{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:23:30Z","timestamp":1787203410982,"version":"build-2736575974"},"reference-count":48,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"French Agency for Food, Environmental and Occupational Health Safety"},{"id":[{"id":"https:\/\/ror.org\/0471kz689","id-type":"ROR","asserted-by":"publisher"}]},{"name":"International Center for Antimicrobial Resistance Solutions","award":["200005"],"award-info":[{"award-number":["200005"]}]},{"award":["200005"],"award-info":[{"award-number":["200005"]}],"id":[{"id":"https:\/\/ror.org\/0235eqf73","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Assistance Publique\u2014H\u00f4pitaux de Paris"},{"id":[{"id":"https:\/\/ror.org\/00pg5jh14","id-type":"ROR","asserted-by":"publisher"}]},{"name":"the University Paris-Saclay"},{"name":"the Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale"},{"id":[{"id":"https:\/\/ror.org\/02vjkv261","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001665","name":"French National Research Agency","doi-asserted-by":"crossref","award":["ANR-20-PAMR-0010"],"award-info":[{"award-number":["ANR-20-PAMR-0010"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"crossref"}]},{"award":["ANR-20-PAMR-0010"],"award-info":[{"award-number":["ANR-20-PAMR-0010"]}],"id":[{"id":"https:\/\/ror.org\/00rbzpz17","id-type":"ROR","asserted-by":"publisher"}]},{"name":"French Embassy in Lebanon"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: The emergence of plasmid-mediated mcr genes has enabled horizontal dissemination of resistance to colistin, a last-resort antibiotic against multidrug-resistant Enterobacterales. In Tunisia, genomic data on mcr-positive Escherichia coli are still limited. This study reports the genomic characterization of human clinical mcr-positive E. coli isolates from the Military Hospital of Tunis. Methods: Between August 2023 and March 2025, seven E. coli isolates with low-level colistin-resistance (MIC = 4\u20138 \u00b5g\/mL) were collected from six patients. They were characterized by antibiotic susceptibility testing and WGS to determine resistome, MLST, genetic relatedness, and plasmid content. Results: The E. coli isolates belonged to diverse sequence types (STs), except for two isolates collected from the same patient 2.5 months apart, which were highly related. Overall, this pattern is consistent with a polyclonal spread. The mcr-1.1 gene was located on IncI2 (n = 5) or IncX4 (n = 2) plasmids, which exhibited high similarity both among themselves and in comparison with plasmids previously reported in human and livestock isolates. Most isolates were multidrug-resistant, harboring acquired resistance genes to multiple antibiotic classes, and chromosomal mutations conferring fluoroquinolone resistance. Three isolates additionally carried chromosomal insertions of the blaCTX-M-55 gene. Resistance to cefiderocol was observed in one isolate and was associated with CirA and Fiu truncation. Conclusions: These findings highlight ongoing dissemination of mcr-1.1-positive E. coli isolates in Tunisia, primarily driven by plasmid transfer. Continuous genomic surveillance and One Health-oriented antibiotic stewardship are essential to limit the spread of colistin-resistance and the emergence of resistance to newer agents such as cefiderocol.<\/jats:p>","DOI":"10.3390\/antibiotics15080802","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T09:06:41Z","timestamp":1787044001000},"page":"802","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduced Susceptibility to Cefiderocol Among Clinical MCR-1-Producing Escherichia coli Isolates from Tunisia"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6141-423X","authenticated-orcid":false,"given":"Nadia","family":"Jaidane","sequence":"first","affiliation":[{"name":"Laboratory of Metabolic Biophysics and Applied Pharmacology (LR12ES02), Department of Biophysics, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse 4002, Tunisia"},{"name":"Higher School of Health Sciences and Techniques of Monastir, University of Monastir, Monastir 5000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9937-9572","authenticated-orcid":false,"given":"Thierry","family":"Naas","sequence":"additional","affiliation":[{"name":"Team \u2018Resist\u2019, UMR1184 \u2018Infectious Disease Models and Innovative Therapies (IDMIT)\u2019 (INSERM, University Paris-Saclay, CEA), Faculty of Medicine, University Paris-Saclay, 94270 Le Kremlin-Bic\u00eatre, France"},{"name":"French National Reference Center for Antibiotic Resistance: Carbapenemase-Producing Enterobacterales, 94270 Le Kremlin-Bic\u00eatre, France"},{"name":"Department of Bacteriology-Hygiene, Bic\u00eatre Hospital, APHP Paris-Saclay, 94270 Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4539-9261","authenticated-orcid":false,"given":"Souad","family":"Fayad","sequence":"additional","affiliation":[{"name":"Team \u2018Resist\u2019, UMR1184 \u2018Infectious Disease Models and Innovative Therapies (IDMIT)\u2019 (INSERM, University Paris-Saclay, CEA), Faculty of Medicine, University Paris-Saclay, 94270 Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4294-2824","authenticated-orcid":false,"given":"Pierre","family":"Ch\u00e2tre","sequence":"additional","affiliation":[{"name":"Unit\u00e9 Antibior\u00e9sistance et Virulence Bact\u00e9riennes, ANSES\u2014Universit\u00e9 de Lyon, 69007 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wejdene","family":"Mansour","sequence":"additional","affiliation":[{"name":"Laboratory of Metabolic Biophysics and Applied Pharmacology (LR12ES02), Department of Biophysics, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse 4002, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aymen","family":"Bouaziz","sequence":"additional","affiliation":[{"name":"Laboratory of Bacteriology, Military Hospital of Tunis, Tunis 1008, Tunisia"},{"name":"Laboratory of Microorganisms and Environment, Molecular Diagnostic Tools and Emerging and Re-Emerging Infections (LR19DN03), Military Hospital of Tunis, Tunis 1008, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7423-3594","authenticated-orcid":false,"given":"Pauline","family":"Fran\u00e7ois","sequence":"additional","affiliation":[{"name":"Unit\u00e9 Antibior\u00e9sistance et Virulence Bact\u00e9riennes, ANSES\u2014Universit\u00e9 de Lyon, 69007 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia Du","family":"Fraysseix","sequence":"additional","affiliation":[{"name":"Unit\u00e9 Antibior\u00e9sistance et Virulence Bact\u00e9riennes, ANSES\u2014Universit\u00e9 de Lyon, 69007 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan I.","family":"Iorga","sequence":"additional","affiliation":[{"name":"Institut de Chimie des Substances Naturelles, CNRS, Universit\u00e9 Paris-Saclay, 91190 Gif-sur-Yvette, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7019-7975","authenticated-orcid":false,"given":"Nahed A.","family":"Al Laham","sequence":"additional","affiliation":[{"name":"Team \u2018Resist\u2019, UMR1184 \u2018Infectious Disease Models and Innovative Therapies (IDMIT)\u2019 (INSERM, University Paris-Saclay, CEA), Faculty of Medicine, University Paris-Saclay, 94270 Le Kremlin-Bic\u00eatre, France"},{"name":"Laboratory Medicine Department, Faculty of Applied Medical Sciences, Al Azhar University, Gaza P.O. Box 1277, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamia","family":"Tilouche","sequence":"additional","affiliation":[{"name":"Laboratory of Metabolic Biophysics and Applied Pharmacology (LR12ES02), Department of Biophysics, Faculty of Medicine Ibn El Jazzar of Sousse, University of Sousse, Sousse 4002, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0494-8080","authenticated-orcid":false,"given":"Farouk","family":"Barguellil","sequence":"additional","affiliation":[{"name":"Laboratory of Bacteriology, Military Hospital of Tunis, Tunis 1008, Tunisia"},{"name":"Laboratory of Microorganisms and Environment, Molecular Diagnostic Tools and Emerging and Re-Emerging Infections (LR19DN03), Military Hospital of Tunis, Tunis 1008, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1333-5603","authenticated-orcid":false,"given":"Marisa","family":"Haenni","sequence":"additional","affiliation":[{"name":"Unit\u00e9 Antibior\u00e9sistance et Virulence Bact\u00e9riennes, ANSES\u2014Universit\u00e9 de Lyon, 69007 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Wang, T., Liu, H., Huang, H., Weng, Y., and Wang, X. (2024). Colistin monotherapy or combination for the treatment of bloodstream infection caused by Klebsiella pneumoniae: A systematic review and meta-analysis. BMC Infect. Dis., 24.","DOI":"10.1186\/s12879-024-09024-6"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.tim.2023.10.006","article-title":"Plasmid-mediated colistin-resistance genes: Mcr","volume":"32","author":"Liu","year":"2024","journal-title":"Trends Microbiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S1473-3099(15)00424-7","article-title":"Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: A microbiological and molecular biological study","volume":"16","author":"Liu","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Bastidas-Caldes, C., de Waard, J.H., Salgado, M.S., Villacis, M.J., Coral-Almeida, M., Yamamoto, Y., and Calvopina, M. (2022). Worldwide Prevalence of mcr-mediated Colistin-Resistance Escherichia coli in Isolates of Clinical Samples, Healthy Humans, and Livestock-A Systematic Review and Meta-Analysis. Pathogens, 11.","DOI":"10.3390\/pathogens11060659"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"5970","DOI":"10.1038\/s41598-020-63167-5","article-title":"Massive analysis of 64,628 bacterial genomes to decipher water reservoir and origin of mobile colistin resistance genes: Is there another role for these enzymes?","volume":"10","author":"Khedher","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1089\/mdr.2014.0278","article-title":"Emergence of ST147 Klebsiella pneumoniae Producing OXA-204 Carbapenemase in a University Hospital, Tunisia","volume":"22","author":"Grami","year":"2016","journal-title":"Microb. Drug Resist."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"108478","DOI":"10.1016\/j.ijfoodmicro.2019.108478","article-title":"High prevalence of mcr-1 encoding colistin resistance and first identification of bla(CTX-M-55) in ESBL\/CMY-2-producing Escherichia coli isolated from chicken faeces and retail meat in Tunisia","volume":"318","author":"Hassen","year":"2020","journal-title":"Int. J. Food Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.jgar.2019.08.009","article-title":"ESBL- and mcr-1-producing Escherichia coli in veal calves in Tunisia","volume":"19","author":"Saidani","year":"2019","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ferjani, S., Maamar, E., Ferjani, A., Meftah, K., Battikh, H., Mnif, B., Hamdoun, M., Chebbi, Y., Kanzari, L., and Achour, W. (2022). Tunisian Multicenter Study on the Prevalence of Colistin Resistance in Clinical Isolates of Gram Negative Bacilli: Emergence of Escherichia coli Harbouring the mcr-1 Gene. Antibiotics, 11.","DOI":"10.3390\/antibiotics11101390"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jgar.2025.06.011","article-title":"Occurrence of mcr-1.1-producing Escherichia coli in clinical settings in Tunisia","volume":"44","author":"Jaidane","year":"2025","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e0217120","DOI":"10.1128\/AAC.02171-20","article-title":"New Perspectives on Antimicrobial Agents: Cefiderocol","volume":"65","author":"McCreary","year":"2021","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Domingues, S., Lima, T., Saavedra, M.J., and Da Silva, G.J. (2023). An Overview of Cefiderocol\u2019s Therapeutic Potential and Underlying Resistance Mechanisms. Life, 13.","DOI":"10.3390\/life13071427"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"101034","DOI":"10.1016\/j.drup.2023.101034","article-title":"Cefiderocol: Clinical application and emergence of resistance","volume":"72","author":"Wang","year":"2024","journal-title":"Drug Resist. Updat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1093\/jac\/dkad004","article-title":"Rapid selection of a cefiderocol-resistant Escherichia coli producing NDM-5 associated with a single amino acid substitution in the CirA siderophore receptor","volume":"78","author":"Jousset","year":"2023","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"14132","DOI":"10.3390\/cimb46120846","article-title":"Updates on the Activity, Efficacy and Emerging Mechanisms of Resistance to Cefiderocol","volume":"46","author":"Bianco","year":"2024","journal-title":"Curr. Issues Mol. Biol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Karakonstantis, S., Rousaki, M., and Kritsotakis, E.I. (2022). Cefiderocol: Systematic Review of Mechanisms of Resistance, Heteroresistance and In Vivo Emergence of Resistance. Antibiotics, 11.","DOI":"10.3390\/antibiotics11060723"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Sadek, M., Ortiz de la Rosa, J.M., Abdelfattah Maky, M., Korashe Dandrawy, M., Nordmann, P., and Poirel, L. (2021). Genomic Features of MCR-1 and Extended-Spectrum beta-Lactamase-Producing Enterobacterales from Retail Raw Chicken in Egypt. Microorganisms, 9.","DOI":"10.3390\/microorganisms9010195"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"dlae149","DOI":"10.1093\/jacamr\/dlae149","article-title":"Genomic insights into epidemic plasmids carrying bla (CTX-M) and mcr-1 genes in Escherichia coli from Lebanese broiler production","volume":"6","author":"Mikhayel","year":"2024","journal-title":"JAC Antimicrob. Resist."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e0011822","DOI":"10.1128\/mra.00118-22","article-title":"Fourteen mcr-1-Positive Salmonella enterica Isolates Recovered from Travelers Returning to the United States from the Dominican Republic","volume":"11","author":"Webb","year":"2022","journal-title":"Microbiol. Resour. Announc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"105996","DOI":"10.1016\/j.ijantimicag.2020.105996","article-title":"Plasmid- and chromosome-located mcr-3 in mcr-1-positive Escherichia coli in Taiwan","volume":"56","author":"Hsu","year":"2020","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5077","DOI":"10.2147\/IDR.S420635","article-title":"Genomic Analysis of an Escherichia coli Sequence Type 167 Isolate Harboring a Multidrug-Resistant Conjugative Plasmid, Suggesting the Potential Transmission of the Type Strains from Animals to Humans","volume":"16","author":"Pan","year":"2023","journal-title":"Infect. Drug Resist."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.jgar.2024.12.021","article-title":"No genetic link between E. coli isolates carrying mcr-1 in bovines and humans in France","volume":"41","author":"Haenni","year":"2025","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3249","DOI":"10.1128\/AAC.00269-16","article-title":"Emergence of Plasmid-Mediated Colistin Resistance Gene mcr-1 in a Clinical Escherichia coli Isolate from Egypt","volume":"60","author":"Elnahriry","year":"2016","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_25","first-page":"1289","article-title":"Environmental emission of multiresistant Escherichia coli carrying the colistin resistance gene mcr-1 from German swine farms","volume":"72","author":"Guenther","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3011","DOI":"10.2147\/IDR.S321732","article-title":"Co-Occurrence of NDM-9 and MCR-1 in a Human Gut Colonized Escherichia coli ST1011","volume":"14","author":"Liang","year":"2021","journal-title":"Infect. Drug Resist."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.jgar.2019.08.019","article-title":"Emergence of clinical mcr-1-positive Escherichia coli in Lebanon","volume":"19","author":"Osman","year":"2019","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1007\/s42770-021-00538-8","article-title":"Phenotypic and genotypic characterization of mcr-1-positive multidrug-resistant Escherichia coli ST93, ST117, ST156, ST10, and ST744 isolated from poultry in Poland","volume":"52","author":"Cwiek","year":"2021","journal-title":"Braz. J. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ijfoodmicro.2016.05.001","article-title":"High prevalence of extended-spectrum and plasmidic AmpC beta-lactamase-producing Escherichia coli from poultry in Tunisia","volume":"231","author":"Maamar","year":"2016","journal-title":"Int. J. Food Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Hamzaoui, Z., Kilani, H., Ferjani, S., Maamar, E., Fakhfakh, A., Kanzari, L., and Boubaker, I.B.-B. (2026). NGS-Based Genomic Characterization of ESBL\/AmpC-Producing Extraintestinal Pathogenic Escherichia coli from Captive Wildlife in Tunisia. Antibiotics, 15.","DOI":"10.3390\/antibiotics15050449"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1093\/cid\/ciab511","article-title":"Rapid Development of Cefiderocol Resistance in Carbapenem-resistant Enterobacter cloacae During Therapy Is Associated With Heterogeneous Mutations in the Catecholate Siderophore Receptor cirA","volume":"74","author":"Klein","year":"2022","journal-title":"Clin. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1038\/s41429-024-00762-y","article-title":"In vitro resistance development gives insights into molecular resistance mechanisms against cefiderocol","volume":"77","author":"Kriz","year":"2024","journal-title":"J. Antibiot."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e0154823","DOI":"10.1128\/aac.01548-23","article-title":"Effect of modification of penicillin-binding protein 3 on susceptibility to ceftazidime-avibactam, imipenem-relebactam, meropenem-vaborbactam, aztreonam-avibactam, cefepime-taniborbactam, and cefiderocol of Escherichia coli strains producing broad-spectrum beta-lactamases","volume":"68","author":"Nordmann","year":"2024","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Wang, C., Yang, D., Wang, Y., and Ni, W. (2022). Cefiderocol for the Treatment of Multidrug-Resistant Gram-Negative Bacteria: A Systematic Review of Currently Available Evidence. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.896971"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"dlae021","DOI":"10.1093\/jacamr\/dlae021","article-title":"Carbapenem- and cefiderocol-resistant Enterobacterales in surface water in Kumasi, Ashanti Region, Ghana","volume":"6","author":"Eger","year":"2024","journal-title":"JAC Antimicrob. Resist."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1038\/s41545-024-00394-7","article-title":"Multidrug-resistant high-risk clonal Escherichia coli lineages occur along an antibiotic residue gradient in the Baltic Sea","volume":"7","author":"Heiden","year":"2024","journal-title":"npj Clean. Water"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2300","DOI":"10.1093\/jac\/dkw093","article-title":"Detection of the plasmid-mediated mcr-1 gene conferring colistin resistance in human and food isolates of Salmonella enterica and Escherichia coli in England and Wales","volume":"71","author":"Doumith","year":"2016","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e00177","DOI":"10.1128\/mBio.00177-16","article-title":"Diversified mcr-1-Harbouring Plasmid Reservoirs Confer Resistance to Colistin in Human Gut Microbiota","volume":"7","author":"Ye","year":"2016","journal-title":"mBio"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e0003621","DOI":"10.1128\/spectrum.00036-21","article-title":"First Report of Extended-Spectrum beta-Lactamase (bla(CTX-M1)) and Colistin Resistance Gene mcr-1 in E. coli of Lineage ST648 from Cockroaches in Tunisia","volume":"10","author":"Landolsi","year":"2022","journal-title":"Microbiol. Spectr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"171562","DOI":"10.1016\/j.scitotenv.2024.171562","article-title":"Occurrence and persistence of multidrug-resistant Enterobacterales isolated from urban, industrial and surface water in Monastir, Tunisia","volume":"926","author":"Ncir","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12941-018-0265-x","article-title":"Genetic contexts related to the diffusion of plasmid-mediated CTX-M-55 extended-spectrum beta-lactamase isolated from Enterobacteriaceae in China","volume":"17","author":"Hu","year":"2018","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Borowiak, M., Baumann, B., Fischer, J., Thomas, K., Deneke, C., Hammerl, J.A., Szabo, I., and Malorny, B. (2020). Development of a Novel mcr-6 to mcr-9 Multiplex PCR and Assessment of mcr-1 to mcr-9 Occurrence in Colistin-Resistant Salmonella enterica Isolates From Environment, Feed, Animals and Food (2011-2018) in Germany. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.00080"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.diagmicrobio.2018.04.010","article-title":"Rapid multiplex polymerase chain reaction for detection of mcr-1 to mcr-5 genes","volume":"92","author":"Lescat","year":"2018","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e00239-25","DOI":"10.1128\/asmcr.00239-25","article-title":"Enterobacter roggenkampii ST422 with highly conjugative IncP plasmid carrying bla (KPC-2) gene from Lebanon: A case report","volume":"2","author":"Fayad","year":"2026","journal-title":"ASM Case Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1093\/bioinformatics\/btu153","article-title":"Prokka: Rapid prokaryotic genome annotation","volume":"30","author":"Seemann","year":"2014","journal-title":"Bioinformatics"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Yang, L.A., Chang, Y.J., Chen, S.H., Lin, C.Y., and Ho, J.M. (2019). SQUAT: A Sequencing Quality Assessment Tool for data quality assessments of genome assemblies. BMC Genom., 19.","DOI":"10.1186\/s12864-019-5445-3"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1093\/bioinformatics\/btab007","article-title":"Clinker & clustermap.js: Automatic generation of gene cluster comparison figures","volume":"37","author":"Gilchrist","year":"2021","journal-title":"Bioinformatics"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/JCM.01454-18","article-title":"Development and Multicentric Validation of a Lateral Flow Immunoassay for Rapid Detection of MCR-1-Producing Enterobacteriaceae","volume":"57","author":"Volland","year":"2019","journal-title":"J. Clin. Microbiol."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/8\/802\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T04:26:32Z","timestamp":1787199992000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/8\/802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":48,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["antibiotics15080802"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15080802","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]}}}