{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:18:07Z","timestamp":1787768287813,"version":"build-2784847793"},"reference-count":88,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    Up to 14 co-occurring antimicrobial resistance genes (ARG) were previously detected in multiple outbreaks in the Netherlands involving various\n                    <jats:italic>Enterobacteriaceae<\/jats:italic>\n                    species, clones and plasmids, but similar multidrug resistance regions (MRR). This study aimed to map the reported occurrence, mosaic and modular genetic context of the involved ARG. Google Scholar and PubMed Central were queried for articles describing long-read assemblies with \u2265 6 co-occurring ARG. Plasmid (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009119) and chromosomal (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20098) sequences of 9 bacterial taxa originating from North America (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200939), Europe (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200934), Africa (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200916), Asia (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200914), Oceania (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200913) and South America (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20097) were extracted from NCBI. Based on colocalized insertions sequences, transposons and integrons, the ARGs could be divided into nine distinct resistance elements. These elements presented a total of 118 mosaic structural variants (SV):\n                    <jats:italic>qnrB1<\/jats:italic>\n                    (SV\u2009=\u200927;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009102),\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>CTX\u2011M\u201115<\/jats:sub>\n                    (SV\u2009=\u200923;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009137),\n                    <jats:italic>tet<\/jats:italic>\n                    (A) (SV\u2009=\u200918;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200993),\n                    <jats:italic>dfrA14<\/jats:italic>\n                    (SV\u2009=\u200914;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009115),\n                    <jats:italic>sul2\u2014strA\u2014strB<\/jats:italic>\n                    (SV\u2009=\u200913;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009120),\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>TEM\u20111b<\/jats:sub>\n                    (SV\u2009=\u200912;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009119),\n                    <jats:italic>aac(6\u2019)\u2011Ib\u2011cr<\/jats:italic>\n                    \u2014\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>OXA\u20111<\/jats:sub>\n                    \u2014\n                    <jats:italic>catB3<\/jats:italic>\n                    (SV\u2009=\u20097;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009137),\n                    <jats:italic>aac(3)\u2011IIe<\/jats:italic>\n                    (SV\u2009=\u20092;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200992), and\n                    <jats:italic>aadA1<\/jats:italic>\n                    \u2014\n                    <jats:italic>catA1<\/jats:italic>\n                    SV\u2009=\u20092;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200912). The MRR showed high modularity with no clear ARG order. Still, three frequent sub-configurations were found. Firstly,\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>TEM\u20111b<\/jats:sub>\n                    was flanked by\n                    <jats:italic>sul2\u2014strA\u2014strB<\/jats:italic>\n                    downstream (92.6%) and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>CTX\u2011M\u201115<\/jats:sub>\n                    upstream (84.0%). Secondly,\n                    <jats:italic>qnrB1<\/jats:italic>\n                    was flanked by\n                    <jats:italic>tet<\/jats:italic>\n                    (A) upstream (62.4%) and\n                    <jats:italic>dfrA14<\/jats:italic>\n                    (63.4%) downstream. Thirdly,\n                    <jats:italic>aac(3)\u2011IIe<\/jats:italic>\n                    was flanked by\n                    <jats:italic>aac(6\u2019)\u2011Ib\u2011cr<\/jats:italic>\n                    \u2014\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>OXA\u20111<\/jats:sub>\n                    \u2014\n                    <jats:italic>catB3<\/jats:italic>\n                    upstream (80.4%). In conclusion, the 14 ARG co-occur globally in similar MRR that are complex to interpret due to modularity and mosaicism. Still, the preservation of these clinically relevant resistance elements infers a potential means of transfer between distinct\n                    <jats:italic>Enterobacteriaceae<\/jats:italic>\n                    isolates.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0355393","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:23:53Z","timestamp":1787765033000},"page":"e0355393","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Structural insights into the mosaic and modular organization of fourteen co-occurring resistance genes in multidrug resistant Enterobacteriaceae"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-7750","authenticated-orcid":true,"given":"Connor A. 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