Molecular mechanisms and epidemiology of fosfomycin resistance in enterococci isolated from patients at a teaching hospital in China from 2013 to 2016.

•Fosfomycin possess strong bacteriostatic activity against enterococci.•Low fosfomycin resistance rate of 2.6% (20/761).•Presence of fosB gene, amino acid mutations in MurA, and high expression level of fosX were the main resistance mechanisms.•Clonal spread of ST78 fosfomycin-resistant enterococci and other sporadic STs in a single hospital.