the main factors believed to influence bacterial resistance are

(p. 360) Belinda recently completed a treatment program for breast cancer. (p. 298) The main factors believed to influence bacterial resistance are D. All symptoms occur in all cases; they are just not always recognized. Int. PubMed Central 114, 326333 (2018). Technol. Note also that selection may occur at concentrations below the MIC. That said, for the overwhelming majority of ARGs, their recent origin is not known, quite possibly because they originate from environmental species that have not been sequenced yet. To improve awareness and understanding of antimicrobial resistance. (p. 333-335) Which type of obesity is NOT associated with obesity? A., Munck, C., Toft-Kehler, R. V. & Andersson, D. I. FEMS Microbiol. Rev. (p. 289) Which of the following is NOT an example from the parasite category? Evol. 14, 21792196 (2020). Nat. Natl Acad. Nat. That means these germs are not killed and continue to grow. Women are more likely to have no symptoms prior to a heart attack. A. Embolism Biotechnol. Flach, C. F. et al. Assays based on analyses of ARGs may be sensitive but can rarely distinguish within-species selection from between-species selection with certainty, and should therefore be interpreted with some caution. Exposure to and colonisation by antibiotic-resistant E. coli in UK coastal water users: environmental surveillance, exposure assessment, and epidemiological study (Beach Bum Survey). 82. 10, 1124 (2019). Integr. B. Malignant tumor Nat. Zhou, S.-Y.-D. et al. Zhu, Y.-G. et al. Aarestrup, F. M. & Woolhouse, M. E. J. Dis. Razavi, M., Kristiansson, E., Flach, C.-F. & Larsson, D. G. J. Which of the following statements about antibiotic resistance is false? 1. Norwegian Hospital Procurement Trust. WHO has been leading multiple initiatives to address antimicrobial resistance: Held annually since 2015, WAAW is a global campaign that aims to increase awareness of antimicrobial resistance worldwide and to encourage best practices among the general public, health workers and policy makers to avoid the further emergence and spread of drug-resistant infections. Quantifying the pathways and identifying the drivers of and bottlenecks for environmental evolution and transmission of antibiotic resistance are key components to understand and manage the resistance crisis as a whole. DCosta, V. M. et al. Which surgical procedure was performed on Marian? Technol. E-COMMERCE-AS-A-SERVICE. Sci. Total Environ. 25, 173181 (2017). MRSA, also called methicillin-resistant Staphylococcus aureus or multiple-resistant S. aureus, bacterium in the genus Staphylococcus that is characterized by its resistance to the antibiotic methicillin and to related semisynthetic penicillins. D. Angioplasty Hepatitis C A growing list of infections such as pneumonia, tuberculosis, blood poisoning, gonorrhoea, and foodborne diseases are becoming harder, and sometimes impossible, to treat as antibiotics become less effective. These surviving germs have resistance traits in their DNA that can spread to other germs. With some exceptions, environmental concentrations of antibiotics are low, much lower than the minimal inhibitory concentrations (MICs) and most often lower than concentrations predicted (or shown) to select for resistant strains in the laboratory63,64. In addition, which of the following skin cancers have been associated with tanning beds? Environ. Antibiotics are overused in fish and cattle production. A. Radically reducing emissions of exceptionally high concentrations from drug manufactures is one such apparent starting point17,19,59. Environmental microorganisms, including both fungi and bacteria, have been a source for many novel candidate antibiotic molecules, thereby advancing drug development108. The consequences of each transmission event are limited, and the risks are in principle quantifiable. Franz, E., Schijven, J., De Roda Husman, A. M. & Blaak, H. Meta-regression analysis of commensal and pathogenic Escherichia coli survival in soil and water. Depardieu, F., Podglajen, I., Leclercq, R., Collatz, E. & Courvalin, P. Modes and modulations of antibiotic resistance gene expression. Environ. (p. 327) Elevated levels of which type of lipoprotein are clearly associated with atherosclerosis? B. the type of stem cell that mutates 22, 536545 (2014). B. As stress-induced HGT is not a new phenomenon, it is unclear whether the induction of HGT by environmental pollutants has a discernible role in the rapid development of resistance in pathogens observed during the antibiotic era. 51, 30403047 (2017). FEMS Microbiol. ISME J. https://doi.org/10.1038/s41396-020-00780-2 (2020). Sci. A. Gullberg, E. et al. 70, 27092717 (2015). 112, 279286 (2018). Environ. Annu. Warning signs include difficulty with urination, blood in the urine, and pain. Measures to limit the risk for transmission of antibiotic-resistant bacteria could involve both reducing emissions to the environment and/or reducing exposure166. People with diabetes are two to four times more likely than people without diabetes to develop cardiovascular disease. Kim, C., Ryu, H.-D., Chung, E. G., Kim, Y. (p. 292) The lymphocytes that monitor blood and tissue fluids are which type of cell? D. 90 to 95 percent, 93. The misuse of antibiotics causes antibiotic resistance genes (ARGs) in bacteria to be gradually enriched by environmental selection, resulting in increased tolerance and resistance in bacteria to antibiotics. 22. PubMed 61. Chow, L. K. M., Ghaly, T. M. & Gillings, M. R. A survey of sub-inhibitory concentrations of antibiotics in the environment. Ballast water is a mobile carrier for the global transfer of bacteria and genes, thus posing a certain risk of ARGs spreading into the global ocean. (p. 290) Develops as you are exposed to potential infections and vaccinations; recognizes specific targets B. Type-1 (p. 347-348) Tanning lamps emit mostly UVA radiation that is associated with signs of skin aging, such as wrinkling and sagging. (p. 306-307) Which of the following statements about human immunodeficiency virus is FALSE? Int. For the last year, she took a drug treatment that worked to interfere with rapid cell division; what type of cancer treatment did Belinda undergo? Microbiol. Many low- and middle-income countries (LMICs) are particularly vulnerable to the antibiotic resistance crisis. Virulence factors assist pathogens in invasion and resistance of host defenses; these factors include Capsule Enzymes Toxins Capsule Some organisms (eg, certain strains of pneumococci, meningococci, Haemophilus influenzae type b ) have a capsule that blocks phagocytosis, making these organisms more virulent than nonencapsulated strains. Hepatitis C B. Type-1 Article The shared antibiotic resistome of soil bacteria and human pathogens. Cold Spring Harb. Exploring the recent history of resistance factors that already have become clinical problems is one possible strategy to reveal patterns and enable generalizations49. 616-617, 172178 (2018). A recent study on sterile-filtered wastewaters indicated no selective effect of the investigated treated municipal effluent and a small selective effect by untreated influent. Presence of SARS-coronavirus-2 RNA in sewage and correlation with reported COVID-19 prevalence in the early stage of the epidemic in the Netherlands. 17. D. People with HIV infection have no greater risk than the general population for active tuberculosis. In the meantime, to ensure continued support, we are displaying the site without styles From a theoretical point of view, the lowest concentration affecting growth of any species in a community represents the lower boundary for possible resistance selection. Flach, C. F., Genheden, M., Fick, J. E. gonorrhea. D. BRCA1, 90. 20, e51e60 (2020). 7, e1002158 (2011). & Prabakar, K. Extracellular DNA (eDNA): neglected and potential sources of antibiotic resistant genes (ARGs) in the aquatic environments. Microbiol. 77. Schijven, J. F., Blaak, H., Schets, F. M. & De Roda Husman, A. M. Fate of extended-spectrum -lactamase-producing Escherichia coli from faecal sources in surface water and probability of human exposure through swimming. The cost of AMR to the economy is significant. Microbiome https://doi.org/10.1186/s40168-017-0379-y (2017). Fick, J. et al. Which of the following statements about microorganisms that cause human infection and disease is false? A. fungus Environ. Antibiotic resistance is prevalent in an isolated cave microbiome. As a comparison, typical minimal inhibitory concentrations (MICs) for many antibioticpathogen combinations often fall within the 1010,000gl1 range. B. sarcoma 6, a025197 (2016). Public Health https://doi.org/10.3389/fpubh.2020.00092 (2020). The dominating routes for transmission of (resistant) pathogens (solid arrows) are between humans, between domestic animals and sometimes between animals and humans. and C.-F.F. C. the initiating event agent https://doi.org/10.1038/s41579-021-00649-x, DOI: https://doi.org/10.1038/s41579-021-00649-x. (p. 288) The term used to describe the speed and intensity with which a pathogen is likely to cause and infection is Evolutionary events that lead to the emergence of new resistance factors in pathogens are rare and challenging to predict, but may be associated with vast ramifications. Spread of Germs & Resistance Mechanisms To survive, germs can develop defense strategies against antibiotics and antifungals called resistance mechanisms. B cell But as overall community growth was assessed rather than the growth of individual strains, reduced growth of some strains could easily be compensated by other strains growing more rapidly. As antibiotics and resistant bacteria often have the same source (excreta from humans or domestic animals), correlations between the two in environmental samples provide, without additional data, very weak evidence for on-site selection by antibiotics. This site is using cookies under cookie policy . Microbiol. Rev. Groups of transcription factor binding sites called enhancers and silencers can turn a gene on/off in specific parts of the body. J. Med. Metals and antibacterial biocides can, in many cases, co-select for antibiotic-resistant strains via cross-resistance (that is, via the same mechanism) or co-resistance (that is, via genetically linked mechanisms)82,83. Article 64. A simplified approach to generate predicted no effect concentrations (PNECs) for resistance selection from available MICs assumes that selection must occur in at least some communities at the lowest reported or predicted MIC for a given antibiotic. (p. 318) The leading cause of death in the United States is This article highlights the needs to consider the environmental gene reservoir and other factors influencing resistance evolution in the development process for new antibiotics. Prevent infections by ensuring your hands, instruments, and environment are clean. Pharmaceuticals, https://www.upphandlingsmyndigheten.se/kriterier/sjukvard-och-omsorg/lakemedel/ (2021). FEMS Microbiol. United Nations Environment Programme. WAAW takes place every year from 18 to 24 November. Environ. This study demonstrates numerous identical resistance gene loci between multiresistant soil bacteria and diverse human pathogens, providing evidence for recent gene exchange across species and environments. D. lung. A. Pertussis This alternative hypothesis speaks in favour of a much greater role of the external environment. (p. 345-346, 352) Which of the following statements about diets effect on cancer is FALSE? In this Review, we present our current understanding of the roles of the environment, including antibiotic pollution, in resistance evolution, in transmission and as a mere reflection of the regional antibiotic resistance situation in the clinic. 133, 182207 (2018). Environ. A. radon D. asthma, bronchitis, and emphysema, 94. Accordingly, correlative analyses have suggested that the overall sanitation and waste infrastructure is a better predictor of national burdens of resistance than is the reported use of antibiotics95. D. 12 million, 62. (p. 326) What is the leading controllable risk factor for all forms of cardiovascular disease? A. the skin. Elucidating selection processes for antibiotic resistance in sewage treatment plants using metagenomics. A. helminths The emergence of new ARGs in the clinic occurs only when all events align in time and space48. 144, 106083 (2020). (p. 324) What is the condition in which the heart becomes scarred after a throat infection with a strain of streptococcus bacteria (usually strep throat)? D. the frequency of resistance genes among bacteria, and antibiotic overuse. Biol. Environ. (p. 343) The replication of a single cell to produce thousands of copies of itself Technol. PubMed Central Use of Ichip for high-throughput in situ cultivation of Uncultivable microbial species. Proc. PubMed Central C. Carcinoma The American Cancer Society recommends a skin exam every three years between ages 20 and 40, and annually after age 40. 2 Infections caused by microorganisms are one of the leading causes of death worldwide. If a woman has a heart attack, she is less likely than a man to die from it. B. the rate of bacteria growth, and poor hand washing practices. 572, 697712 (2016). (p. 326) Which of the following statements regarding tobacco use and cardiovascular disease is FALSE? Lack of clean water and sanitation and inadequate infection prevention and control promotes the spread of microbes, some of which can be resistant to antimicrobial treatment. Microbiol. Although some studies report increases in the relative abundance of certain ARGs in such environments, it is difficult to distinguish whether this is a result merely of taxonomic changes, unrelated to antibiotic selection pressures, or from direct selection of resistant strains within species66,67,68. PubMed https://doi.org/10.1128/cmr.00088-17 (2018). Call of the wild: antibiotic resistance genes in natural environments. Role of environmental poliovirus surveillance in global polio eradication and beyond. These so-called efflux pumps are very common in bacteria and can transport a variety of compounds such as signal molecules and nutrients. C. 9 million Make information available on the impact of antibiotic resistance. C. Postmenopausal women who take estrogen therapy have a higher risk of colon cancer. & Davies, R. Co-selection of resistance to antibiotics, biocides and heavy metals, and its relevance to foodborne pathogens. Other biotic and abiotic factors, such as temperature, oxygen pressure, nutrients, predation, and competition with other species, all unrelated to the antibiotic resistance profile of the bacteria, are likely to be much more important for environmental transmission opportunities for both resistant and non-resistant strains. Environ. 100% (2 ratings) Ans:- The physical factors that bacterial growth are mentioned below. Infect. B. Increases in temperature and population density are associated with antibiotic resistance, and resistance may get stronger over time. Article Nat. Laxminarayan, R. et al. B. B. Postmenopausal estrogen replacement decreases the risk of heart disease. 276, 25212530 (2009). Misuse and overuse of antimicrobials are the main drivers in the development of drug-resistant pathogens. & Hughes, D. Antibiotic resistance and its cost: is it possible to reverse resistance? He went to the hospital and, several hours later, his speech was back to normal. Manaia, C. M. Assessing the risk of antibiotic resistance transmission from the environment to humans: non-direct proportionality between abundance and risk. https://doi.org/10.1093/femsec/fiy195 (2018). Song, J., Rensing, C., Holm, P. E., Virta, M. & Brandt, K. K. Comparison of metals and tetracycline as selective agents for development of tetracycline resistant bacterial communities in agricultural soil. If costs are very low, the estimation of cost, the estimation of balancing benefits and thus estimates of the MSC become more sensitive to noise. (p. 356) Which of the following is NOT a type of skin cancer? Google Scholar. An individual may feel a heavy weight or feeling of pressure in the chest. Food Sci. (p. 334) Type-2 diabetes accounts for ________ of all cases of diabetes. D. Lymphocytes Broad host range plasmids can invade an unexpectedly diverse fraction of a soil bacterial community. Technol. The genetic reservoir is considerably larger in the environment, suggesting that the source for new ARGs is often environmental bacteria. The confidence interval associated with such estimates could be high150 unless there is good replication around the MSC. For example, isolate-based sewage surveillance has a greater potential to inform empirical treatment than metagenomics, as only the former can provide species-specific phenotypic data with certainty, but the simplicity of metagenomics could make it attractive for monitoring regional and temporal trends in resistance112,119. White (p. 307) Which of the following is true regarding perinatal transmission of HIV? You are using a browser version with limited support for CSS. Microbiol. (p. 300-301) Most common infectious disease worldwide C. Removal of the ovaries decreases the risk of ovarian cancer. Strategic approach to pharmaceuticals in the environment, https://www.europarl.europa.eu/doceo/document/TA-9-2020-0226_EN.pdf (2020). Shotgun metagenomics reveals a wide array of antibiotic resistance genes and mobile elements in a polluted lake in India. Antibiotic resistance can arise both from mutations in the pre-existing genome of a bacterium and from the uptake of foreign DNA. Int. The antibiotic kills most of the infecting bacteria, and therefore only the resistant forms remain. Culture-based assays often suffer from only one or a few species within a community being studied at a time. The third step is the horizontal transfer of a mobilized resistance gene, either directly to a pathogen or via one or several intermediary bacterial hosts. By contrast, reoccurring, strong antibiotic selection pressures and close contact with pathogens are more common in humans and domestic animals, although some external environments also share those drivers. Lett. Wang, J., Chu, L., Wojnrovits, L. & Takcs, E. Occurrence and fate of antibiotics, antibiotic resistant genes (ARGs) and antibiotic resistant bacteria (ARB) in municipal wastewater treatment plant: an overview. B. Thrombus Modeling the emergence of antibiotic resistance in the environment: an analytical solution for the minimum selection concentration. D. pumps oxygen-poor blood to the lungs. Internet Explorer). An alarming increase in resistance of bacteria that cause community acquired infections has also been documented, especially in the staphylococci and pneumococci (Streptococcus pneumoniae) , which are prevalent causes of disease and mortality. Virulence factors are molecules expressed on or secreted by microorganisms that enable them to colonize the host, evade or inhibit the immune responses of the host, enter into or out of a host cell, and/or obtain nutrition from the host. (p. 321) An insufficient supply of blood to tissues D. immunity. Food, including raw vegetables, is another possible exposure route99. Front. Bacteria resist a drug when the bacteria change in some way. (p. 289) Mad cow disease is caused by what type of poorly understood microorganism? Infections caused by, for example, Salmonella spp., enterohaemorrhagic E. coli and Campylobacter jejuni as a result of consumption of contaminated fresh produce occur frequently100, but we are not aware of studies showing that consumers of contaminated produce have an increased probability of being colonized by resistant strains. 150, 106436 (2021). 261, 114200 (2020). Ischemia Women with either infection are usually asymptomatic. 1. A. Prediabetes This chain of events is very difficult to trace back, and also to study in controlled experiments. The evolution of class 1 integrons and the rise of antibiotic resistance. Agents Chemother. Larsson, D.G.J., Flach, CF. These transmission routes can be direct or indirect via the external environment (lower part of the figure), often through faecal contamination. C. congenital heart disease PubMedGoogle Scholar. Ashton, P. M. et al. Jutkina, J., Rutgersson, C., Flach, C. F. & Joakim Larsson, D. G. An assay for determining minimal concentrations of antibiotics that drive horizontal transfer of resistance. Soil biota, antimicrobial resistance and planetary health. Negative environmental impacts of antibiotic-contaminated effluents from pharmaceutical industries. Total Environ. Chemother. B. What does main factor mean? The chief disadvantage, even with short reads, is the limitation in sensitivity139. CABI Agric. b.frequency of resistance genes among bacteria and antibiotic overuse. 46, 1154111549 (2012). A. Prediabetes Continental-scale pollution of estuaries with antibiotic resistance genes. A. PVD most often involves the muscles of the legs. Mobile genetic elements associated with antimicrobial resistance. Microbiol. A. Embolism In this Review, we describe our current understanding of the role of the environment in the evolution of resistance and as a route for transmission of resistant bacteria that already circulate in humans. August 26, 2021. PubMed Central Kraupner, N. et al. A. Innate immunity Provided by the Springer Nature SharedIt content-sharing initiative, Nature Reviews Microbiology (Nat Rev Microbiol) Accordingly, environmental microbiologists most often define resistance as a decreased susceptibility to an antibiotic compared with other strains of the same species. Biosci. a) A client with amyotrophic lateral sclerosis (ALS) tells the nurse, "Sometimes I feel so frustrated. The limited number of antibiotics used to . The authors declare no competing interests. Bengtsson-Palme, J., Kristiansson, E. & Larsson, D. G. J. Kraupner, N. et al. Berglund, F. et al. Lessons may be learned from sewage surveillance of poliovirus, which has been in place for decades121. Antibiotics produced by environmental microorganisms are widespread, but act largely on a microscale, as concentrations characteristically would be expected to drop rapidly around the producing organisms, hence limiting exposure. A. very low density lipoproteins (VLDLs) C. Type-2 Trop. A. phagocytes that. In the presence of drugs, only drug-resistant bacteria survive. Acquired immunity This study shows that plasmids that are common in pathogens can easily be taken up by diverse environmental bacteria, thereby providing pathways for the exchange of resistance genes. By contrast, wherever such transmission events become common, as is probably the case in many low- and middle income countries with inferior infrastructure for handling faecal waste (Box1), environmental transmission may have profound effects on the overall resistance situation95. Study design and careful interpretation are therefore always key concerns. 2). Ecol. Treatment for tuberculosis that is not drug-resistant requires six to nine months of medication. researched data for the article, contributed to the discussion of the content, and reviewed and edited the manuscript before submission. Microbiol. As an increased relative abundance of a species that tends to carry a given ARG can be unrelated to an antibiotic selection pressure, increased abundance of resistant strains over non-resistant strains within the same species adds to the evidence (see later). Still, although resistance surveillance in sewage provides several benefits over traditional surveillance, more research and extensive benchmarking are required to understand the potential and limitations, and to bring this surveillance strategy into practical use. Commun. Lugli, G. A. et al. Antibiotic resistance occurs naturally, but misuse of antibiotics in humans and animals is accelerating the process. B. Type-1 (p. 336) The two most common forms of chronic lung disease are asthma and Environ. Rep. https://doi.org/10.1038/s41598-021-84914-2 (2021). When antibiotic resistance happens, fewer antibiotics are effective against a particular bacterium. mSphere https://doi.org/10.1128/msphere.00418-20 (2020). C. melanoma, basal cell, and squamous cell, 40. Mackenzie, J. S. & Jeggo, M. The one health approach why is it so important? High metabolic activity and extensive cell-to-cell contact (such as in biofilms) are probably increasing the rate of most steps. Work with our consultant to learn what to alter. Repressors decrease transcription. Such actions often coincide with measures to reduce infections in general. Insights into the phylogeny and coding potential of microbial dark matter. C. Aneurysm Pneumonia A. the tissue in which a cancer originates or the primary site The ultimate, well-known consequences of such accumulating evolutionary events are gradually increasing difficulties to prevent and treat bacterial infections. (p. 344) A collection of cells that grow abnormally and are capable of spreading to other parts of the body Total Environ. Wellington, E. M. et al. Adv. (p. 332) Marian recently went through a surgery in which blood vessels were taken from her legs and then attached to her coronary arteries to allow a bypass of blood flow around some narrowed vessels. (p. 309) Which of the following statements regarding gonorrhea and chlamydia is FALSE? Lung cancer is the leading cause of cancer death. Andersson, D. I. et al. D. alcohol use. Another possible technology involves genomic crosslinking137. 461462, 480498 (2013). Additional treatment of wastewaters with more advanced methods (such as ozonation or activated carbon) is a second step that would remove not only many selective agents but also a large range of additional contaminants165. World Health Organ. As the bacterial host and the genetic context of mobile ARGs are critical for transmission risks, models based on specific resistant bacteria are more likely to become predictive than are ARG-based models. 13, 310317 (2015). J. Environ. B. emphysema There is potential to refine MSC predictions from MICs by taking into account also the shape of the doseresponse curves153. Occurrence, distribution and potential affecting factors of antibiotics in sewage sludge of wastewater treatment plants in China. Sewers and wastewater treatment plant environments harbour dense, complex bacterial communities that often include pathogens. B. hepatitis C J. Antimicrob. C. ectoparasite CAS D. transient ischemic attack, 49. Sci. Chem. Nor would lowered growth of any but the most abundant strains be easy to detect, leading to limited sensitivity of such assays. The concentrations needed for selection or co-selection are even less studied for metals and biocides, and need further attention. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. A. colon Science-based targets for antibiotics in receiving waters from pharmaceutical manufacturing operations. (p. 326) Which of the following statements regarding tobacco and cardiovascular risk is FALSE? Agents 45, 2532 (2015). Antibiotic resistance mechanisms. The structure and diversity of human, animal and environmental resistomes. Nat. C. 43 million Int. When feasible, cultivation-based approaches are still superior in terms of providing insights into both the phenotype and the context, particularly if combined with whole-genome sequencing. Environ. B. prion Opin. C. chronic bronchitis C. skin Rutgersson, C. et al. What is the most common infectious disease worldwide? 33, 296300 (2015). & Larsson, D. G. J. Water 11, 27 (2018). Environ. Which of the following statements regarding bacteria and viruses is false? B. rheumatic heart disease Surveillance of antimicrobial resistance in Europe 2017 (Stockholm, Sweden, 2018). Antibiotic resistance is a type of antimicrobial resistance. Discovery of the fourth mobile sulfonamide resistance gene. MinION nanopore sequencing identifies the position and structure of a bacterial antibiotic resistance island. Microbiol. Sci. Selective concentrations for trimethoprim resistance in aquatic environments. Infect. Environ. Here, we discuss the mechanism of bacterial (p. 334) Insulin receptors in body cells become insulin resistant This is based on the exceedance of selective concentrations by orders of magnitude at industrially polluted sites58,60,61,62, increased relative abundance of resistant bacteria61,71, and considerable increases in the number of ARGs60,72, including previously unknown ARGs73, which are not accompanied by increases in faecal contamination65. When infections can no longer be treated by first-line antibiotics, more expensive medicines must be used. The scourge of antibiotic resistance: the important role of the environment. Environ. Vaccinate animals to reduce the need for antibiotics and use alternatives to antibiotics when available. A. brain Infect. B. cellular "suicide" However, evidence suggests that it is the historical exposure to antibiotics, rather than metal or biocide exposure, that has led to the current co-occurrence of metal and biocide resistance genes and ARGs on plasmids, as abundant co-occurrence is largely restricted to communities that have been shaped by strong antibiotic selection pressures the human and domestic animal microbiota84. Similarly, over the past year, numerous research groups across the world have monitored the dynamics of severe acute respiratory syndrome coronavirus 2 in sewage122,123, increasing the awareness of the approach.
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