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Microbial Diversity and Antimicrobial Resistance Genes in the Environment

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A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Antimicrobial Agents and Resistance".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 18407

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Prof. Dr. Dirk P. Bockmühl

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Guest Editor

Faculty of Life Sciences, Rhine-Waal University of Applied Sciences, Marie-Curie-Straße 1, 47533 Kleve, Germany
Interests: antibiotic resistance; biofilms; biocides; domestic hygiene; laundry; dishwashing; cleaning; disinfection

Prof. Dr. Séamus Fanning

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Guest Editor

UCD-Centre for Food Safety, UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, D04 N2E5 Dublin, Ireland
Interests: use of cutting-edge genomics and metagenomics approaches to the diagnosis, treatment, and surveillance of infectious disease and food-borne pathogens; using novel sequencing technologies and high-definition phenotypic characterisation for revealing molecular mechanisms that control gene expression in bacteria, with particular attention to studying the regulation of determinants and processes related to antimicrobial resistance; real-time genomic surveillance of SARS-CoV-2 in Ireland
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Special Issue Information

Dear Colleagues,

Antimicrobial resistance is considered to be one of the major global challenges of the 21st century. Though a large volume of research has already been published, gaps in our knowledge remain, particularly in certain settings, such as our understanding of how selection can influence the One Health paradigm. Describing the nature of microbial communities in different environments, understanding their resistance profiles or resistome, and those factors influencing the emergence and spread of resistance is crucial to enable the development of tools carefully designed to address this challenge.

This Special Issue of Microorganisms on “Microbial Diversity and Antimicrobial Resistance Genes in the Environment” aims to compile the latest research, and to provide scientific opinion on bacteriological topics related to antimicrobial resistance in different ecological niche settings. We cordially invite you to contribute research papers, reviews and short communications.

While emphasizing the non-clinical environment, as part of the One Health model, papers dealing with medical aspects are also welcome, since one of the main ambitions of the Special Issue is to promote a holistic view of antimicrobial resistance, allowing for a higher-level assessment of the challenge and a better evaluation of potential solutions. We appreciate contributions covering various settings, such as natural and man-made environments, agriculture and wastewater, as well as papers focusing on either the biology of resistant organisms or possible solutions, such as alternatives to antimicrobials.

Prof. Dr. Dirk P. Bockmühl
Prof. Dr. Séamus Fanning
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (11 papers)

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Research

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12 pages, 1558 KiB

Open AccessArticle

Biological and Synthetic Surfactants Increase Class I Integron Prevalence in Ex Situ Biofilms

by Ralf Lucassen, Nicole van Leuven and Dirk Bockmühl

Microorganisms 2024, 12(4), 712; https://doi.org/10.3390/microorganisms12040712 - 31 Mar 2024

Viewed by 597

Abstract

The role of biocides in the spread of antimicrobial resistance (AMR) has been addressed but only a few studies focus on the impact of surfactants on microbial diversity and AMR, although they are common constituents of cleaners, disinfectants, and personal care products and are thus released into the environment in large quantities. In this study, we used a static ex situ biofilm model to examine the development of four biofilms exposed to surfactants and analyzed the biofilms for their prevalence of class I integrons as a proxy for the overall abundance of AMR in a sample. We furthermore determined the shift in bacterial community composition by high-resolution melt analysis and 16S ribosomal RNA (16S rRNA) gene sequencing. Depending on the initial intrinsic prevalence of class I integrons in the respective ex situ biofilm, benzalkonium chloride, alkylbenzene sulfonate, and cocamidopropyl betaine increased its prevalence by up to 6.5× on average. For fatty alcohol ethoxylate and the biosurfactants sophorolipid and rhamnolipid, the mean increase did not exceed 2.5-fold. Across all surfactants, the increase in class I integrons was accompanied by a shift in bacterial community composition. Especially benzalkonium chloride, cocamidopropyl betaine, and alkylbenzene sulfonate changed the communities, while fatty alcohol ethoxylate, sophorolipid, and rhamnolipid had a lower effect on the bacterial biofilm composition. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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25 pages, 5825 KiB

Open AccessArticle

Analysis of Antimicrobial Resistance in Bacterial Pathogens Recovered from Food and Human Sources: Insights from 639,087 Bacterial Whole-Genome Sequences in the NCBI Pathogen Detection Database

by Ashley L. Cooper, Alex Wong, Sandeep Tamber, Burton W. Blais and Catherine D. Carrillo

Microorganisms 2024, 12(4), 709; https://doi.org/10.3390/microorganisms12040709 - 30 Mar 2024

Viewed by 830

Abstract

Understanding the role of foods in the emergence and spread of antimicrobial resistance necessitates the initial documentation of antibiotic resistance genes within bacterial species found in foods. Here, the NCBI Pathogen Detection database was used to query antimicrobial resistance gene prevalence in foodborne and human clinical bacterial isolates. Of the 1,843,630 sequence entries, 639,087 (34.7%) were assigned to foodborne or human clinical sources with 147,788 (23.14%) from food and 427,614 (76.88%) from humans. The majority of foodborne isolates were either Salmonella (47.88%), Campylobacter (23.03%), Escherichia (11.79%), or Listeria (11.3%), and the remaining 6% belonged to 20 other genera. Most foodborne isolates were from meat/poultry (95,251 or 64.45%), followed by multi-product mixed food sources (29,892 or 20.23%) and fish/seafood (6503 or 4.4%); however, the most prominent isolation source varied depending on the genus/species. Resistance gene carriage also varied depending on isolation source and genus/species. Of note, Klebsiella pneumoniae and Enterobacter spp. carried larger proportions of the quinolone resistance gene qnrS and some clinically relevant beta-lactam resistance genes in comparison to Salmonella and Escherichia coli. The prevalence of mec in S. aureus did not significantly differ between meat/poultry and multi-product sources relative to clinical sources, whereas this resistance was rare in isolates from dairy sources. The proportion of biocide resistance in Bacillus and Escherichia was significantly higher in clinical isolates compared to many foodborne sources but significantly lower in clinical Listeria compared to foodborne Listeria. This work exposes the gaps in current publicly available sequence data repositories, which are largely composed of clinical isolates and are biased towards specific highly abundant pathogenic species. We also highlight the importance of requiring and curating metadata on sequence submission to not only ensure correct information and data interpretation but also foster efficient analysis, sharing, and collaboration. To effectively monitor resistance carriage in food production, additional work on sequencing and characterizing AMR carriage in common commensal foodborne bacteria is critical. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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11 pages, 632 KiB

Open AccessCommunication

Enterococci, Van Gene-Carrying Enterococci, and Vancomycin Concentrations in the Influent of a Wastewater Treatment Plant in Southeast Germany

by Michael Geissler, Percy Schröttner, Reinhard Oertel and Roger Dumke

Microorganisms 2024, 12(1), 149; https://doi.org/10.3390/microorganisms12010149 - 12 Jan 2024

Viewed by 978

Abstract

Vancomycin-resistant (VR) Enterococcus spp. can be detected in high concentrations in wastewaters and pose a risk to public health. During a one-year study (September 2022–August 2023), 24 h composite raw wastewater samples (n = 192) of a municipal wastewater treatment plant were investigated for cultivable enterococci. After growth on Slanetz–Bartley agar (SBA), a mean concentration of 29,736 ± 9919 cfu/mL was calculated. Using MALDI-TOF MS to characterize randomly picked colonies (n = 576), the most common species were found to be Enterococcus faecium (72.6%), E. hirae (13.7%), and E. faecalis (8.0%). Parallel incubation of wastewater samples on SBA and VRESelect agar resulted in a mean rate of VR enterococci of 2.0 ± 1.5%. All the tested strains grown on the VRESelect agar (n = 172) were E. faecium and carried the vanA (54.6%) or vanB gene (45.4%) with limited sequence differences. In susceptibility experiments, these isolates showed a high-level resistance to vancomycin (>256 µg/mL). Concentration of vancomycin was determined in 93.7% of 112 wastewater samples (mean: 123.1 ± 64.0 ng/L) and varied between below 100 ng/L (the detection limit) and 246.6 ng/L. A correlation between the concentration of vancomycin and the rate of VR strains among the total enterococci could not be found. The combination of incubation of samples on SBA and a commercial vancomycin-containing agar applied in clinical microbiology with a multiplex PCR for detection of van genes is an easy-to-use tool to quantify and characterize VR Enterococcus spp. in water samples. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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20 pages, 5777 KiB

Open AccessArticle

Clostridioides difficile from Fecally Contaminated Environmental Sources: Resistance and Genetic Relatedness from a Molecular Epidemiological Perspective

by Khald Blau, Fabian K. Berger, Alexander Mellmann and Claudia Gallert

Microorganisms 2023, 11(10), 2497; https://doi.org/10.3390/microorganisms11102497 - 05 Oct 2023

Cited by 2 | Viewed by 1058

Abstract

Clostridioides difficile is the most important pathogen causing antimicrobial-associated diarrhea and has recently been recognized as a cause of community-associated C. difficile infection (CA-CDI). This study aimed to characterize virulence factors, antimicrobial resistance (AMR), ribotype (RT) distribution and genetic relationship of C. difficile isolates from diverse fecally contaminated environmental sources. C. difficile isolates were recovered from different environmental samples in Northern Germany. Antimicrobial susceptibility testing was determined by E-test or disk diffusion method. Toxin genes (tcdA and tcdB), genes coding for binary toxins (cdtAB) and ribotyping were determined by PCR. Furthermore, 166 isolates were subjected to whole genome sequencing (WGS) for core genome multi-locus sequence typing (cgMLST) and extraction of AMR and virulence-encoding genes. Eighty-nine percent (148/166) of isolates were toxigenic, and 51% (76/148) were positive for cdtAB. Eighteen isolates (11%) were non-toxigenic. Thirty distinct RTs were identified. The most common RTs were RT127, RT126, RT001, RT078, and RT014. MLST identified 32 different sequence types (ST). The dominant STs were ST11, followed by ST2, ST3, and ST109. All isolates were susceptible to vancomycin and metronidazole and displayed a variable rate of resistance to moxifloxacin (14%), clarithromycin (26%) and rifampicin (2%). AMR genes, such as gyrA/B, blaCDD-1/2, aph(3′)-llla-sat-4-ant(6)-la cassette, ermB, tet(M), tet(40), and tetA/B(P), conferring resistance toward fluoroquinolone, beta-lactam, aminoglycoside, macrolide and tetracycline antimicrobials, were found in 166, 137, 29, 32, 21, 72, 17, and 9 isolates, respectively. Eleven “hypervirulent” RT078 strains were detected, and several isolates belonged to RTs (i.e., RT127, RT126, RT023, RT017, RT001, RT014, RT020, and RT106) associated with CA-CDI, indicating possible transmission between humans and environmental sources pointing out to a zoonotic potential. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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11 pages, 1207 KiB

Open AccessArticle

The First Swedish Outbreak with VIM-2-Producing Pseudomonas aeruginosa, Occurring between 2006 and 2007, Was Probably Due to Contaminated Hospital Sinks

by Carl-Johan Fraenkel, Gustaf Starlander, Eva Tano, Susanne Sütterlin and Åsa Melhus

Microorganisms 2023, 11(4), 974; https://doi.org/10.3390/microorganisms11040974 - 08 Apr 2023

Cited by 3 | Viewed by 1377

Abstract

Multidrug-resistant Pseudomonas aeruginosa is an increasing clinical problem worldwide. The aim of this study was to describe the first outbreak of a Verona integron-borne metallo-ß-lactamase (VIM)-2-producing P. aeruginosa strain in Sweden and its expansion in the region. A cluster of multidrug-resistant P. aeruginosa appeared at two neighbouring hospitals in 2006. The isolates were characterized by PCR, pulsed-field gel electrophoresis (PFGE), and whole-genome sequencing. Patient charts, laboratory records, and hygiene routines were reviewed, and patients, staff, and the environment were screened. The investigation revealed a clonal outbreak of a VIM-2-producing P. aeruginosa strain belonging to the high-risk clonal complex 111, susceptible only to gentamicin and colistin. No direct contact between patients could be established, but most of them had stayed in certain rooms/wards weeks to months apart. Cultures from two sinks yielded growth of the same strain. The outbreak ended when control measures against the sinks were taken, but new cases occurred in a tertiary care hospital in the region. In conclusion, when facing prolonged outbreaks with this bacterium, sinks and other water sources in the hospital environment should be considered. By implementing proactive control measures to limit the bacterial load in sinks, the waterborne transmission of P. aeruginosa may be reduced. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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10 pages, 5562 KiB

Open AccessArticle

Source Control of Gram-Negative Bacteria Using Self-Disinfecting Sinks in a Swedish Burn Centre

by Maria Gideskog, Tina Falkeborn, Jenny Welander and Åsa Melhus

Microorganisms 2023, 11(4), 965; https://doi.org/10.3390/microorganisms11040965 - 07 Apr 2023

Cited by 2 | Viewed by 1481

Abstract

Several retrospective studies have identified hospital sinks as reservoirs of Gram-negative bacteria. The aim of this study was to prospectively investigate the bacterial transmission from sinks to patients and if self-disinfecting sinks could reduce this risk. Samples were collected weekly from sinks (self-disinfecting, treated with boiling water, not treated) and patients in the Burn Centre at Linköping University Hospital, Sweden. The antibiotic susceptibility of Gram-negative isolates was tested, and eight randomly chosen patient isolates and their connected sink isolates were subjected to whole genome sequencing (WGS). Of 489 sink samples, 232 (47%) showed growth. The most frequent findings were Stenotrophomonas maltophilia (n = 130), Pseudomonas aeruginosa (n = 128), and Acinetobacter spp. (n = 55). Bacterial growth was observed in 20% of the samplings from the self-disinfecting sinks and in 57% from the sinks treated with boiling water (p = 0.0029). WGS recognized one transmission of Escherichia coli sampled from an untreated sink to a patient admitted to the same room. In conclusion, the results showed that sinks can serve as reservoirs of Gram-negative bacteria and that self-disinfecting sinks can reduce the transmission risk. Installing self-disinfecting sinks in intensive care units is an important measure in preventing nosocomial infection among critically ill patients. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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13 pages, 1331 KiB

Open AccessArticle

Microbiological Hazards Associated with the Use of Oligocene Waters: A Study of Water Intakes in Warsaw, Poland

by Ewa Karwowska, Ewa Miaśkiewicz-Pęska, Katarzyna Gołębiewska and Paulina Tomaszewska

Microorganisms 2023, 11(4), 826; https://doi.org/10.3390/microorganisms11040826 - 24 Mar 2023

Viewed by 1360

Abstract

Oligocene waters are widely recognized as excellent sources of drinking water. Due to the belief in their good quality, the water from Oligocene intakes in Warsaw, Poland, is made available to users without prior treatment or disinfection. The present study aimed at assessing possible microbiological risks associated with the use of this water. The occurrence of microbiological contaminants in selected intakes was evaluated, in addition to an assessment of possible changes in the microbiological quality of the water under typical storage conditions. The possibility of antibiotic resistance in bacteria isolated from Oligocene water samples was also investigated, as was their sensitivity to selected disinfectants. A small number of bacteria—27.0 ± 60.8 CFU/cm³ and 3.0 ± 3.0 CFU/cm³—were found in Oligocene water intakes for psychrophilic and mesophilic bacteria, respectively. Fecal bacteria were not detected. Bacteria present in Oligocene waters showed the ability to multiply intensively during standard water storage; this was especially true for mesophilic bacteria in water stored at room temperature. In some samples, bacterial counts reached 10³–10⁴ CFU/cm³ after 48 h. Almost all bacterial isolates were resistant to the commonly used antibiotics: ampicillin, vancomycin and rifampicin. The bacteria were also insensitive to some disinfectants. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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13 pages, 2246 KiB

Open AccessArticle

Comparative Genomic Analysis of Enterococci across Sectors of the One Health Continuum

by Sani-e-Zehra Zaidi, Rahat Zaheer, Dominic Poulin-Laprade, Andrew Scott, Muhammad Attiq Rehman, Moussa Diarra, Edward Topp, Gary Van Domselaar, Athanasios Zovoilis and Tim A. McAllister

Microorganisms 2023, 11(3), 727; https://doi.org/10.3390/microorganisms11030727 - 11 Mar 2023

Cited by 3 | Viewed by 1851

Abstract

Enterococci are Gram-positive bacteria that can be isolated from a variety of environments including soil, water, plants, and the intestinal tract of humans and animals. Although they are considered commensals in humans, Enterococcus spp. are important opportunistic pathogens. Due to their presence and persistence in diverse environments, Enterococcus spp. are ideal for studying antimicrobial resistance (AMR) from the One Health perspective. We undertook a comparative genomic analysis of the virulome, resistome, mobilome, and the association between the resistome and mobilome of 246 E. faecium and 376 E. faecalis recovered from livestock (swine, beef cattle, poultry, dairy cattle), human clinical samples, municipal wastewater, and environmental sources. Comparative genomics of E. faecium and E. faecalis identified 31 and 34 different antimicrobial resistance genes (ARGs), with 62% and 68% of the isolates having plasmid-associated ARGs, respectively. Across the One Health continuum, tetracycline (tetL and tetM) and macrolide resistance (ermB) were commonly identified in E. faecium and E. faecalis. These ARGs were frequently associated with mobile genetic elements along with other ARGs conferring resistance against aminoglycosides [ant(6)-la, aph(3′)-IIIa], lincosamides [lnuG, lsaE], and streptogramins (sat4). Study of the core E. faecium genome identified two main clades, clade ‘A’ and ‘B’, with clade A isolates primarily originating from humans and municipal wastewater and carrying more virulence genes and ARGs related to category I antimicrobials. Overall, despite differences in antimicrobial usage across the continuum, tetracycline and macrolide resistance genes persisted in all sectors. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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15 pages, 641 KiB

Open AccessArticle

Genomic Islands Identified in Highly Resistant Serratia sp. HRI: A Pathway to Discover New Disinfectant Resistance Elements

by Samantha J. McCarlie, Charlotte E. Boucher and Robert R. Bragg

Microorganisms 2023, 11(2), 515; https://doi.org/10.3390/microorganisms11020515 - 17 Feb 2023

Cited by 1 | Viewed by 1667

Abstract

Molecular insights into the mechanisms of resistance to disinfectants are severely limited, together with the roles of various mobile genetic elements. Genomic islands are a well-characterised molecular resistance element in antibiotic resistance, but it is unknown whether genomic islands play a role in disinfectant resistance. Through whole-genome sequencing and the bioinformatic analysis of Serratia sp. HRI, an isolate with high disinfectant resistance capabilities, nine resistance islands were predicted and annotated within the genome. Resistance genes active against several antimicrobials were annotated in these islands, most of which are multidrug efflux pumps belonging to the MFS, ABC and DMT efflux families. Antibiotic resistance islands containing genes encoding for multidrug resistance proteins ErmB (macrolide and erythromycin resistance) and biclomycin were also found. A metal fitness island harbouring 13 resistance and response genes to copper, silver, lead, cadmium, zinc, and mercury was identified. In the search for disinfectant resistance islands, two genomic islands were identified to harbour smr genes, notorious for conferring disinfectant resistance. This suggests that genomic islands are capable of conferring disinfectant resistance, a phenomenon that has not yet been observed in the study of biocide resistance and tolerance. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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Review

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23 pages, 4826 KiB

Open AccessReview

Current Understanding of Potential Linkages between Biocide Tolerance and Antibiotic Cross-Resistance

by Kent Coombs, Cristina Rodriguez-Quijada, Jason O. Clevenger and Alexis F. Sauer-Budge

Microorganisms 2023, 11(8), 2000; https://doi.org/10.3390/microorganisms11082000 - 03 Aug 2023

Cited by 2 | Viewed by 2685

Abstract

Antimicrobials (e.g., antibiotics and biocides) are invaluable chemicals used to control microbes in numerous contexts. Because of the simultaneous use of antibiotics and biocides, questions have arisen as to whether environments commonly treated with biocides (e.g., hospitals, food processing, wastewater, agriculture, etc.) could act as a reservoir for the development of antibiotic cross-resistance. Theoretically, cross-resistance could occur if the mechanism of bacterial tolerance to biocides also resulted in antibiotic resistance. On the other hand, biocides would likely present a higher evolutionary barrier to the development of resistance given the different modes of action between biocides and antibiotics and the broad-based physicochemical effects associated with most biocides. Published studies have shown that the induction of biocide tolerance in a laboratory can result in cross-resistance to some antibiotics, most commonly hypothesized to be due to efflux pump upregulation. However, testing of environmental isolates for biocide tolerance and antibiotic cross-resistance has yielded conflicting results, potentially due to the lack of standardized testing. In this review, we aim to describe the state of the science on the potential linkage between biocide tolerance and antibiotic cross-resistance. Questions still remain about whether the directed evolution of biocide tolerance and the associated antibiotic cross-resistance in a laboratory are or are not representative of real-world settings. Thus, research should continue to generate informative data to guide policies and preserve these tools’ utility and availability. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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11 pages, 267 KiB

Open AccessReview

Genetic Factors That Contribute to Antibiotic Resistance through Intrinsic and Acquired Bacterial Genes in Urinary Tract Infections

by Mohammed Harris, Tracy Fasolino, Diana Ivankovic, Nicole J. Davis and Noel Brownlee

Microorganisms 2023, 11(6), 1407; https://doi.org/10.3390/microorganisms11061407 - 26 May 2023

Cited by 2 | Viewed by 3634

Abstract

The overprescribing and misuse of antibiotics have led to the rapid development of multidrug-resistant bacteria, such as those that cause UTIs. UTIs are the most common outpatient infections and are mainly caused by Escherichia coli and Klebsiella spp., although some Gram-positive bacteria, such as Pseudomonas aeruginosa, have been isolated in many cases. The rise of antimicrobial-resistant bacteria is a major public health concern, as it is predicted to lead to increased healthcare costs and poor patient outcomes and is expected to be the leading cause of global mortality by 2050. Antibiotic resistance among bacterial species can arise from a myriad of factors, including intrinsic and acquired resistance mechanisms, as well as mobile genetic elements, such as transposons, integrons, and plasmids. Plasmid-mediated resistance is of major concern as drug-resistance genes can quickly and efficiently spread across bacterial species via horizontal gene transfer. The emergence of extended-spectrum β-lactamases (ESBLs) such as NDM-1, OXA, KPC, and CTX-M family members has conferred resistance to many commonly used antibiotics in the treatment of UTIs, including penicillins, carbapenems, cephalosporins, and sulfamethoxazole. This review will focus on plasmid-mediated bacterial genes, especially those that encode ESBLs, and how they contribute to antibiotic resistance. Early clinical detection of these genes in patient samples will provide better treatment options and reduce the threat of antibiotic resistance. Full article

(This article belongs to the Special Issue Microbial Diversity and Antimicrobial Resistance Genes in the Environment)

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