Risk factors and outcomes associated with the carriage of tigecycline- and vancomycin-resistant Enterococcus faecium

■Identification of tigecycline exposure as the main risk factor for the emergence of vancomycin and tigecycline resistant enterococci (TVRE).■Clinical characterization of a large cohort of TVRE patients showed that bloodstream-infection with TVRE is associated with worse clinical outcome.■Whole genome sequencing helps to detect transmission routes of TVRE.■Antimicrobial stewardship and infection control interventions are appropriate to prevent the emergence and spread of TVRE.