{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:50:36Z","timestamp":1787788236951,"version":"build-2784847793"},"reference-count":48,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>\n                    The emerging Vancomycin-resistant\n                    <jats:italic>Enterococcus faecium<\/jats:italic>\n                    (VRE-fm) is an opportunistic pathogen causing nosocomial infections. The identification of VRE-fm is important for successful prevention and control in healthcare settings. VRE-fm clinical isolates obtained from regional hospitals in northern Taiwan were characterized for antimicrobial susceptibility, virulence genes and biofilm production. Most isolates exhibited multi-drug resistance and carried the virulence genes,\n                    <jats:italic>esp<\/jats:italic>\n                    and\n                    <jats:italic>hyl<\/jats:italic>\n                    . While all isolates produce biofilms, those isolates that carried\n                    <jats:italic>esp<\/jats:italic>\n                    exhibited greater biofilm production. Isolates with different virulence gene carriages were examined for pathogenicity by using a nematode model,\n                    <jats:italic>Caenorhabditis elegans<\/jats:italic>\n                    , for determining microbial-host interactions. The survival assay showed that\n                    <jats:italic>C. elegans<\/jats:italic>\n                    was susceptible to Linezolid-resistant VRE-fm isolates with\n                    <jats:italic>hyl<\/jats:italic>\n                    . Combining the molecular epidemiological profiles regarding pathogenesis in\n                    <jats:italic>C. elegans<\/jats:italic>\n                    can serve as a guide for physicians in limiting opportunistic infections caused by VRE-fm.\n                  <\/jats:p>","DOI":"10.7717\/peerj.14859","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T04:32:36Z","timestamp":1677126756000},"page":"e14859","source":"Crossref","is-referenced-by-count":9,"title":["Epidemiological profiles and pathogenicity of Vancomycin-resistant\n                    <i>Enterococcus faecium<\/i>\n                    clinical isolates in Taiwan"],"prefix":"10.7717","volume":"11","author":[{"given":"Pei-Yun","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Laboratory, Taipei City Hospital, Yang-Ming Branch, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang-Yih","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Taipei City Hospital, Yang-Ming Branch, Taipei, Taiwan"},{"name":"Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan"},{"name":"Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold","family":"Stern","sequence":"additional","affiliation":[{"name":"Grossman School of Medicine, New York University, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Hsiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Research Center for Chinese Herbal Medicine, Graduate Institute of Health Industry Technology, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Chi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology, Hsinchu, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"issue":"24","key":"10.7717\/peerj.14859\/ref-1","doi-asserted-by":"publisher","first-page":"e00361","DOI":"10.1128\/JB.00361-18","article-title":"Planktonic interference and biofilm alliance between aggregation substance and endocarditis- and biofilm-associated pili in Enterococcus faecalis","volume":"200","author":"Afonina","year":"2018","journal-title":"Journal of Bacteriology"},{"issue":"2","key":"10.7717\/peerj.14859\/ref-2","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1111\/1574-6968.12418","article-title":"Influence of isolate origin and presence of various genes on biofilm formation by Enterococcus faecium","volume":"353","author":"Almohamad","year":"2014","journal-title":"FEMS Microbiology Letters"},{"key":"10.7717\/peerj.14859\/ref-3","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":"Iranian Journal of Public Health"},{"key":"10.7717\/peerj.14859\/ref-4","doi-asserted-by":"publisher","first-page":"1596","DOI":"10.3389\/fmicb.2017.01596","article-title":"Characterization of Enterococcus isolates colonizing the intestinal tract of intensive care unit patients receiving selective digestive decontamination","volume":"8","author":"Bello Gonzalez","year":"2017","journal-title":"Frontiers in Microbiology"},{"issue":"1","key":"10.7717\/peerj.14859\/ref-5","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1089\/mdr.2018.0027","article-title":"Relationship between biofilm formation and antimicrobial resistance in gram-negative bacteria","volume":"25","author":"Cepas","year":"2019","journal-title":"Microbial Drug Resistance"},{"issue":"1","key":"10.7717\/peerj.14859\/ref-6","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1096\/fj.201901959R","article-title":"Nucleolar control by a non-apoptotic p53-caspases-deubiquitinylase axis promotes resistance to bacterial infection","volume":"34","author":"Chen","year":"2020","journal-title":"The FASEB Journal"},{"key":"10.7717\/peerj.14859\/ref-7","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.jgar.2017.09.009","article-title":"Resistance mechanisms and clinical characteristics of linezolid-resistant Enterococcus faecium isolates: a single-centre study in South Korea","volume":"12","author":"Cho","year":"2018a","journal-title":"Journal of Global Antimicrobial Resistance"},{"issue":"3","key":"10.7717\/peerj.14859\/ref-8","doi-asserted-by":"publisher","first-page":"226","DOI":"10.3343\/alm.2018.38.3.226","article-title":"Comparison of Enterococcus faecium bacteremic isolates from hematologic and non-hematologic patients: differences in antimicrobial resistance and molecular characteristics","volume":"38","author":"Cho","year":"2018b","journal-title":"Annals of Laboratory Medicine"},{"issue":"4","key":"10.7717\/peerj.14859\/ref-9","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.micpath.2017.05.014","article-title":"Phenotypic and genotypic study of biofilm formation in Enterococci isolated from urinary tract infections","volume":"108","author":"Fallah","year":"2017","journal-title":"Microbial Pathogenesis"},{"issue":"2","key":"10.7717\/peerj.14859\/ref-10","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1093\/jac\/dkx387","article-title":"Distribution of putative virulence markers in Enterococcus faecium: towards a safety profile review","volume":"73","author":"Freitas","year":"2018","journal-title":"Journal of Antimicrobial Chemotherapy"},{"issue":"8","key":"10.7717\/peerj.14859\/ref-11","doi-asserted-by":"publisher","first-page":"1525","DOI":"10.1080\/21505594.2017.1279766","article-title":"Model systems for the study of enterococcal colonization and infection","volume":"8","author":"Goh","year":"2017","journal-title":"Virulence"},{"issue":"1","key":"10.7717\/peerj.14859\/ref-12","doi-asserted-by":"publisher","first-page":"26","DOI":"10.5578\/mb.68810","article-title":"Investigation of antibiotic resistance and virulence factors of Enterococcus faecium and Enterococcus faecalis strains isolated from clinical samples","volume":"54","author":"Gok","year":"2020","journal-title":"Mikrobiyoloji Bulteni"},{"key":"10.7717\/peerj.14859\/ref-13","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.2147\/IDR.S305167","article-title":"Phenotype-genotype correlations and distribution of key virulence factors in Enterococcus faecalis isolated from patients with urinary tract infections","volume":"14","author":"Hashem","year":"2021","journal-title":"Infection and Drug Resistance"},{"issue":"6","key":"10.7717\/peerj.14859\/ref-14","doi-asserted-by":"publisher","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":"Journal of Clinical Microbiology"},{"key":"10.7717\/peerj.14859\/ref-15","doi-asserted-by":"publisher","first-page":"728","DOI":"10.3389\/fmicb.2019.00728","article-title":"Antimicrobial resistance, virulence determinants, and biofilm formation of Enterococcus species from ready-to-eat seafood","volume":"10","author":"Igbinosa","year":"2019","journal-title":"Frontiers in Microbiology"},{"issue":"11","key":"10.7717\/peerj.14859\/ref-16","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.archoralbio.2018.01.008","article-title":"Presence of the esp gene in Enterococcus faecium derived from oropharyngeal microbiota of haematology patients","volume":"88","author":"Jovanovic","year":"2018","journal-title":"Archives of Oral Biology"},{"issue":"9","key":"10.7717\/peerj.14859\/ref-17","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1111\/1348-0421.12834","article-title":"Animal infection models using non-mammals","volume":"64","author":"Kaito","year":"2020","journal-title":"Microbiology and Immunology"},{"issue":"8","key":"10.7717\/peerj.14859\/ref-18","doi-asserted-by":"publisher","first-page":"3092","DOI":"10.1128\/JCM.38.8.3092-3095.2000","article-title":"Simple and reliable multiplex PCR assay for surveillance isolates of Vancomycin-resistant Enterococci","volume":"38","author":"Kariyama","year":"2000","journal-title":"Journal of Clinical Microbiology"},{"issue":"3","key":"10.7717\/peerj.14859\/ref-19","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.micres.2018.06.012","article-title":"Bacteria and bacterial products: foe and friends to Caenorhabditis elegans","volume":"215","author":"Khan","year":"2018","journal-title":"Microbiological Research"},{"issue":"9","key":"10.7717\/peerj.14859\/ref-20","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.3390\/antibiotics11091175","article-title":"Phage cocktails with daptomycin and ampicillin eradicates biofilm-embedded multidrug-resistant Enterococcus faecium with preserved phage susceptibility","volume":"11","author":"Kunz Coyne","year":"2022","journal-title":"Antibiotics"},{"issue":"6","key":"10.7717\/peerj.14859\/ref-21","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1016\/j.jmii.2018.08.008","article-title":"Vancomycin-resistant Enterococcus faecium at a university hospital in Taiwan, 2002-2015: fluctuation of genetic populations and emergence of a new structure type of the Tn1546-like element","volume":"51","author":"Kuo","year":"2018","journal-title":"Journal of Microbiology, Immunology and Infection"},{"issue":"Suppl. 1","key":"10.7717\/peerj.14859\/ref-22","doi-asserted-by":"publisher","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":"Journal of Global Antimicrobial Resistance"},{"issue":"15","key":"10.7717\/peerj.14859\/ref-23","doi-asserted-by":"publisher","first-page":"5320","DOI":"10.3390\/ijms21155320","article-title":"Microbial virulence factors","volume":"21","author":"Leitao","year":"2020","journal-title":"International Journal of Molecular Sciences"},{"issue":"5","key":"10.7717\/peerj.14859\/ref-24","doi-asserted-by":"publisher","first-page":"e01978","DOI":"10.1128\/AAC.01978-18","article-title":"Expansion of Vancomycin-resistant Enterococcus faecium in an academic tertiary hospital in Southwest Germany: a large-scale whole-genome-based outbreak investigation","volume":"63","author":"Liese","year":"2019","journal-title":"Antimicrobial Agents and Chemotherapy"},{"key":"10.7717\/peerj.14859\/ref-25","doi-asserted-by":"publisher","first-page":"e9020","DOI":"10.7717\/peerj.9020","article-title":"Characterization of biofilm production in different strains of Acinetobacter baumannii and the effects of chemical compounds on biofilm formation","volume":"8","author":"Lin","year":"2020","journal-title":"PeerJ"},{"issue":"1","key":"10.7717\/peerj.14859\/ref-26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4014\/jmb.2010.10021","article-title":"Mechanisms and control strategies of antibiotic resistance in pathological biofilms","volume":"31","author":"Luo","year":"2021","journal-title":"Journal of Microbiology and Biotechnology"},{"issue":"1","key":"10.7717\/peerj.14859\/ref-27","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1186\/s13104-018-3820-9","article-title":"Evaluation of methods to detect in vitro biofilm formation by staphylococcal clinical isolates","volume":"11","author":"Manandhar","year":"2018","journal-title":"BMC Research Notes"},{"key":"10.7717\/peerj.14859\/ref-28","doi-asserted-by":"publisher","first-page":"2246","DOI":"10.3389\/fcimb.2020.600325","article-title":"Single-nucleotide RNA maps for the two major nosocomial pathogens Enterococcus faecalis and Enterococcus faecium","volume":"10","author":"Michaux","year":"2020","journal-title":"Frontiers in Cellular and Infection Microbiology"},{"issue":"4","key":"10.7717\/peerj.14859\/ref-29","doi-asserted-by":"publisher","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":"Infectious Disease Clinics of North America"},{"issue":"2","key":"10.7717\/peerj.14859\/ref-30","doi-asserted-by":"publisher","first-page":"151477","DOI":"10.1016\/j.ijmm.2021.151477","article-title":"Emergence of linezolid-resistance in Vancomycin-resistant Enterococcus faecium ST117 associated with increased linezolid-consumption","volume":"311","author":"Olearo","year":"2021","journal-title":"International Journal of Medical Microbiology"},{"issue":"1","key":"10.7717\/peerj.14859\/ref-31","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/1471-2180-11-20","article-title":"The hylEfm gene in pHylEfm of Enterococcus faecium is not required in pathogenesis of murine peritonitis","volume":"11","author":"Panesso","year":"2011","journal-title":"BMC Microbiology"},{"issue":"1","key":"10.7717\/peerj.14859\/ref-32","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.4102\/ojvr.v85i1.1583","article-title":"Prevalence of virulence genes in Enterococcus species isolated from companion animals and livestock","volume":"85","author":"Pillay","year":"2018","journal-title":"Onderstepoort Journal of Veterinary Research"},{"issue":"1","key":"10.7717\/peerj.14859\/ref-33","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1038\/s41522-018-0056-3","article-title":"Targeted disruption of the extracellular polymeric network of Pseudomonas aeruginosa biofilms by alginate oligosaccharides","volume":"4","author":"Powell","year":"2018","journal-title":"NPJ Biofilms Microbiomes"},{"issue":"5","key":"10.7717\/peerj.14859\/ref-34","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1002\/jobm.202000678","article-title":"Microbial biofilm: a matter of grave concern for human health and food industry","volume":"61","author":"Rather","year":"2021a","journal-title":"Journal of Basic Microbiology"},{"issue":"4","key":"10.7717\/peerj.14859\/ref-35","doi-asserted-by":"publisher","first-page":"1701","DOI":"10.1007\/s42770-021-00624-x","article-title":"Microbial biofilm: formation, architecture, antibiotic resistance, and control strategies","volume":"52","author":"Rather","year":"2021b","journal-title":"Brazilian Journal of Microbiology"},{"key":"10.7717\/peerj.14859\/ref-36","doi-asserted-by":"publisher","first-page":"667327","DOI":"10.3389\/fcimb.2021.667327","article-title":"Development and characterization of high-throughput Caenorhabditis elegans\u2014Enterococcus faecium infection model","volume":"11","author":"Revtovich","year":"2021","journal-title":"Frontiers in Cellular and Infection Microbiology"},{"issue":"2","key":"10.7717\/peerj.14859\/ref-37","doi-asserted-by":"publisher","first-page":"14","DOI":"10.14715\/cmb\/2019.65.2.3","article-title":"Investigation of the relationship between virulence factors and antibiotic resistance of Enterococci isolates","volume":"65","author":"Say Coskun","year":"2019","journal-title":"Cellular and Molecular Biology"},{"issue":"5","key":"10.7717\/peerj.14859\/ref-38","doi-asserted-by":"publisher","first-page":"7854968","DOI":"10.1155\/2019\/7854968","article-title":"Antibiotic susceptibility pattern and biofilm formation in clinical isolates of Enterococcus spp","volume":"2019","author":"Shridhar","year":"2019","journal-title":"Interdisciplinary Perspectives on Infectious Diseases"},{"issue":"8","key":"10.7717\/peerj.14859\/ref-39","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1111\/j.1600-0463.2007.apm_630.x","article-title":"Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by Staphylococci","volume":"115","author":"Stepanovic","year":"2007","journal-title":"APMIS"},{"key":"10.7717\/peerj.14859\/ref-40","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/S1473-3099(17)30753-3","article-title":"Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis","volume":"18","author":"Tacconelli","year":"2018","journal-title":"Lancet Infectious Diseases"},{"issue":"10","key":"10.7717\/peerj.14859\/ref-41","doi-asserted-by":"publisher","first-page":"6032","DOI":"10.1128\/IAI.72.10.6032-6039.2004","article-title":"Enterococcal surface protein, Esp, enhances biofilm formation by Enterococcus faecalis","volume":"72","author":"Tendolkar","year":"2004","journal-title":"Infection and Immunity"},{"issue":"10","key":"10.7717\/peerj.14859\/ref-42","doi-asserted-by":"publisher","first-page":"4538","DOI":"10.1128\/AEM.67.10.4538-4545.2001","article-title":"The enterococcal surface protein, Esp, is involved in Enterococcus faecalis biofilm formation","volume":"67","author":"Toledo-Arana","year":"2001","journal-title":"Applied and Environmental Microbiology"},{"key":"10.7717\/peerj.14859\/ref-43","doi-asserted-by":"publisher","first-page":"637656","DOI":"10.3389\/fmicb.2021.637656","article-title":"Genomic insights into last-line antimicrobial resistance in multidrug-resistant Staphylococcus and Vancomycin-resistant Enterococcus","volume":"12","author":"Turner","year":"2021","journal-title":"Frontiers in Microbiology"},{"issue":"4","key":"10.7717\/peerj.14859\/ref-44","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1016\/j.idc.2020.08.002","article-title":"Multidrug-resistant bacteria in the community: an update","volume":"34","author":"van Duin","year":"2020","journal-title":"Infectious Disease Clinics of North America"},{"issue":"10","key":"10.7717\/peerj.14859\/ref-45","doi-asserted-by":"publisher","first-page":"4473","DOI":"10.1128\/JCM.42.10.4473-4479.2004","article-title":"Development of a multiplex PCR for the detection of asa1, gelE, cylA, esp, and hyl genes in Enterococci and survey for virulence determinants among European hospital isolates of Enterococcus faecium","volume":"42","author":"Vankerckhoven","year":"2004","journal-title":"Journal of Clinical Microbiology"},{"issue":"12","key":"10.7717\/peerj.14859\/ref-46","doi-asserted-by":"publisher","first-page":"3445","DOI":"10.1093\/jac\/dkz367","article-title":"Phenotypic and genotypic characterization of linezolid-resistant Enterococcus faecium from the USA and Pakistan","volume":"74","author":"Wardenburg","year":"2019","journal-title":"Journal of Antimicrobial Chemotherapy"},{"issue":"18","key":"10.7717\/peerj.14859\/ref-47","doi-asserted-by":"publisher","first-page":"3439","DOI":"10.3390\/ijerph16183439","article-title":"Antibiotic susceptibility patterns, biofilm formation and esp gene among clinical Enterococci: is there any association?","volume":"16","author":"Weng","year":"2019","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"14","key":"10.7717\/peerj.14859\/ref-48","doi-asserted-by":"publisher","first-page":"3423","DOI":"10.3390\/ijms20143423","article-title":"Biofilms: the microbial \u201cprotective clothing\u201d in extreme environments","volume":"20","author":"Yin","year":"2019","journal-title":"International Journal of Molecular Sciences"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/14859.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/14859.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/14859.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/14859.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T04:32:40Z","timestamp":1677126760000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/14859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,23]]},"references-count":48,"alternative-id":["10.7717\/peerj.14859"],"URL":"https:\/\/doi.org\/10.7717\/peerj.14859","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.7287\/peerj.14859v0.1\/reviews\/2","asserted-by":"object"},{"id-type":"doi","id":"10.7287\/peerj.14859v0.1\/reviews\/1","asserted-by":"object"}]},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,23]]},"article-number":"e14859"}}