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During the summer of 2022, 68 isolates were recovered using ESBL-selective and non-selective agar, including 40 from wastewater and 28 from fresh or brackish water. Isolates were characterised by phenotypic antibiotic susceptibility testing, conjugation assays, and whole-genome sequencing. Antibiotic residues were quantified, with higher concentrations detected at WWTP inlets and outlets than in natural water sources. Overall, 28 isolates (41.17%) were phenotypically multidrug-resistant (MDR), and 18 (26.47%) carried \u22653 ARGs. WWTP-derived isolates showed a significantly higher prevalence of extended-spectrum \u03b2-lactamase (ESBL) genes than freshwater isolates (p\u2009&lt;\u20090.0001). Isolates represented diverse multilocus sequence types (MLST), and most harboured \u22651 plasmid. Sixteen strains transferred conjugative plasmids encoding resistance to cefotaxime, tetracycline, streptomycin, and trimethoprim. ESBL genes, including\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>CTX-M-15<\/jats:sub>\n                    , were located on IncF, IncN, IncB\/O\/K\/Z, and IncI plasmids, with IncF plasmids showing lower transfer frequencies than IncN and IncI1 conjugative plasmids. These findings identify WWTPs as a major source of MDR and pathogenic\n                    <jats:italic>E. coli<\/jats:italic>\n                    , highlighting their role in environmental dissemination.\n                  <\/jats:p>","DOI":"10.1038\/s44259-026-00208-5","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T16:59:51Z","timestamp":1777568391000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Antimicrobial resistance, conjugative plasmids and pathogenicity in wastewater and freshwater Escherichia spp. in Stockholm, Sweden"],"prefix":"10.1038","volume":"4","author":[{"given":"Annie","family":"Justh de Neczpal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaisa","family":"Thorell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurens","family":"Tuts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geertrui","family":"Rasschaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto J.","family":"Mart\u00edn-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Joffr\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5sa","family":"Sj\u00f6ling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"208_CR1","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1038\/nrmicro3439","volume":"13","author":"TU Berendonk","year":"2015","unstructured":"Berendonk, T. 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