The article by Patrice Courvalin reviews the emergence and spread of vancomycin-resistant enterococci (VRE) and the mechanisms of bacterial resistance to glycopeptides. The first VRE clinical isolates were reported in Europe in 1988, and the resistance has since spread rapidly to hospitals worldwide. The mode of action of vancomycin involves binding to the d-Ala-d-Ala C-terminus of peptidoglycan precursors, preventing their cross-linking and cell wall synthesis. Resistance mechanisms include the production of precursors with modified d-Ala residues (e.g., d-lactate or d-serine) and the elimination of high-affinity precursors. The VanA type, mediated by transposon Tn1546, is the most common and characterized resistance mechanism, involving the synthesis of d-Ala-d-Lac depsipeptides. Other types include VanB, VanC, VanD, VanE, and VanG, each with distinct genetic and regulatory features. The article also discusses the transfer of vancomycin resistance genes from Enterococcus to methicillin-resistant Staphylococcus aureus (MRSA), leading to high levels of resistance in MRSA isolates. The stability and dissemination of these resistance genes are influenced by the 2-component signal-transduction system and the transfer of plasmids or chromosomal elements. The emergence of VRE and its resistance to glycopeptides poses significant challenges in clinical settings, highlighting the need for continued research and surveillance.The article by Patrice Courvalin reviews the emergence and spread of vancomycin-resistant enterococci (VRE) and the mechanisms of bacterial resistance to glycopeptides. The first VRE clinical isolates were reported in Europe in 1988, and the resistance has since spread rapidly to hospitals worldwide. The mode of action of vancomycin involves binding to the d-Ala-d-Ala C-terminus of peptidoglycan precursors, preventing their cross-linking and cell wall synthesis. Resistance mechanisms include the production of precursors with modified d-Ala residues (e.g., d-lactate or d-serine) and the elimination of high-affinity precursors. The VanA type, mediated by transposon Tn1546, is the most common and characterized resistance mechanism, involving the synthesis of d-Ala-d-Lac depsipeptides. Other types include VanB, VanC, VanD, VanE, and VanG, each with distinct genetic and regulatory features. The article also discusses the transfer of vancomycin resistance genes from Enterococcus to methicillin-resistant Staphylococcus aureus (MRSA), leading to high levels of resistance in MRSA isolates. The stability and dissemination of these resistance genes are influenced by the 2-component signal-transduction system and the transfer of plasmids or chromosomal elements. The emergence of VRE and its resistance to glycopeptides poses significant challenges in clinical settings, highlighting the need for continued research and surveillance.