Ongoing independent evolution of linezolid and vancomycin-resistance pELF-type linear plasmids across the One Health spectrum

Vancomycin and linezolid are crucial for treating enterococcal infections. The global emergence of linezolid- and vancomycin-resistant enterococci is a growing concern. Enterococcal pELF-type linear plasmids, which confer both types of resistance, have been identified worldwide from clinical and environmental sources. Phylogenetic and structural analyses of pELF-type linear plasmids revealed that they diverged into two distinct lineages and evolved through the integration of circular plasmids. Our findings on this ongoing evolution advance the fundamental knowledge required for the future development of global and cross-sectoral surveillance.