Article open access publication

Update on prevalence and mechanisms of resistance to linezolid, tigecycline and daptomycin in enterococci in Europe: towards a common nomenclature

Drug Resistance Updates, Elsevier, ISSN 1532-2084

Volume 40, 2018

DOI:10.1016/j.drup.2018.10.002, Dimensions: pub.1107982541, PMID: 30447411,



  1. (1) Robert Koch Institute, grid.13652.33
  2. (2) Centre Hospitalier Universitaire de Rennes, grid.411154.4
  3. (3) University of Rennes 1, grid.410368.8
  4. (4) The Arctic University of Norway, grid.10919.30
  5. (5) Narodowy Instytut Leków, grid.419694.7
  6. (6) Institute of Health Carlos III, grid.413448.e
  7. (7) Ramón y Cajal Health Research Institute, Ramóny Cajal University Hospital, Department of Microbiology, Madrid, Spain
  8. (8) Hvidovre Hospital, grid.411905.8, Capital Region
  9. (9) State Serum Institute, grid.6203.7
  10. (10) St. Vincent's University Hospital, grid.412751.4
  11. (11) Beaumont Hospital, grid.414315.6
  12. (12) Health Protection Surveillance Center, Dublin, Ireland
  13. (13) University of Porto, grid.5808.5
  14. (14) Istituto Superiore di Sanità, grid.416651.1


Vancomycin-resistant enterococci (VRE) are important nosocomial pathogens. Invasive VRE infections are difficult to treat since common therapeutic options including ampicillin and glycopeptides often fail. In vitro, most VRE remain susceptible to last-resort antibiotics such as linezolid, tigecycline and daptomycin. However, neither tigecycline nor linezolid act in a bactericidal manner, and daptomycin has proven activity only at high dosages licensed for treating enterococcal endocarditis. Despite these pharmacological and therapeutic limitations, reports on resistance to these last-resort drugs in VRE, and enterococci in general, have increased in recent years. In this review, we briefly recapitulate the current knowledge on the mode of action as well as the known and novel mechanisms of resistance and describe surveillance data on resistance to linezolid, tigecycline and daptomycin in enterococci. In addition, we also suggest a common nomenclature for designating enterococci and VRE with resistances to these important last-resort antibiotics.

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