (2019). Antimicrobial Resistance, Virulence Determinants, and Biofilm Formation of Enterococcus Species from Ready-to-Eat Seafood. Front. Microbiol., 10.","DOI":"10.3389\/fmicb.2019.00728"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"34","DOI":"10.2174\/1874285801206010034","article-title":"Survey of Virulence Determinants among Vancomycin Resistant Enterococcus faecalis and Enterococcus faecium Isolated from Clinical Specimens of Hospitalized Patients of North west of Iran","volume":"6","author":"Sharifi","year":"2012","journal-title":"Open Microbiol. J."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Shahraki, S., and Mousavi, M.R.N. (2017). Determination of virulence factors in clinical multidrug resistance enterococci isolates at Southeast of Iran. Jundishapur J. Microbiol., 10.","DOI":"10.5812\/jjm.45514"},{"key":"ref_63","first-page":"692612","article-title":"Prevalence of Virulence Factors and Drug Resistance in Clinical Isolates of Enterococci: A Study from North India","volume":"2015","author":"Banerjee","year":"2015","journal-title":"J. Pathog."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e02763-16","DOI":"10.1128\/AAC.02763-16","article-title":"Subinhibitory Concentrations of Ciprofloxacin Enhance Antimicrobial Resistance and Pathogenicity of Enterococcus faecium","volume":"61","author":"Sinel","year":"2017","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Geraldes, C., Tavares, L., Gil, S., and Oliveira, M. (2022). Enterococcus Virulence and Resistant Traits Associated with Its Permanence in the Hospital Environment. Antibiotics, 11.","DOI":"10.3390\/antibiotics11070857"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1128\/microbiolspec.GPP3-0053-2018","article-title":"Pathogenicity of Enterococci","volume":"7","author":"Fiore","year":"2019","journal-title":"Microbiol. Spectr."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Zhu, L., Yang, X., Fu, X., Yang, P., Lin, X., Wang, F., Shen, Z., Wang, J., Sun, F., and Qiu, Z. (2024). Pheromone cCF10 inhibits the antibiotic persistence of Enterococcus faecalis by modulating energy metabolism. Front. Microbiol., 15.","DOI":"10.3389\/fmicb.2024.1408701"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1128\/AEM.67.4.1628-1635.2001","article-title":"Molecular Screening of Enterococcus Virulence Determinants and Potential for Genetic Exchange between Food and Medical Isolates","volume":"67","author":"Eaton","year":"2001","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/lam.12474","article-title":"Virulence and antimicrobial resistance of Enterococcus faecium isolated from water samples","volume":"61","author":"Enayati","year":"2015","journal-title":"Lett. Appl. Microbiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1128\/JCM.40.6.1963-1971.2002","article-title":"Multilocus sequence typing scheme for Enterococcus faecium","volume":"40","author":"Homan","year":"2002","journal-title":"J. Clin. Microbiol."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/7\/663\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:02:14Z","timestamp":1760032934000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/7\/663"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":70,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["antibiotics14070663"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14070663","relation":{},"ISSN":["2079-6382"],"issn-type":[{"type":"electronic","value":"2079-6382"}],"subject":[],"published":{"date-parts":[[2025,6,30]]}}}