Figure 2.

The relationships between enterococci in the transition towards pathogenicity. Legend: HGT—horizontal gene transfer; Vfs—virulence factors, ARG—antibiotic resistance gene. Antibiotics, chemotherapeutics, and diet can alter the composition of the gut microbiota. The overgrowth of Enterococcus causes dysbiosis and often disorders homeostasis. Biofilm is a key process in horizontal gene transfer (HGT). Transfer antibiotic resistance genes and virulence factors are facilitated. Commensal strains and probiotic strains can convert into pathogenic strains. For oncological patients and people with a weakened immune system, the translocation of pathogenic strains into the circulatory system is highly likely.