 Enterococcus feciam is a gram-positive bacteria that causes nosocomial infections in immunocompromised patients. It has been found to contain multiple antibiotic resistance genes, such as the van-A transposin that confers resistance to vancomycin. Additionally, it possesses unique genetic features that allow it to rapidly adapt to new environments. These include the ability to acquire and integrate exogenous DNA into its genome, as well as the presence of phage and a large pathogenicity island, PAI, containing the ESP gene, which is associated with urinary tract infections and biofilm formation. Furthermore, the ESP gene is located on a large PAI that can be transferred horizontally and inserted at a specific location. This suggests that effeciam has the potential to quickly evolve and become resistant to antimicrobial agents. This article was authored by Bon-10 Mark J.M., Nijman Isaac J., Hendricks Anthony P.A. and others.