Evidence mapPaperPMID 42545643Full record

ReviewEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026

Genotypic features of antimicrobial resistance, virulence determinants, and clonal lineages of Enterococcus spp. reported in Brazil: a scoping review with marked regional asymmetry.

Josiane Trevisol Leal, Matheus Negri Boschiero, Luciana Sartori, Ana Cristina Gales

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Review in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Josiane Trevisol LealLaboratório ALERTA, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo 781, São Paulo, 04039-032, SP, Brazil. josi_trevisol@hotmail.com.ORCID http://orcid.org/0000-0002-8685-3199
Matheus Negri BoschieroLaboratório ALERTA, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo 781, São Paulo, 04039-032, SP, Brazil.ORCID http://orcid.org/0000-0002-2866-391X
Luciana SartoriLaboratório ALERTA, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo 781, São Paulo, 04039-032, SP, Brazil.ORCID http://orcid.org/0000-0002-3694-3364
Ana Cristina GalesLaboratório ALERTA, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo 781, São Paulo, 04039-032, SP, Brazil.ORCID http://orcid.org/0000-0003-0913-768X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeVancomycin-resistant Enterococcus faecium is listed in the 2024 WHO Bacterial Priority Pathogens List as a high-priority agent of hospital-acquired infections. Its persistence is supported by marked genomic plasticity across human, animal, food, and environmental sources. We aimed to map antimicrobial resistance genes, virulence determinants, and clonal lineages of Enterococcus spp. reported in Brazil across these four sampling contexts.

methodsScoping review following JBI methodological guidance and reported per PRISMA-ScR. Four databases (PubMed, Embase, SciELO, LILACS) were searched without time restrictions in English, Portuguese, and Spanish. Two reviewers screened studies in Rayyan and extracted data using a standardised instrument.

resultsA total of 133 studies (1999 to 2025) were included. Evidence was concentrated in the Southeast and South. Sixty-seven acquired resistance genes and 11 chromosomal mutations were identified across 14 species, predominantly E. faecalis and E. faecium. Twelve broadly reported genes, including vanA, erm(B), and tet(M), spanned all four One Health contexts. Of 67 E. faecium sequence types, 28 (42%) were assigned to CC17 according to the current PubMLST classification and were reported across 26 studies in six states. Forty-six virulence determinants were mapped, with nine adhesion- and biofilm-associated genes shared across all four contexts.

conclusionEnterococcus resistance, virulence, and lineage diversity in Brazil show a structured but unevenly characterised distribution with substantial surveillance gaps relevant to infection control and antimicrobial stewardship. The co-occurrence of PubMLST-assigned CC17 STs and last-resort resistance genes across compartments underscores the need for coordinated genomic surveillance.

Indexed as

Gram-positive cocciMLSTMolecular epidemiologyOne HealthVancomycin-resistant Enterococcus

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.