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Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2023,12,19]]},"abstract":"<jats:p>\n                    Conjugative plasmids play a key role in the dissemination of antimicrobial resistance (AMR) genes across bacterial pathogens. AMR plasmids are widespread in clinical settings, but their distribution is not random, and certain associations between plasmids and bacterial clones are particularly successful. For example, the globally spread carbapenem resistance plasmid pOXA-48 can use a wide range of enterobacterial species as hosts, but it is usually associated with a small number of specific\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    clones. These successful associations represent an important threat for hospitalized patients. However, knowledge remains limited about the factors determining AMR plasmid distribution in clinically relevant bacteria. Here, we combined in vitro and in vivo experimental approaches to analyze pOXA-48-associated AMR levels and conjugation dynamics in a collection of wild-type enterobacterial strains isolated from hospitalized patients. Our results revealed significant variability in these traits across different bacterial hosts, with\n                    <jats:italic>Klebsiella<\/jats:italic>\n                    spp. strains showing higher pOXA-48-mediated AMR and conjugation frequencies than\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    strains. Using experimentally determined parameters, we developed a simple mathematical model to interrogate the contribution of AMR levels and conjugation permissiveness to plasmid distribution in bacterial communities. The simulations revealed that a small subset of clones, combining high AMR levels and conjugation permissiveness, play a critical role in stabilizing the plasmid in different polyclonal microbial communities. These results help to explain the preferential association of plasmid pOXA-48 with\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    clones in clinical settings. More generally, our study reveals that species- and strain-specific variability in plasmid-associated phenotypes shape AMR evolution in clinically relevant bacterial communities.\n                  <\/jats:p>","DOI":"10.1073\/pnas.2314135120","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T14:57:25Z","timestamp":1702565845000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":61,"title":["Antimicrobial resistance level and conjugation permissiveness shape plasmid distribution in clinical enterobacteria"],"prefix":"10.1073","volume":"120","author":[{"given":"Aida","family":"Alonso-del Valle","sequence":"first","affiliation":[{"name":"Centro Nacional de Biotecnolog\u00eda, Consejo Superior de Investigaciones Cientificas, Madrid 28049, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Toribio-Celestino","sequence":"additional","affiliation":[{"name":"Centro Nacional de Biotecnolog\u00eda, Consejo Superior de Investigaciones Cientificas, Madrid 28049, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Quirant","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n para el Fomento de la Investigaci\u00f3n Sanitaria y Biom\u00e9dica de la Comunitat Valenciana, Valencia 46020, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1794-799X","authenticated-orcid":false,"given":"Carles Tardio","family":"Pi","sequence":"additional","affiliation":[{"name":"Centro de Ciencias Gen\u00f3micas, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Cuernavaca 62209, M\u00e9xico"},{"name":"Instituto de Investigaciones en Matem\u00e1ticas Aplicadas y en Sistemas, Unidad Acad\u00e9mica Yucat\u00e1n, Universidad Nacional Aut\u00f3noma de M\u00e9xico, Yucat\u00e1n 04510, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"DelaFuente","sequence":"additional","affiliation":[{"name":"Centro Nacional de Biotecnolog\u00eda, Consejo Superior de Investigaciones Cientificas, Madrid 28049, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1675-3173","authenticated-orcid":false,"given":"Rafael","family":"Canton","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal-Instituto Ramon y Cajal de Investigacion Sanitaria, Madrid 28034, Spain"},{"name":"Centro de Investigaci\u00f3n Biol\u00f3gica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid 28029, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7704-822X","authenticated-orcid":false,"given":"Eduardo P. 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