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Additional evidence supporting the idea of horizontal transfer of multiple antimicrobial resistance determinants comes from a recent study conducted on multidrug resistant S. Agona isolates containing a DT104-like antimicrobial resistance gene cluster in their genome (28 ).
High throughput genotyping is essential for studying the spread of multiple antimicrobial resistance.
Recently, class 1 integrons carrying multiple antimicrobial resistance genes were identified in 6.5% of L. hongkongensis isolates from aquatic products in Guangzhou city, China [ 110].
Nearly half (49.5percentt) of the isolates carried the class 1 integron, a marker for the acquisition of cassettes containing multiple antimicrobial resistance genes.
Plasmids carrying multiple antimicrobial resistance determinants, including ESBL genes, can spread widely within the Enterobacteriaceae and can cause epidemics in food animals [ 10].
The armA gene was found on a large plasmid which carries a type 1 integron (8) that mediates various gene cassettes responsible for multiple antimicrobial resistance.
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Like many Gram-positive pathogens, multiple antimicrobial resistances are fast becoming a major problem for the healthcare sector [44], [45].
One milk isolate and one faecal isolate of cow showed multiple antimicrobial resistances to 60% of the antimicrobials tested (Table 2).
The pUSA300HOUMR-like plasmids all carry multiple antimicrobial resistances, and two of them, SAP027A and SAP052A, have insertions with additional resistance genes.
This is probably one of the most important factors for multiple antimicrobial resistances in potential EHEC isolates observed in the present study.
The increasing development of multiple antimicrobial resistances in this pathogen has severely restricted the therapeutic options available for infected patients, and increased the length of stay in ICUs and mortality [ 1, 2].
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