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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Vet. Sci.</journal-id>
<journal-title-group>
<journal-title>Frontiers in Veterinary Science</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Vet. Sci.</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">2297-1769</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fvets.2025.1746399</article-id>
<article-version article-version-type="Version of Record" vocab="NISO-RP-8-2008"/>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Case Report: Transferable IncX4 plasmid carrying <italic>mcr-1</italic> in colistin-resistant <italic>Escherichia coli</italic> from a healthy pet dog in South Korea</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>Oh</surname> <given-names>Jae Young</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<contrib contrib-type="author"><name><surname>Kwak</surname> <given-names>Su Min</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
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<contrib contrib-type="author"><name><surname>Kim</surname> <given-names>Joo Yeol</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<contrib contrib-type="author"><name><surname>Ro</surname> <given-names>Woong-Bin</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
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<contrib contrib-type="author" corresp="yes"><name><surname>Lee</surname> <given-names>Kwang Jun</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref><xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
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<contrib contrib-type="author" corresp="yes"><name><surname>Chae</surname> <given-names>Jong-Chan</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
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<aff id="aff1"><label>1</label><institution>Division of Biotechnology, Jeonbuk National University</institution>, <city>Iksan</city>, <country country="kr">Republic of Korea</country></aff>
<aff id="aff2"><label>2</label><institution>Advanced Institute of Environment and Bioscience, Jeonbuk National University</institution>, <city>Iksan</city>, <country country="kr">Republic of Korea</country></aff>
<aff id="aff3"><label>3</label><institution>Department of Veterinary Emergency and Critical Care Medicine, College of Veterinary Medicine, Chonnam National University</institution>, <city>Gwangju</city>, <country country="kr">Republic of Korea</country></aff>
<aff id="aff4"><label>4</label><institution>Division of Zoonotic and Vector Borne Disease Research, National Institute of Health</institution>, <city>Cheongju</city>, <country country="kr">Republic of Korea</country></aff>
<author-notes>
<corresp id="c001"><label>&#x002A;</label>Correspondence: Kwang Jun Lee, <email xlink:href="mailto:kwangjun@korea.kr">kwangjun@korea.kr</email>; Jong-Chan Chae, <email xlink:href="mailto:chae@jbnu.ac.kr">chae@jbnu.ac.kr</email></corresp>
</author-notes>
<pub-date publication-format="electronic" date-type="pub" iso-8601-date="2026-01-27">
<day>27</day>
<month>01</month>
<year>2026</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2025</year>
</pub-date>
<volume>12</volume>
<elocation-id>1746399</elocation-id>
<history>
<date date-type="received">
<day>14</day>
<month>11</month>
<year>2025</year>
</date>
<date date-type="rev-recd">
<day>24</day>
<month>12</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>26</day>
<month>12</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2026 Oh, Kwak, Kim, Ro, Lee and Chae.</copyright-statement>
<copyright-year>2026</copyright-year>
<copyright-holder>Oh, Kwak, Kim, Ro, Lee and Chae</copyright-holder>
<license>
<ali:license_ref start_date="2026-01-27">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract>
<p>Colistin resistance mediated by the plasmid-borne <italic>mcr-1</italic> gene presents a significant challenge in both human and veterinary medicine. While colistin-resistant bacteria have been reported in food-producing animals and humans, <italic>mcr-1</italic>-harboring strains remain relatively underreported in companion animals, particularly in South Korea. In this study, a colistin-resistant <italic>Escherichia coli</italic> strain Z1324PEC0026 was isolated from a clinically healthy companion dog owned by a veterinary nurse, which exhibited resistance to multiple antimicrobials, including colistin, &#x03B2;-lactams, aminoglycosides, tetracyclines, and phenicols. Its genome harbored two plasmids: a 33.9&#x202F;kb IncX4 plasmid pEC027-3 carrying <italic>mcr-1</italic> gene with a high conjugation frequency, 4.64&#x202F;&#x00D7;&#x202F;10<sup>&#x2212;2</sup> per recipient cell, and another plasmid pEC027-2 carrying additional resistance genes such as <italic>bla</italic><sub>CTX-M-55</sub>, <italic>bla</italic><sub>OXA-10</sub>, <italic>qnrS1</italic>, <italic>dfrA14</italic>, <italic>aph(3&#x201D;)-Ia</italic>, <italic>aadA1</italic>, <italic>cmlA1</italic>, <italic>arr-2</italic>, and <italic>tet(A)</italic>. The genetic structure of pEC027-3 exhibited high synteny with global IncX4 plasmids but showed divergence from <italic>mcr-1</italic>-carrying plasmids previously reported in South Korea, suggesting an independent origin. The presence of a transferable <italic>mcr-1</italic>-harboring IncX4 plasmid in a healthy dog with no prior colistin exposure implies the risk of silent dissemination of antimicrobial resistance.</p>
</abstract>
<kwd-group>
<kwd>colistin resistance</kwd>
<kwd>companion dog</kwd>
<kwd>
<italic>Escherichia coli</italic>
</kwd>
<kwd>IncX4 plasmid</kwd>
<kwd>
<italic>mcr-1</italic>
</kwd>
</kwd-group>
<funding-group>
<funding-statement>The author(s) declared that financial support was received for this work and/or its publication. This work was supported by a grant of Korea Disease Control and Prevention Agency (2024-ER2103-00).</funding-statement>
</funding-group>
<counts>
<fig-count count="2"/>
<table-count count="1"/>
<equation-count count="0"/>
<ref-count count="48"/>
<page-count count="7"/>
<word-count count="5758"/>
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<custom-meta-group>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>One Health</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<label>1</label>
<title>Introduction</title>
<p>Antimicrobial resistance (AMR) has emerged as a critical global health challenge, threatening the efficacy of last-line antibiotics. Among these, colistin has been reintroduced as a therapeutic option against multidrug-resistant Gram-negative pathogens due to its potent bactericidal activity (<xref ref-type="bibr" rid="ref1">1</xref>). However, the emergence of colistin-resistant bacteria, particularly those harboring mobile colistin resistance (<italic>mcr</italic>) genes, has raised serious concerns regarding treatment failure and the potential for widespread dissemination (<xref ref-type="bibr" rid="ref2">2</xref>). Colistin resistance in <italic>Escherichia coli</italic> is mediated by both chromosomal mutations and plasmid-borne genes. Chromosome-mediated resistance is typically associated with modifications in the lipid A component of lipopolysaccharides (LPS), which reduce the negative charge and impedes colistin binding. The modification is regulated by two-component systems such as PmrAB and PhoPQ, which activate enzymes like ArnT and EptA that add 4-amino-4-deoxy-L-arabinose or phosphoethanolamine (pEtN) to lipid A, thereby conferring resistance (<xref ref-type="bibr" rid="ref3">3</xref>). In contrast, plasmid-mediated resistance is primarily driven by the <italic>mcr</italic> gene family, which currently comprises <italic>mcr</italic>-1 to <italic>mcr</italic>-10. These genes encode pEtN transferases that similarly modify lipid A, but their plasmid localization facilitates horizontal gene transfer across bacterial populations and host species. Additionally, non-MCR-mediated resistance has been observed in <italic>mcr-</italic>deficient <italic>E. coli</italic> strains, suggesting alternative pathways such as chromosomal mutations in LPS biosynthesis or regulatory genes. This highlights the complexity of colistin resistance and the need for comprehensive molecular surveillance to inform treatment and containment strategies (<xref ref-type="bibr" rid="ref4">4</xref>).</p>
<p>Since the first identification of <italic>mcr-1</italic> in <italic>E. coli</italic> in 2015, <italic>mcr</italic> genes have been reported in bacteria isolated from humans, livestock, and the environment in more than 60 countries, implicating the zoonotic potential and widespread dissemination (<xref ref-type="bibr" rid="ref5">5</xref>, <xref ref-type="bibr" rid="ref6">6</xref>). Furthermore, the plasmid-mediated <italic>mcr</italic> genes have been detected not only in <italic>E. coli</italic> but also in other genera belonging to Enterobacteriaceae such as <italic>Salmonella</italic>, <italic>Klebsiella</italic>, <italic>Kluyvera</italic>, <italic>Citrobacter</italic>, and <italic>Cronobacter</italic>, indicating their widespread distribution across hosts (<xref ref-type="bibr" rid="ref1">1</xref>, <xref ref-type="bibr" rid="ref7">7</xref>). Recent studies have demonstrated genetic similarities between <italic>mcr</italic>-positive isolates from humans and companion animals, suggesting possible zoonotic transmission (<xref ref-type="bibr" rid="ref8">8</xref>). In particular, companion animals may act as reservoirs and vectors for resistant strains due to their close contact with humans and frequent exposure to antimicrobials (<xref ref-type="bibr" rid="ref9">9</xref>). In China, resistance to colistin in <italic>E. coli</italic> from livestock and human sources has remarkably declined since the banning of its use as a growth promoter in 2017. However, colistin-resistant strains have been continuously detected in companion animals, along with the report of plasmid-mediated <italic>mcr</italic> gene transmission between pets and humans (<xref ref-type="bibr" rid="ref8">8</xref>). These observations underscore the importance of surveillance on antimicrobial resistance in veterinary settings, particularly in countries such as South Korea, where the rapidly growing companion animal population has contributed to the increase of antimicrobial use in veterinary practice. In South Korea, the companion animal population is estimated to comprise approximately 6&#x2013;7 million dogs and 2&#x2013;3 million cats (<xref ref-type="bibr" rid="ref10">10</xref>). In addition, more than 110,000 companion animals are abandoned and sent to shelters each year (<xref ref-type="bibr" rid="ref11">11</xref>).</p>
<p>In this study, we characterized colistin-resistant <italic>E. coli</italic> isolated from a companion animal, elucidating the genetic features of plasmid-mediated <italic>mcr</italic>-carrying IncX4 plasmids and their potential for horizontal transmission.</p>
</sec>
<sec sec-type="materials|methods" id="sec2">
<label>2</label>
<title>Materials and methods</title>
<sec id="sec3">
<label>2.1</label>
<title>Specimen collection and isolation</title>
<p>A castrated male Pomeranian dog born in August 2016 presented with suspected spinal or neurological issues in April 2024. However, the dog exhibited no clinical signs of infectious disease. It was treated with a multimodal oral protocol, including gabapentin (10&#x202F;mg/kg), methocarbamol (10&#x202F;mg/kg), tramadol (5&#x202F;mg/kg), and prednisolone (0.25&#x202F;mg/kg with tapering), along with silymarin (10&#x202F;mg/kg) and ursodeoxycholic acid (10&#x202F;mg/kg). All prescribed medications were administered twice daily. The patient showed improvement in pain syndrome, with appetite and elimination patterns remaining stable throughout the treatment period. A follow-up examination was conducted in June 2024 to assess the patient&#x2019;s condition with fecal screening. A rectal swab was collected during this visit for microbiological analysis. It was suspended in 2&#x202F;mL of buffered peptone water (BD Difco, USA), and one loopful of the suspension was streaked onto MacConkey agar (BD Difco, USA). The plate was incubated at 37 &#x00B0;C for 18&#x2013;20&#x202F;h. A single red colony was isolated and subcultured for purification. The isolate was identified by polymerase chain reaction (PCR) targeting a beta-glucuronidase gene, <italic>uidA</italic>, and a universal stress protein marker gene, <italic>uspA</italic>, in <italic>E. coli</italic> (<xref ref-type="bibr" rid="ref12">12</xref>). <italic>E. coli</italic> ATCC 25922 was used as a positive control.</p>
</sec>
<sec id="sec4">
<label>2.2</label>
<title>Antimicrobial susceptibility testing</title>
<p>Antibiotic susceptibility of the <italic>E. coli</italic> strain Z1324PEC0027 was assessed using the broth microdilution method. Fresh colonies grown on MacConkey agar were suspended in 2&#x202F;mL of 0.85% saline. The turbidity of the suspension was adjusted to a 0.6 McFarland standard using a densitometer (Densimat, bioM&#x00E9;rieux, France). A 10&#x202F;&#x03BC;L aliquot of the standardized bacterial suspension was then added to 11&#x202F;mL of Sensititre Cation-Adjusted Mueller-Hinton Broth (Thermo Scientific, Remel Inc., USA) and mixed thoroughly. Fifty microliters of the resulting mixture were dispensed into each well of a Sensititre custom Gram-negative panel (KRCDC2F; TREK Diagnostic Systems Ltd., UK), sealed with a transparent film, and incubated at 36 &#x00B0;C for more than 18&#x202F;h. The minimum inhibitory concentrations (MICs) were determined for 16 antibiotics: ampicillin (AMP), cefoxitin (FOX), cefotaxime (CTX), ceftriaxone (CRO), ceftazidime (CAZ), imipenem (IPM), streptomycin (STR), gentamicin (GEN), amikacin (AMK), nalidixic acid (NAL), ciprofloxacin (CIP), tetracycline (TET), chloramphenicol (CHL), colistin (COL), azithromycin (AZI), and trimethoprim/sulfamethoxazole (SXT). Interpretation of MIC values followed the guidelines established by the Clinical and Laboratory Standards Institute (<xref ref-type="bibr" rid="ref13">13</xref>).</p>
</sec>
<sec id="sec5">
<label>2.3</label>
<title>Detection of ESBL and colistin resistance genes</title>
<p>The resistance to third-generation cephalosporins of a bacterium was determined with cefotaxime and ceftriaxone. Total genomic DNA was extracted from an overnight culture using the LaboPass&#x2122; Bacteria Mini DNA purification kit (Cosmogentech, South Korea). The detection of extended-spectrum &#x03B2;-lactamase (ESBL) genes was performed using multiplex PCR for the presence of the <italic>bla</italic><sub>CTX-M</sub> gene as previously described (<xref ref-type="bibr" rid="ref14">14</xref>). Also, PCR targeting the <italic>mcr-1</italic> and <italic>mcr-2</italic> genes was conducted to detect plasmid-mediated colistin resistance as the two variants are the most prevalent among <italic>mcr</italic> types identified in <italic>E. coli</italic> (<xref ref-type="bibr" rid="ref15">15</xref>, <xref ref-type="bibr" rid="ref16">16</xref>). Amplified products were verified by agarose gel electrophoresis.</p>
</sec>
<sec id="sec6">
<label>2.4</label>
<title>Conjugation assay</title>
<p>To evaluate the horizontal transfer of colistin resistance, conjugation experiments were performed using a broth mating method (<xref ref-type="bibr" rid="ref15">15</xref>). Donor strain, <italic>E. coli</italic> Z1324PEC0027 carrying the plasmid-mediated <italic>mcr-1</italic> gene, was cultivated until reaching the logarithmic phase and mixed with the recipient strain, sodium azide-resistant <italic>E. coli</italic> J53, at a 1:1 ratio (2&#x202F;mL each). The mixture was incubated at 37 &#x00B0;C for 18&#x2013;24&#x202F;h without shaking to facilitate conjugation. Following incubation, the mating mixture was serially diluted and plated onto selective media supplemented with colistin (2&#x202F;&#x03BC;g/mL) and sodium azide (200&#x202F;&#x03BC;g/mL) to select transconjugants. Donor or recipient strains were maintained on the media supplemented only with colistin (2&#x202F;&#x03BC;g/mL) or sodium azide (200&#x202F;&#x03BC;g/mL), respectively. Conjugation frequency was calculated as the ratio of colony-forming units (CFU) of transconjugants to CFU of recipient cells, expressed as the number of transconjugants per recipient cell. Plasmid transfer was confirmed by PCR amplification of the <italic>mcr-1</italic> gene in transconjugants.</p>
</sec>
<sec id="sec7">
<label>2.5</label>
<title>Genome analysis</title>
<p>Whole-genome sequencing of the colistin-resistant <italic>E. coli</italic> strain Z1324PEC0027 was carried out by Macrogen Inc. (Seoul, South Korea) using the Revio system (Pacific Biosciences, USA). The extracted genomic DNA with high quality was used to determine long-read sequences suitable for <italic>de novo</italic> assembly. The raw reads were assembled with Canu (v2.2) (<xref ref-type="bibr" rid="ref17">17</xref>), resulting in high-quality contigs. Genome annotation was performed using the Bacterial and Viral Bioinformatics Resource Center (BV-BRC, v3.28.5) (<xref ref-type="bibr" rid="ref18">18</xref>). Antimicrobial resistance genes were identified with ResFinder (v4.1) (<xref ref-type="bibr" rid="ref19">19</xref>). Circular genome maps were generated with ProkSee (v1.0) (<xref ref-type="bibr" rid="ref20">20</xref>) to visualize the genomic architecture.</p>
<p>The plasmids identified in this study were compared with previously reported colistin-resistant plasmids (<xref ref-type="bibr" rid="ref15">15</xref>, <xref ref-type="bibr" rid="ref16">16</xref>, <xref ref-type="bibr" rid="ref21 ref22 ref23 ref24 ref25">21&#x2013;25</xref>). Publicly available sequences of IncX4 plasmids harboring <italic>mcr-1</italic> were retrieved from the NCBI GenBank database based on relevant literature. Accession numbers of the plasmids used for comparative analysis are listed in <xref ref-type="supplementary-material" rid="SM1">Supplementary Table S3</xref>. Multiple sequence alignments were performed using EasyFig (v2.2.5) (<xref ref-type="bibr" rid="ref26">26</xref>) to assess backbone synteny and gene organization.</p>
</sec>
</sec>
<sec sec-type="results" id="sec8">
<label>3</label>
<title>Results</title>
<sec id="sec9">
<label>3.1</label>
<title>Isolation and characterization of colistin-resistant ESBL-producing <italic>E. coli</italic></title>
<p>A colistin-resistant <italic>E. coli</italic> strain Z1324PEC0027 was isolated from the rectal swab sample obtained from a pet dog owned by a veterinary nurse in South Korea. The dog had no previous exposure to colistin treatment, but the <italic>E. coli</italic> strain was isolated during a clinical examination for symptoms unrelated to infection. The unexpected detection of a colistin-resistant strain in a healthy dog suggests the potential for environmental or occupational dissemination of resistant bacteria.</p>
<p>The isolate was resistant to CTX (MIC&#x202F;=&#x202F;8&#x202F;&#x03BC;g/mL), CRO (MIC&#x202F;=&#x202F;32&#x202F;&#x03BC;g/mL), and colistin (MIC&#x202F;=&#x202F;8&#x202F;&#x03BC;g/mL). The strain was classified as multidrug-resistant (MDR) because it also exhibited resistance to multiple other antibiotics, including AMP, TET, CHL, and STR (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table S1</xref>). The <italic>bla</italic><sub>CTX-M-55</sub> gene for conferring resistance to third-generation cephalosporins was detected in the ESBL-producer, which also harbored <italic>mcr-1</italic> responsible for colistin resistance.</p>
</sec>
<sec id="sec10">
<label>3.2</label>
<title>Plasmid replicon and conjugation</title>
<p>The genome of <italic>E. coli</italic> Z1324PEC0027 comprised of a chromosome and four plasmids, which was deposited in GenBank under accession numbers CP195926 to CP195930. Specifically, an IncX4-type plasmid (33,858 bp, GC content 41.6%) designated pEC027-3 (CP195929) harbored the <italic>mcr-1</italic> gene, while the other plasmid (53,335 bp, GC content 47.6%), pEC027-1 (CP195927), was classified as an IncX1-type and carried additional multiple resistance genes, including <italic>bla</italic><sub>CTX-M-55</sub><italic>, bla</italic><sub>OXA-10</sub><italic>, qnrS1</italic>, <italic>dfrA14</italic>, <italic>aph(3&#x2033;)-Ia</italic>, <italic>aadA1</italic>, <italic>cmlA1</italic>, <italic>arr-2</italic>, and <italic>tet(A)</italic> (<xref ref-type="table" rid="tab1">Table 1</xref>; <xref ref-type="fig" rid="fig1">Figures 1A</xref>,<xref ref-type="fig" rid="fig1">B</xref>). The remaining two plasmids, pEC027-2 (35,576 bp; GC content 48.2%) and pEC027-4 (3,793&#x202F;bp; GC content 40.6%), did not contain any identifiable antimicrobial resistance genes. Conjugation assays demonstrated successful transfer of the colistin resistance phenotype to a recipient strain with a frequency of 4.64&#x202F;&#x00D7;&#x202F;10<sup>&#x2212;2</sup> per recipient cell, indicating the mobility of the <italic>mcr-1</italic>-carrying plasmid pEC027-3 under laboratory conditions (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table S2</xref>). In contrast, other plasmids, including pEC027-1 carrying <italic>bla</italic><sub>CTX-M-55</sub>, were not transferred to the recipient strain.</p>
<table-wrap position="float" id="tab1">
<label>Table 1</label>
<caption>
<p>Genomic features of colistin-resistant <italic>Escherichia coli</italic> Z1324PEC0026 describing antimicrobial resistance genes (ARGs) and plasmid replicon types.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Contig</th>
<th align="left" valign="top">Name (accession no.)</th>
<th align="center" valign="top">Size (bp)</th>
<th align="center" valign="top">G+C %</th>
<th align="center" valign="top">CDS</th>
<th align="left" valign="top">Inc type</th>
<th align="left" valign="top">Resistance gene</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">1</td>
<td align="left" valign="top">Chromosome (CP195926)</td>
<td align="center" valign="top">4,616,439</td>
<td align="center" valign="top">50.7</td>
<td align="center" valign="top">4,485</td>
<td align="left" valign="top">NA</td>
<td align="left" valign="top">No ARG</td>
</tr>
<tr>
<td align="left" valign="top">2</td>
<td align="left" valign="top">Plasmid pEC027-1 (CP195927)</td>
<td align="center" valign="top">53,335</td>
<td align="center" valign="top">47.6</td>
<td align="center" valign="top">66</td>
<td align="left" valign="top">IncX1</td>
<td align="left" valign="top"><italic>bla</italic><sub>CTX-M-55</sub>, <italic>bla</italic><sub>OXA-10</sub>, <italic>qnrS1</italic>, <italic>dfrA14</italic>, <italic>aph(3&#x2033;)-Ia</italic>, <italic>aadA1</italic>, <italic>cmlA1</italic>, <italic>arr-2</italic>, <italic>tet(A)</italic></td>
</tr>
<tr>
<td align="left" valign="top">3</td>
<td align="left" valign="top">Plasmid pEC027-2 (CP195928)</td>
<td align="center" valign="top">35,576</td>
<td align="center" valign="top">48.2</td>
<td align="center" valign="top">59</td>
<td align="left" valign="top">ND</td>
<td align="left" valign="top">No ARG</td>
</tr>
<tr>
<td align="left" valign="top">4</td>
<td align="left" valign="top">Plasmid pEC027-3 (CP195929)</td>
<td align="center" valign="top">33,858</td>
<td align="center" valign="top">41.6</td>
<td align="center" valign="top">54</td>
<td align="left" valign="top">IncX4</td>
<td align="left" valign="top"><italic>mcr-1</italic></td>
</tr>
<tr>
<td align="left" valign="top">5</td>
<td align="left" valign="top">Plasmid pEC027-4 (CP195930)</td>
<td align="center" valign="top">3,793</td>
<td align="center" valign="top">40.6</td>
<td align="center" valign="top">7</td>
<td align="left" valign="top">ND</td>
<td align="left" valign="top">No ARG</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p>CDS, coding DNA sequence; Inc, Incompatibility; NA, not applicable; ND, not determined.</p>
</table-wrap-foot>
</table-wrap>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>Circular map of plasmids, pEC027-2 <bold>(A)</bold> and pEC027-3 <bold>(B)</bold>, isolated from colistin-resistant <italic>Escherichia coli</italic> Z1324PEC0026 strain. Each map displays annotated genetic elements, including antimicrobial resistance genes (red), transfer/integration/excision-related genes (blue), and replication/recombination/repair-associated genes (orange). Concentric rings represent GC content, GC skew (positive/negative).</p>
</caption>
<graphic xlink:href="fvets-12-1746399-g001.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Circular genomic maps showing sequences labeled (A) pEC027-2 and (B) pEC027-3. pEC027-2 is 53,335 base pairs with 47.6% GC content, and pEC027-3 is 33,858 base pairs with 41.6% GC content. Both maps display annotations for genes involved in replication, recombination, repair, and antibiotic resistance, with a legend indicating color-coded categories: black for GC content, green for positive GC skew, purple for negative GC skew, red for antibiotic resistance genes (CARD), orange for replication-related genes, and blue for transfer-related genes.</alt-text>
</graphic>
</fig>
</sec>
<sec id="sec11">
<label>3.3</label>
<title>Comparative genomic analysis of <italic>mcr-1</italic> carrying IncX4 plasmids</title>
<p>The <italic>mcr-1</italic>-carrying IncX4 plasmid, pEC027-3, was compared with reported IncX4 plasmids to assess the genetic similarity and structural conservation (<xref ref-type="fig" rid="fig2">Figure 2</xref> and <xref ref-type="supplementary-material" rid="SM1">Supplementary Table S3</xref>). The earliest <italic>mcr-1</italic>-carrying plasmid was reported in China as an IncI2 type (accession no. KP347127) in which the <italic>mcr-1</italic> gene was flanked by the insertion sequences, IS<italic>Apl1</italic>, on both sides, suggesting facilitated gene mobilization (<xref ref-type="bibr" rid="ref15">15</xref>). In contrast, the IS<italic>Apl1</italic> elements were absent in the compared IncX4 plasmids, indicating that the <italic>mcr-1</italic> gene had been stably integrated into the plasmid backbone and its subsequent mobilization might be limited. Similarly, IS<italic>Apl1</italic> was not found in the plasmid pEC027-3, and the <italic>mcr-1</italic> gene was located without any associated mobile genetic elements. The plasmid shared a highly conserved backbone structure, exhibiting 99.8% of sequence similarity when compared with IncX4 plasmids previously identified from humans, swine, and companion animals in East and Southeast Asia (<xref ref-type="fig" rid="fig2">Figure 2</xref> and <xref ref-type="supplementary-material" rid="SM1">Supplementary Table S3</xref>). In particular, the <italic>mcr-1</italic> gene was conserved with only minor variations in flanking regions among the compared plasmids. Although the IncX4 plasmids reported in Asia were found in different genera, including <italic>E. coli</italic> and <italic>Klebsiella pneumoniae</italic>, their significant genetic similarities indicated their widespread dissemination and horizontal gene transfer across microbial hosts. In contrast, a distinct genetic structure was also identified in the IncX4 plasmid from Brazil (South America). The genetic structure suggested recombination events that maintained the same gene context while leading to regional genetic divergence (<xref ref-type="fig" rid="fig2">Figure 2</xref>).</p>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>Comparative analysis of <italic>mcr-1</italic>-carrying plasmids in <italic>Escherichia coli</italic> (ECO) and <italic>Klebsiella pneumoniae</italic> (KPN) isolates from humans, food-producing animals, and companion animals. Regions with &#x003E;95% nucleotide identity are shaded in green, indicating highly conserved backbone structures among the plasmids. Red arrows represent the colistin resistance gene (<italic>mcr</italic>-1), while blue arrows indicate coding sequences, including plasmid replication, mobilization, and maintenance.</p>
</caption>
<graphic xlink:href="fvets-12-1746399-g002.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Genomic comparison diagram showing nine plasmid sequences, featuring types IncI2 and IncX4 from various countries and hosts such as pigs and humans from 2015 to 2024. The sequences are aligned horizontally with labeled genes indicated by blue arrows; identical regions highlighted in green. Sequence lengths range from thirty-three thousand three hundred four to sixty-four thousand fifteen base pairs.</alt-text>
</graphic>
</fig>
</sec>
</sec>
<sec sec-type="discussion" id="sec12">
<label>4</label>
<title>Discussion</title>
<p>The identification of a colistin-resistant <italic>E. coli</italic> strain in a companion dog with no prior exposure to colistin is of particular concern, as colistin is considered a last-resort antibiotic, and the presence of <italic>mcr</italic>-mediated resistance in household animals may facilitate the silent dissemination of AMR within veterinary clinics, households, and the broader community. The dog, owned by a veterinary nurse, presented a non-infectious spinal condition but harbored the colistin-resistant strain despite no prior antimicrobial treatment, suggesting environmental, dietary, or occupational acquisition of AMR bacteria (<xref ref-type="bibr" rid="ref27">27</xref>). Companion animals are increasingly recognized as reservoirs and potential transmitters of multidrug-resistant microorganisms, including <italic>mcr</italic>-positive <italic>E. coli</italic>, particularly in households or veterinary environments with high antibiotic use (<xref ref-type="bibr" rid="ref28">28</xref>, <xref ref-type="bibr" rid="ref29">29</xref>). The detection of colistin resistance in a domestic dog without any history of corresponding antimicrobial treatment is consistent with recent reports that resistant bacteria can circulate silently through indirect contact routes, such as exposure to shared environmental surfaces or utensils, as well as human-mediated transfer between pets and owners (<xref ref-type="bibr" rid="ref27">27</xref>, <xref ref-type="bibr" rid="ref30">30</xref>).</p>
<p>The strain Z1324PEC0026, an ESBL-producer harboring the <italic>mcr-1</italic> gene on an IncX4-type plasmid, was resistant to colistin, cephalosporins, aminoglycosides, tetracyclines, and phenicols, which was consistent with the definition of multidrug resistance (MDR), acquired non-susceptibility to at least one agent in three or more antimicrobial classes (<xref ref-type="bibr" rid="ref31">31</xref>). The worldwide spread of MDR strains poses a severe public health challenge, as infections caused by pathogens exhibiting MDR phenotypes may lead to antibiotic treatment failure. Among ESBL-producing Enterobacteriaceae, CTX-M type lactamases are currently the most prevalent and <italic>E. coli</italic> carrying <italic>bla</italic><sub>CTX-M-55</sub> has been reported globally, with a particularly high prevalence in Asia (<xref ref-type="bibr" rid="ref32">32</xref>). The co-existence of <italic>mcr-1</italic> and <italic>bla</italic><sub>CTX-M-55</sub> in a single strain confers resistance to two last-line antibiotic classes, polymyxins and &#x03B2;-lactams, causing serious problems in both human and veterinary medicine. Such co-resistance has been increasingly reported in isolates from humans, animals, and environmental sources worldwide (<xref ref-type="bibr" rid="ref33 ref34 ref35">33&#x2013;35</xref>).</p>
<p>The IncX4-type plasmid is a representative incompatibility group that is known as a common vehicle for colistin resistance (<xref ref-type="bibr" rid="ref36">36</xref>). IncX4 plasmids are relatively small, impose minimal fitness costs on their bacterial hosts, and have transferability at high frequencies, facilitating the spread of <italic>mcr-1</italic> among Enterobacteriaceae in both clinical settings and animal-associated environments, including household settings, animal shelters, farms, and veterinary clinics (<xref ref-type="bibr" rid="ref37">37</xref>, <xref ref-type="bibr" rid="ref38">38</xref>). The IncX4 plasmid pEC027-3 carrying <italic>mcr-1</italic> in strain Z1324PEC0026 exhibited a conjugation frequency of 4.64&#x202F;&#x00D7;&#x202F;10<sup>&#x2212;2</sup> per recipient cell, consistent with previously reported frequencies for IncX4 plasmids ranging from 10<sup>&#x2212;2</sup> to 10<sup>&#x2212;4</sup> (<xref ref-type="bibr" rid="ref39">39</xref>). The frequency was relatively higher than that observed in other incompatibility groups. IncX4 plasmids are generally reported to display higher conjugation frequencies than other <italic>mcr</italic>-carrying plasmids, such as IncI2 or IncHI2, which typically exhibit frequencies in the range of 10<sup>&#x2212;2</sup> to 10<sup>&#x2212;6</sup> per recipient cell (<xref ref-type="bibr" rid="ref36">36</xref>, <xref ref-type="bibr" rid="ref39">39</xref>). Therefore, IncX4 plasmids are considered key drivers in the global dissemination of <italic>mcr</italic>-mediated colistin resistance, as their high transfer efficiency combined with low fitness costs enables widespread propagation among bacterial populations under favorable conditions (<xref ref-type="bibr" rid="ref39">39</xref>, <xref ref-type="bibr" rid="ref41">41</xref>). The relatively high conjugation frequency observed in this study highlights the potential of these plasmids for horizontal dissemination within the gut microbiota, posing a threat to both animal and human health. The comparison of plasmid sequences showed high synteny and backbone conservation between pEC027-3 and previously reported <italic>mcr-1</italic>-positive IncX4 plasmids identified from humans, food-producing animals, wild mammals, and environmental sources (<xref ref-type="bibr" rid="ref42 ref43 ref44 ref45">42&#x2013;45</xref>), suggesting their broad distribution across diverse ecological niches.</p>
<p>Earlier studies in South Korea have reported <italic>mcr-1</italic>-bearing plasmids predominantly belonging to the IncI2 and IncHI2 types, identified in <italic>E. coli</italic> and <italic>Enterobacter aerogenes</italic> isolated from humans and companion animals (<xref ref-type="bibr" rid="ref16">16</xref>, <xref ref-type="bibr" rid="ref21">21</xref>, <xref ref-type="bibr" rid="ref46">46</xref>). An <italic>mcr-1</italic>-positive IncI2 plasmid was found in <italic>E. coli</italic> obtained from a healthy dog, and its chromosomal context resembled that of human isolates in the community (<xref ref-type="bibr" rid="ref21">21</xref>). These plasmids ranged from 60 to 250&#x202F;kb in size and harbored additional resistance markers. By contrast, the IncX4 type pEC027-3 identified in this study was 33.9&#x202F;kb, showing high synteny with global IncX4 <italic>mcr-1</italic> plasmids but possessed distinct backbone structure compared to IncI2 type plasmids found in South Korea (<xref ref-type="fig" rid="fig2">Figure 2</xref>). The discovery of this unique IncX4 plasmid in a companion animal with no documented antibiotic exposure suggested an increasing diversity of <italic>mcr</italic>-harboring plasmids in South Korea. In addition to household pets, recent studies have identified <italic>mcr-1</italic>&#x2013;positive colistin-resistant <italic>E. coli</italic> in stray or free-roaming dogs, suggesting that non-household animals may also act as environmental reservoirs contributing to AMR dissemination (<xref ref-type="bibr" rid="ref30">30</xref>, <xref ref-type="bibr" rid="ref47">47</xref>). Our findings demonstrated not only the capacity of highly transferable IncX4 plasmids to disseminate <italic>mcr-1</italic> in companion animals but also the imperative of integrated surveillance strategies to detect the silent dissemination of antimicrobial resistance across ecological boundaries.</p>
<p>The other plasmid pEC027-2 in strain Z1324PEC0026 carried additional antimicrobial resistance genes, <italic>bla</italic><sub>CTX-M-55</sub>, <italic>bla</italic><sub>OXA-10</sub>, <italic>qnrS1</italic>, <italic>dfrA14</italic>, <italic>aph(3&#x2033;)-Ia</italic>, <italic>aadA1</italic>, <italic>cmlA1</italic>, <italic>arr-2</italic>, and <italic>tet(A)</italic>, which further contributed to the MDR phenotype. The coexistence of multiple plasmids carrying different AMR genes within a single host cell may exacerbate the spread of plasmid-mediated resistance, as co-selective pressures maintain diverse resistance traits (<xref ref-type="bibr" rid="ref48">48</xref>).</p>
<p>Although the detection of <italic>mcr-1</italic>&#x2013;carrying <italic>E. coli</italic> in a household pet suggests the potential for AMR dissemination at the human&#x2013;animal interface, this study has limitations in conclusively demonstrating such transmission. Therefore, longitudinal cohort studies incorporating owner&#x2013;pet paired surveillance are required.</p>
</sec>
<sec sec-type="conclusions" id="sec13">
<label>5</label>
<title>Conclusion</title>
<p>In this study, we isolated and characterized a colistin-resistant <italic>E. coli</italic> from a companion dog with no history of colistin treatment in South Korea. The strain carried the plasmid-mediated <italic>mcr-1</italic> gene on a transferable IncX4 plasmid with high conjugation potential, indicating its capability for horizontal dissemination of colistin resistance among <italic>E. coli</italic> strains. The presence of <italic>mcr</italic>-mediated resistance in a household pet raises concerns about community-level public health, particularly at the human-animal interface where close contact occurs. These results suggest the potential for the silent dissemination of IncX4 plasmids carrying colistin resistance both clinical and non-clinical settings.</p>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="sec14">
<title>Data availability statement</title>
<p>The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found at: <ext-link xlink:href="https://www.ncbi.nlm.nih.gov/genbank/" ext-link-type="uri">https://www.ncbi.nlm.nih.gov/genbank/</ext-link>, CP195926, CP195927, CP195928, CP195929, and CP195930.</p>
</sec>
<sec sec-type="ethics-statement" id="sec15">
<title>Ethics statement</title>
<p>The animal studies were approved by Chonnam National University Institutional Animal Care and Use Committee (CNU IACUC-YB-2024-74). The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent was obtained from the owners for the participation of their animals in this study and the publication of this case report. Written informed consent was obtained from the participant/patient(s) for the publication of this case report.</p>
</sec>
<sec sec-type="author-contributions" id="sec16">
<title>Author contributions</title>
<p>JO: Writing &#x2013; review &#x0026; editing, Investigation, Data curation, Conceptualization, Writing &#x2013; original draft. SK: Writing &#x2013; review &#x0026; editing, Data curation, Investigation. JK: Investigation, Writing &#x2013; review &#x0026; editing, Data curation. W-BR: Writing &#x2013; review &#x0026; editing, Conceptualization, Data curation, Resources. KL: Writing &#x2013; review &#x0026; editing, Supervision, Data curation, Conceptualization. J-CC: Conceptualization, Writing &#x2013; review &#x0026; editing, Supervision, Data curation.</p>
</sec>
<sec sec-type="COI-statement" id="sec17">
<title>Conflict of interest</title>
<p>The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="ai-statement" id="sec18">
<title>Generative AI statement</title>
<p>The author(s) declared that Generative AI was used in the creation of this manuscript. Authors used ChatGPT v4.0 only for the purpose of polishing of English grammar.</p>
<p>Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.</p>
</sec>
<sec sec-type="disclaimer" id="sec19">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec sec-type="supplementary-material" id="sec20">
<title>Supplementary material</title>
<p>The Supplementary material for this article can be found online at: <ext-link xlink:href="https://www.frontiersin.org/articles/10.3389/fvets.2025.1746399/full#supplementary-material" ext-link-type="uri">https://www.frontiersin.org/articles/10.3389/fvets.2025.1746399/full#supplementary-material</ext-link></p>
<supplementary-material xlink:href="Data_Sheet_1.pdf" id="SM1" mimetype="application/pdf" xmlns:xlink="http://www.w3.org/1999/xlink"/>
</sec>
<ref-list>
<title>References</title>
<ref id="ref1"><label>1.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Poirel</surname> <given-names>L</given-names></name> <name><surname>Jayol</surname> <given-names>A</given-names></name> <name><surname>Nordmann</surname> <given-names>P</given-names></name></person-group>. <article-title>Polymyxins: antibacterial activity, susceptibility testing, and resistance mechanisms encoded by plasmids or chromosomes</article-title>. <source>Clin Microbiol Rev</source>. (<year>2017</year>) <volume>30</volume>:<fpage>557</fpage>&#x2013;<lpage>96</lpage>. doi: <pub-id pub-id-type="doi">10.1128/CMR.00064-16</pub-id>, <pub-id pub-id-type="pmid">28275006</pub-id></mixed-citation></ref>
<ref id="ref2"><label>2.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bastidas-Caldes</surname> <given-names>C</given-names></name> <name><surname>de Waard</surname> <given-names>JH</given-names></name> <name><surname>Salgado</surname> <given-names>MS</given-names></name> <name><surname>Villac&#x00ED;s</surname> <given-names>MJ</given-names></name> <name><surname>Coral-Almeida</surname> <given-names>M</given-names></name> <name><surname>Yamamoto</surname> <given-names>Y</given-names></name> <etal/></person-group>. <article-title>Worldwide prevalence of <italic>mcr</italic>-mediated colistin-resistant <italic>Escherichia coli</italic> in isolates of clinical samples, healthy humans, and livestock&#x2013;a systematic review and meta-analysis</article-title>. <source>Pathogens</source>. (<year>2022</year>) <volume>11</volume>:<fpage>659</fpage>. doi: <pub-id pub-id-type="doi">10.3390/pathogens11060659</pub-id></mixed-citation></ref>
<ref id="ref3"><label>3.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Janssen</surname> <given-names>AB</given-names></name> <name><surname>van Schaik</surname> <given-names>W</given-names></name></person-group>. <article-title>Harder, better, faster, stronger: colistin resistance mechanisms in <italic>Escherichia coli</italic></article-title>. <source>PLoS Genet</source>. (<year>2021</year>) <volume>17</volume>:<fpage>e1009262</fpage>. doi: <pub-id pub-id-type="doi">10.1371/journal.pgen.1009262</pub-id>, <pub-id pub-id-type="pmid">33411745</pub-id></mixed-citation></ref>
<ref id="ref4"><label>4.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Luo</surname> <given-names>Q</given-names></name> <name><surname>Yu</surname> <given-names>W</given-names></name> <name><surname>Zhou</surname> <given-names>K</given-names></name> <name><surname>Guo</surname> <given-names>L</given-names></name> <name><surname>Shen</surname> <given-names>P</given-names></name> <name><surname>Lu</surname> <given-names>H</given-names></name> <etal/></person-group>. <article-title>Molecular epidemiology and colistin resistance mechanisms of mcr-positive and <italic>mcr</italic>-negative clinical isolated <italic>Escherichia coli</italic></article-title>. <source>Front Microbiol</source>. (<year>2017</year>) <volume>8</volume>:<fpage>2262</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fmicb.2017.02262</pub-id></mixed-citation></ref>
<ref id="ref5"><label>5.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Abavisani</surname> <given-names>M</given-names></name> <name><surname>Bostanghadiri</surname> <given-names>N</given-names></name> <name><surname>Ghahramanpour</surname> <given-names>H</given-names></name> <name><surname>Kodori</surname> <given-names>M</given-names></name> <name><surname>Akrami</surname> <given-names>F</given-names></name> <name><surname>Fathizadeh</surname> <given-names>H</given-names></name> <etal/></person-group>. <article-title>Colistin resistance mechanisms in gram-negative bacteria: a focus on <italic>Escherichia coli</italic></article-title>. <source>Lett Appl Microbiol</source>. (<year>2023</year>) <volume>76</volume>:<fpage>ovad023</fpage>. doi: <pub-id pub-id-type="doi">10.1093/lambio/ovad023</pub-id>, <pub-id pub-id-type="pmid">36754367</pub-id></mixed-citation></ref>
<ref id="ref6"><label>6.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yin</surname> <given-names>Y</given-names></name> <name><surname>Qiu</surname> <given-names>L</given-names></name> <name><surname>Wang</surname> <given-names>G</given-names></name> <name><surname>Guo</surname> <given-names>Z</given-names></name> <name><surname>Wang</surname> <given-names>Z</given-names></name> <name><surname>Qiu</surname> <given-names>J</given-names></name> <etal/></person-group>. <article-title>Emergence and transmission of plasmid-mediated mobile colistin resistance gene <italic>mcr-10</italic> in humans and companion animals</article-title>. <source>Microbiol Spectr</source>. (<year>2022</year>) <volume>10</volume>:<fpage>e0209722</fpage>. doi: <pub-id pub-id-type="doi">10.1128/spectrum.02097-22</pub-id>, <pub-id pub-id-type="pmid">36000890</pub-id></mixed-citation></ref>
<ref id="ref7"><label>7.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname> <given-names>R</given-names></name> <name><surname>van Dorp</surname> <given-names>L</given-names></name> <name><surname>Shaw</surname> <given-names>LP</given-names></name> <name><surname>Bradley</surname> <given-names>P</given-names></name> <name><surname>Wang</surname> <given-names>Q</given-names></name> <name><surname>Wang</surname> <given-names>X</given-names></name> <etal/></person-group>. <article-title>The global distribution and spread of the mobilized colistin resistance gene <italic>mcr-1</italic></article-title>. <source>Nat Commun</source>. (<year>2018</year>) <volume>9</volume>:<fpage>1179</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41467-018-03205-z</pub-id>, <pub-id pub-id-type="pmid">29563494</pub-id></mixed-citation></ref>
<ref id="ref8"><label>8.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jiang</surname> <given-names>J</given-names></name> <name><surname>Ma</surname> <given-names>S</given-names></name> <name><surname>Chen</surname> <given-names>S</given-names></name> <name><surname>Schwarz</surname> <given-names>S</given-names></name> <name><surname>Cao</surname> <given-names>Y</given-names></name> <name><surname>Dang</surname> <given-names>X</given-names></name> <etal/></person-group>. <article-title>Low prevalence of colistin-resistant <italic>Escherichia coli</italic> from companion animals, China, 2018&#x2013;2021</article-title>. <source>One Health Adv</source>. (<year>2023</year>) <volume>1</volume>:<fpage>14</fpage>. doi: <pub-id pub-id-type="doi">10.1186/s44280-023-00015-x</pub-id></mixed-citation></ref>
<ref id="ref9"><label>9.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sato</surname> <given-names>T</given-names></name> <name><surname>Harada</surname> <given-names>K</given-names></name> <name><surname>Usui</surname> <given-names>M</given-names></name> <name><surname>Yokota</surname> <given-names>S-I</given-names></name> <name><surname>Horiuchi</surname> <given-names>M</given-names></name></person-group>. <article-title>Colistin susceptibility in companion animal-derived <italic>Escherichia coli</italic>, <italic>Klebsiella</italic> spp., and <italic>Enterobacter</italic> spp. in Japan: frequent isolation of colistin-resistant <italic>Enterobacter cloacae</italic> complex</article-title>. <source>Front Cell Infect Microbiol</source>. (<year>2022</year>) <volume>12</volume>:<fpage>946841</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fcimb.2022.946841</pub-id>, <pub-id pub-id-type="pmid">35873176</pub-id></mixed-citation></ref>
<ref id="ref10"><label>10.</label><mixed-citation publication-type="book"><person-group person-group-type="author"><collab id="coll1">Ministry of Agriculture, Food and Rural Affairs</collab></person-group>. <source>Nurturing pet food and pet healthcare as national strategic industries</source>. <publisher-loc>Sejong</publisher-loc>: <publisher-name>Ministry of Agriculture, Food and Rural Affairs</publisher-name> (<year>2023</year>).</mixed-citation></ref>
<ref id="ref11"><label>11.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Rah</surname> <given-names>H</given-names></name> <name><surname>Choi</surname> <given-names>SH</given-names></name></person-group>. <article-title>Are veterinary costs and socioeconomic status risk factors for companion animal relinquishment in the Republic of Korea?</article-title> <source>Animals</source>. (<year>2023</year>) <volume>13</volume>:<fpage>3406</fpage>. doi: <pub-id pub-id-type="doi">10.3390/ani13213406</pub-id>, <pub-id pub-id-type="pmid">37958161</pub-id></mixed-citation></ref>
<ref id="ref12"><label>12.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Godambe</surname> <given-names>LP</given-names></name> <name><surname>Bandekar</surname> <given-names>J</given-names></name> <name><surname>Shashidhar</surname> <given-names>R</given-names></name></person-group>. <article-title>Species specific PCR based detection of <italic>Escherichia coli</italic> from Indian foods</article-title>. <source>3 Biotech</source>. (<year>2017</year>) <volume>7</volume>:<fpage>130</fpage>. doi: <pub-id pub-id-type="doi">10.1007/s13205-017-0784-8</pub-id>, <pub-id pub-id-type="pmid">28573400</pub-id></mixed-citation></ref>
<ref id="ref13"><label>13.</label><mixed-citation publication-type="book"><person-group person-group-type="author"><collab id="coll2">Clinical and Laboratory Standards Institute</collab></person-group>. <source>Performance standards for antimicrobial susceptibility testing; 26th informational supplement. CLSI document M100-S26</source>. <publisher-loc>Wayne</publisher-loc>: <publisher-name>Clinical and Laboratory Standards Institute</publisher-name> (<year>2022</year>).</mixed-citation></ref>
<ref id="ref14"><label>14.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Dor</surname> <given-names>Z</given-names></name> <name><surname>Shnaiderman-Torban</surname> <given-names>A</given-names></name> <name><surname>Kondratyeva</surname> <given-names>K</given-names></name> <name><surname>Davidovich-Cohen</surname> <given-names>M</given-names></name> <name><surname>Rokney</surname> <given-names>A</given-names></name> <name><surname>Steinman</surname> <given-names>A</given-names></name> <etal/></person-group>. <article-title>Emergence and spread of different ESBL-producing <italic>Salmonella enterica</italic> serovars in hospitalized horses sharing a highly transferable IncM2 CTX-M-3-encoding plasmid</article-title>. <source>Front Microbiol</source>. (<year>2020</year>) <volume>11</volume>:<fpage>616032</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fmicb.2020.616032</pub-id>, <pub-id pub-id-type="pmid">33391248</pub-id></mixed-citation></ref>
<ref id="ref15"><label>15.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Liu</surname> <given-names>Y-Y</given-names></name> <name><surname>Wang</surname> <given-names>Y</given-names></name> <name><surname>Walsh</surname> <given-names>TR</given-names></name> <name><surname>Yi</surname> <given-names>L-X</given-names></name> <name><surname>Zhang</surname> <given-names>R</given-names></name> <name><surname>Spencer</surname> <given-names>J</given-names></name> <etal/></person-group>. <article-title>Emergence of plasmid-mediated colistin resistance mechanism <italic>mcr-1</italic> in animals and human beings in China: a microbiological and molecular biological study</article-title>. <source>Lancet Infect Dis</source>. (<year>2016</year>) <volume>16</volume>:<fpage>161</fpage>. doi: <pub-id pub-id-type="doi">10.1016/S1473-3099(15)00424-7</pub-id>, <pub-id pub-id-type="pmid">26603172</pub-id></mixed-citation></ref>
<ref id="ref16"><label>16.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yoon</surname> <given-names>E-J</given-names></name> <name><surname>Hong</surname> <given-names>JS</given-names></name> <name><surname>Yang</surname> <given-names>JW</given-names></name> <name><surname>Lee</surname> <given-names>KJ</given-names></name> <name><surname>Lee</surname> <given-names>H</given-names></name> <name><surname>Jeong</surname> <given-names>SH</given-names></name></person-group>. <article-title>Detection of <italic>mcr</italic>-1 plasmids in <italic>Enterobacteriaceae</italic> isolates from human specimens: comparison with those in <italic>Escherichia coli</italic> isolates from livestock in Korea</article-title>. <source>Ann Lab Med</source>. (<year>2018</year>) <volume>38</volume>:<fpage>555</fpage>&#x2013;<lpage>62</lpage>. doi: <pub-id pub-id-type="doi">10.3343/alm.2018.38.6.555</pub-id>, <pub-id pub-id-type="pmid">30027699</pub-id></mixed-citation></ref>
<ref id="ref17"><label>17.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Koren</surname> <given-names>S</given-names></name> <name><surname>Walenz</surname> <given-names>BP</given-names></name> <name><surname>Berlin</surname> <given-names>K</given-names></name> <name><surname>Miller</surname> <given-names>JR</given-names></name> <name><surname>Bergman</surname> <given-names>NH</given-names></name> <name><surname>Phillippy</surname> <given-names>AM</given-names></name></person-group>. <article-title>Canu: scalable and accurate long-read assembly via adaptive k-mer weighting and repeat separation</article-title>. <source>Genome Res</source>. (<year>2017</year>) <volume>27</volume>:<fpage>722</fpage>&#x2013;<lpage>36</lpage>. doi: <pub-id pub-id-type="doi">10.1101/gr.215087.116</pub-id>, <pub-id pub-id-type="pmid">28298431</pub-id></mixed-citation></ref>
<ref id="ref18"><label>18.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Olson</surname> <given-names>RD</given-names></name> <name><surname>Assaf</surname> <given-names>R</given-names></name> <name><surname>Brettin</surname> <given-names>T</given-names></name> <name><surname>Conrad</surname> <given-names>N</given-names></name> <name><surname>Cucinell</surname> <given-names>C</given-names></name> <name><surname>Davis</surname> <given-names>JJ</given-names></name> <etal/></person-group>. <article-title>Introducing the bacterial and viral bioinformatics resource center (BV-BRC): a resource combining PATRIC, IRD, and ViPR</article-title>. <source>Nucleic Acids Res</source>. (<year>2023</year>) <volume>51</volume>:<fpage>D678</fpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkac1003</pub-id>, <pub-id pub-id-type="pmid">36350631</pub-id></mixed-citation></ref>
<ref id="ref19"><label>19.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Florensa</surname> <given-names>AF</given-names></name> <name><surname>Kaas</surname> <given-names>RS</given-names></name> <name><surname>Clausen</surname> <given-names>PTLC</given-names></name> <name><surname>Aytan-Aktug</surname> <given-names>D</given-names></name> <name><surname>Aarestrup</surname> <given-names>FM</given-names></name></person-group>. <article-title>ResFinder-an open online resource for identification of antimicrobial resistance genes in next-generation sequencing data and prediction of phenotypes from genotypes</article-title>. <source>Microb Genom</source>. (<year>2022</year>) <volume>8</volume>:<fpage>000748</fpage>. doi: <pub-id pub-id-type="doi">10.1099/mgen.0.000748</pub-id>, <pub-id pub-id-type="pmid">35072601</pub-id></mixed-citation></ref>
<ref id="ref20"><label>20.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Grant</surname> <given-names>JR</given-names></name> <name><surname>Enns</surname> <given-names>E</given-names></name> <name><surname>Marinier</surname> <given-names>E</given-names></name> <name><surname>Mandal</surname> <given-names>A</given-names></name> <name><surname>Herman</surname> <given-names>EK</given-names></name> <name><surname>Chen</surname> <given-names>C-Y</given-names></name> <etal/></person-group>. <article-title>Proksee: in-depth characterization and visualization of bacterial genomes</article-title>. <source>Nucleic Acids Res</source>. (<year>2023</year>) <volume>51</volume>:<fpage>W484</fpage>&#x2013;<lpage>92</lpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkad326</pub-id>, <pub-id pub-id-type="pmid">37140037</pub-id></mixed-citation></ref>
<ref id="ref21"><label>21.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Moon</surname> <given-names>DC</given-names></name> <name><surname>Mechesso</surname> <given-names>AF</given-names></name> <name><surname>Kang</surname> <given-names>HY</given-names></name> <name><surname>Kim</surname> <given-names>SJ</given-names></name> <name><surname>Choi</surname> <given-names>J-H</given-names></name> <name><surname>Kim</surname> <given-names>MH</given-names></name> <etal/></person-group>. <article-title>First report of an <italic>Escherichia coli</italic> strain carrying the colistin resistance determinant <italic>mcr-1</italic> from a dog in South Korea</article-title>. <source>Antibiotics</source>. (<year>2020</year>) <volume>9</volume>:<fpage>768</fpage>. doi: <pub-id pub-id-type="doi">10.3390/antibiotics9110768</pub-id>, <pub-id pub-id-type="pmid">33147688</pub-id></mixed-citation></ref>
<ref id="ref22"><label>22.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Khine</surname> <given-names>NO</given-names></name> <name><surname>Wongsurawat</surname> <given-names>T</given-names></name> <name><surname>Jenjaroenpun</surname> <given-names>P</given-names></name> <name><surname>Hampson</surname> <given-names>DJ</given-names></name> <name><surname>Prapasarakul</surname> <given-names>N</given-names></name></person-group>. <article-title>Comparative genomic analysis of colistin-resistant <italic>Escherichia coli</italic> isolated from pigs, a human and wastewater on colistin withdrawn pig farm</article-title>. <source>Sci Rep</source>. (<year>2023</year>) <volume>13</volume>:<fpage>5124</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-023-32406-w</pub-id>, <pub-id pub-id-type="pmid">36991093</pub-id></mixed-citation></ref>
<ref id="ref23"><label>23.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Moser</surname> <given-names>AI</given-names></name> <name><surname>Kuenzli</surname> <given-names>E</given-names></name> <name><surname>Campos-Madueno</surname> <given-names>EI</given-names></name> <name><surname>B&#x00FC;del</surname> <given-names>T</given-names></name> <name><surname>Rattanavong</surname> <given-names>S</given-names></name> <name><surname>Vongsouvath</surname> <given-names>M</given-names></name> <etal/></person-group>. <article-title>Antimicrobial-resistant <italic>Escherichia coli</italic> strains and their plasmids in people, poultry, and chicken meat in Laos</article-title>. <source>Front Microbiol</source>. (<year>2021</year>) <volume>12</volume>:<fpage>708182</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fmicb.2021.708182</pub-id>, <pub-id pub-id-type="pmid">34381435</pub-id></mixed-citation></ref>
<ref id="ref24"><label>24.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Boueroy</surname> <given-names>P</given-names></name> <name><surname>Wongsurawat</surname> <given-names>T</given-names></name> <name><surname>Jenjaroenpun</surname> <given-names>P</given-names></name> <name><surname>Chopjitt</surname> <given-names>P</given-names></name> <name><surname>Hatrongjit</surname> <given-names>R</given-names></name> <name><surname>Jittapalapong</surname> <given-names>S</given-names></name> <etal/></person-group>. <article-title>Plasmidome in <italic>mcr-1</italic> harboring carbapenem-resistant enterobacterales isolates from human in Thailand</article-title>. <source>Sci Rep</source>. (<year>2022</year>) <volume>12</volume>:<fpage>19051</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-022-21836-7</pub-id>, <pub-id pub-id-type="pmid">36351969</pub-id></mixed-citation></ref>
<ref id="ref25"><label>25.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Fernandes</surname> <given-names>MR</given-names></name> <name><surname>McCulloch</surname> <given-names>JA</given-names></name> <name><surname>Vianello</surname> <given-names>MA</given-names></name> <name><surname>Moura</surname> <given-names>Q</given-names></name> <name><surname>P&#x00E9;rez-Chaparro</surname> <given-names>PJ</given-names></name> <name><surname>Esposito</surname> <given-names>F</given-names></name> <etal/></person-group>. <article-title>First report of the globally disseminated IncX4 plasmid carrying the <italic>mcr-1</italic> gene in a colistin-resistant <italic>Escherichia coli</italic> sequence type 101 isolate from a human infection in Brazil</article-title>. <source>Antimicrob Agents Chemother</source>. (<year>2016</year>) <volume>60</volume>:<fpage>6415</fpage>. doi: <pub-id pub-id-type="doi">10.1128/AAC.01325-16</pub-id>, <pub-id pub-id-type="pmid">27503650</pub-id></mixed-citation></ref>
<ref id="ref26"><label>26.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sullivan</surname> <given-names>MJ</given-names></name> <name><surname>Petty</surname> <given-names>NK</given-names></name> <name><surname>Beatson</surname> <given-names>SA</given-names></name></person-group>. <article-title>Easyfig: a genome comparison visualizer</article-title>. <source>Bioinformatics</source>. (<year>2011</year>) <volume>27</volume>:<fpage>1009</fpage>&#x2013;<lpage>10</lpage>. doi: <pub-id pub-id-type="doi">10.1093/bioinformatics/btr039</pub-id>, <pub-id pub-id-type="pmid">21278367</pub-id></mixed-citation></ref>
<ref id="ref27"><label>27.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lei</surname> <given-names>L</given-names></name> <name><surname>Wang</surname> <given-names>Y</given-names></name> <name><surname>He</surname> <given-names>J</given-names></name> <name><surname>Cai</surname> <given-names>C</given-names></name> <name><surname>Liu</surname> <given-names>Q</given-names></name> <name><surname>Yang</surname> <given-names>D</given-names></name> <etal/></person-group>. <article-title>Prevalence and risk analysis of mobile colistin resistance and extended-spectrum &#x03B2;-lactamase genes carriage in pet dogs and their owners: a population based cross-sectional study</article-title>. <source>Emerg Microb Infect</source>. (<year>2021</year>) <volume>10</volume>:<fpage>242</fpage>&#x2013;<lpage>51</lpage>. doi: <pub-id pub-id-type="doi">10.1080/22221751.2021.1882884</pub-id>, <pub-id pub-id-type="pmid">33502946</pub-id></mixed-citation></ref>
<ref id="ref28"><label>28.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lin</surname> <given-names>H</given-names></name> <name><surname>Chen</surname> <given-names>W</given-names></name> <name><surname>Zhou</surname> <given-names>R</given-names></name> <name><surname>Yang</surname> <given-names>J</given-names></name> <name><surname>Wu</surname> <given-names>Y</given-names></name> <name><surname>Zheng</surname> <given-names>J</given-names></name> <etal/></person-group>. <article-title>Characteristics of the plasmid-mediated colistin-resistance gene <italic>mcr-1</italic> in <italic>Escherichia coli</italic> isolated from a veterinary hospital in Shanghai</article-title>. <source>Front Microbiol</source>. (<year>2022</year>) <volume>13</volume>:<fpage>1002827</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fmicb.2022.1002827</pub-id>, <pub-id pub-id-type="pmid">36386648</pub-id></mixed-citation></ref>
<ref id="ref29"><label>29.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Menezes</surname> <given-names>J</given-names></name> <name><surname>da Moreira Silva</surname> <given-names>J</given-names></name> <name><surname>Frosini</surname> <given-names>S-M</given-names></name> <name><surname>Loeffler</surname> <given-names>A</given-names></name> <name><surname>Weese</surname> <given-names>S</given-names></name> <name><surname>Perreten</surname> <given-names>V</given-names></name> <etal/></person-group>. <article-title><italic>Mcr-1</italic> colistin resistance gene sharing between <italic>Escherichia coli</italic> from cohabiting dogs and humans, Lisbon, Portugal, 2018 to 2020</article-title>. <source>Euro Surveill</source>. (<year>2022</year>) <volume>27</volume>:<fpage>2101144</fpage>. doi: <pub-id pub-id-type="doi">10.2807/1560-7917.ES.2022.27.44.2101144</pub-id>, <pub-id pub-id-type="pmid">36330821</pub-id></mixed-citation></ref>
<ref id="ref30"><label>30.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hamame</surname> <given-names>A</given-names></name> <name><surname>Davoust</surname> <given-names>B</given-names></name> <name><surname>Cherak</surname> <given-names>Z</given-names></name> <name><surname>Rolain</surname> <given-names>J-M</given-names></name> <name><surname>Diene</surname> <given-names>SM</given-names></name></person-group>. <article-title>Mobile colistin resistance (<italic>mcr</italic>) genes in cats and dogs and their zoonotic transmission risks</article-title>. <source>Pathogens</source>. (<year>2022</year>) <volume>11</volume>:<fpage>698</fpage>. doi: <pub-id pub-id-type="doi">10.3390/pathogens11060698</pub-id>, <pub-id pub-id-type="pmid">35745552</pub-id></mixed-citation></ref>
<ref id="ref31"><label>31.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Magiorakos</surname> <given-names>A-P</given-names></name> <name><surname>Srinivasan</surname> <given-names>A</given-names></name> <name><surname>Carey</surname> <given-names>RB</given-names></name> <name><surname>Carmeli</surname> <given-names>Y</given-names></name> <name><surname>Falagas</surname> <given-names>ME</given-names></name> <name><surname>Giske</surname> <given-names>CG</given-names></name> <etal/></person-group>. <article-title>Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance</article-title>. <source>Clin Microbiol Infect</source>. (<year>2012</year>) <volume>18</volume>:<fpage>268</fpage>&#x2013;<lpage>81</lpage>. doi: <pub-id pub-id-type="doi">10.1111/j.1469-0691.2011.03570.x</pub-id>, <pub-id pub-id-type="pmid">21793988</pub-id></mixed-citation></ref>
<ref id="ref32"><label>32.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yang</surname> <given-names>J-T</given-names></name> <name><surname>Zhang</surname> <given-names>L-J</given-names></name> <name><surname>Lu</surname> <given-names>Y</given-names></name> <name><surname>Zhang</surname> <given-names>R-M</given-names></name> <name><surname>Jiang</surname> <given-names>H-X</given-names></name></person-group>. <article-title>Genomic insights into global blaCTX-M-55-positive <italic>Escherichia coli</italic> epidemiology and transmission characteristics</article-title>. <source>Microbiol Spectr</source>. (<year>2023</year>) <volume>11</volume>:<fpage>e0108923</fpage>. doi: <pub-id pub-id-type="doi">10.1128/spectrum.01089-23</pub-id>, <pub-id pub-id-type="pmid">37358409</pub-id></mixed-citation></ref>
<ref id="ref33"><label>33.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lupo</surname> <given-names>A</given-names></name> <name><surname>Saras</surname> <given-names>E</given-names></name> <name><surname>Madec</surname> <given-names>J-Y</given-names></name> <name><surname>Haenni</surname> <given-names>M</given-names></name></person-group>. <article-title>Emergence of <italic>bla</italic><sub>CTX-M-55</sub> associated with <italic>fosA</italic>, <italic>rmtB,</italic> and <italic>mcr</italic> gene variants in <italic>Escherichia coli</italic> from various animal species in France</article-title>. <source>J Antimicrob Chemother</source>. (<year>2018</year>) <volume>73</volume>:<fpage>867</fpage>&#x2013;<lpage>72</lpage>. doi: <pub-id pub-id-type="doi">10.1093/jac/dkx489</pub-id>, <pub-id pub-id-type="pmid">29340602</pub-id></mixed-citation></ref>
<ref id="ref34"><label>34.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>De La Cadena</surname> <given-names>E</given-names></name> <name><surname>Mahecha</surname> <given-names>M</given-names></name> <name><surname>Velandia</surname> <given-names>AM</given-names></name> <name><surname>Garc&#x00ED;a-Betancur</surname> <given-names>JC</given-names></name> <name><surname>Rojas</surname> <given-names>LJ</given-names></name> <name><surname>Porras</surname> <given-names>J</given-names></name> <etal/></person-group>. <article-title>Identification of mcr-1 genes and characterization of resistance mechanisms to colistin in <italic>Escherichia coli</italic> isolates from Colombian hospitals</article-title>. <source>Antibiotics</source>. (<year>2023</year>) <volume>12</volume>:<fpage>488</fpage>. doi: <pub-id pub-id-type="doi">10.3390/antibiotics12030488</pub-id>, <pub-id pub-id-type="pmid">36978355</pub-id></mixed-citation></ref>
<ref id="ref35"><label>35.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zhao</surname> <given-names>X</given-names></name> <name><surname>Chen</surname> <given-names>H</given-names></name> <name><surname>Bi</surname> <given-names>W</given-names></name> <name><surname>Shan</surname> <given-names>H</given-names></name> <name><surname>Wang</surname> <given-names>J</given-names></name> <name><surname>Yang</surname> <given-names>Z</given-names></name></person-group>. <article-title>Coexistence and genomics characterization of <italic>mcr-1</italic> and extended-spectrum-&#x03B2;-lactamase-producing <italic>Escherichia coli</italic>, an emerging extensively drug-resistant bacteria from sheep in China</article-title>. <source>Sci Total Environ</source>. (<year>2024</year>) <volume>955</volume>:<fpage>177016</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.scitotenv.2024.177016</pub-id>, <pub-id pub-id-type="pmid">39426540</pub-id></mixed-citation></ref>
<ref id="ref36"><label>36.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wu</surname> <given-names>R</given-names></name> <name><surname>Yi</surname> <given-names>L-X</given-names></name> <name><surname>Yu</surname> <given-names>L-F</given-names></name> <name><surname>Wang</surname> <given-names>J</given-names></name> <name><surname>Liu</surname> <given-names>Y</given-names></name> <name><surname>Chen</surname> <given-names>X</given-names></name> <etal/></person-group>. <article-title>Fitness advantage of <italic>mcr-1</italic>-bearing IncI2 and IncX4 plasmids <italic>in vitro</italic></article-title>. <source>Front Microbiol</source>. (<year>2018</year>) <volume>9</volume>:<fpage>331</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fmicb.2018.00331</pub-id>, <pub-id pub-id-type="pmid">29535696</pub-id></mixed-citation></ref>
<ref id="ref37"><label>37.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Majewski</surname> <given-names>P</given-names></name> <name><surname>Gutowska</surname> <given-names>A</given-names></name> <name><surname>Smith</surname> <given-names>DGE</given-names></name> <name><surname>Hauschild</surname> <given-names>T</given-names></name> <name><surname>Majewska</surname> <given-names>P</given-names></name> <name><surname>Hryszko</surname> <given-names>T</given-names></name> <etal/></person-group>. <article-title>Plasmid mediated <italic>mcr-1.1</italic> colistin-resistance in clinical extraintestinal <italic>Escherichia coli</italic> strains isolated in Poland</article-title>. <source>Front Microbiol</source>. (<year>2021</year>) <volume>12</volume>:<fpage>547020</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fmicb.2021.547020</pub-id>, <pub-id pub-id-type="pmid">34956105</pub-id></mixed-citation></ref>
<ref id="ref38"><label>38.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zelendova</surname> <given-names>M</given-names></name> <name><surname>Papagiannitsis</surname> <given-names>CC</given-names></name> <name><surname>Valcek</surname> <given-names>A</given-names></name> <name><surname>Medvecky</surname> <given-names>M</given-names></name> <name><surname>Bitar</surname> <given-names>I</given-names></name> <name><surname>Hrabak</surname> <given-names>J</given-names></name> <etal/></person-group>. <article-title>Characterization of the complete nucleotide sequences of <italic>mcr-1</italic>-encoding plasmids from Enterobacterales isolates in retailed raw meat products from the Czech Republic</article-title>. <source>Front Microbiol</source>. (<year>2021</year>) <volume>11</volume>:<fpage>604067</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fmicb.2020.604067</pub-id>, <pub-id pub-id-type="pmid">33519748</pub-id></mixed-citation></ref>
<ref id="ref39"><label>39.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yi</surname> <given-names>L</given-names></name> <name><surname>Durand</surname> <given-names>R</given-names></name> <name><surname>Grenier</surname> <given-names>F</given-names></name> <name><surname>Yang</surname> <given-names>J</given-names></name> <name><surname>Yu</surname> <given-names>K</given-names></name> <name><surname>Burrus</surname> <given-names>V</given-names></name> <etal/></person-group>. <article-title>PixR, a novel activator of conjugative transfer of IncX4 resistance plasmids, mitigates the fitness cost of <italic>mcr-1</italic> carriage in <italic>Escherichia coli</italic></article-title>. <source>MBio</source>. (<year>2022</year>) <volume>13</volume>:<fpage>e0320921</fpage>. doi: <pub-id pub-id-type="doi">10.1128/mbio.03209-21</pub-id></mixed-citation></ref>
<ref id="ref40"><label>40.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Liu</surname> <given-names>Y-Y</given-names></name> <name><surname>Zhu</surname> <given-names>X-Q</given-names></name> <name><surname>Nang</surname> <given-names>SC</given-names></name> <name><surname>Xun</surname> <given-names>H</given-names></name> <name><surname>Lv</surname> <given-names>L</given-names></name> <name><surname>Yang</surname> <given-names>J</given-names></name> <etal/></person-group>. <article-title>Greater invasion and persistence of <italic>mcr-1-</italic>bearing plasmids in <italic>Escherichia coli</italic> than in <italic>Klebsiella pneumoniae</italic></article-title>. <source>Microbiol Spectr</source>. (<year>2023</year>) <volume>11</volume>:<fpage>e0322322</fpage>. doi: <pub-id pub-id-type="doi">10.1128/spectrum.03223-22</pub-id>, <pub-id pub-id-type="pmid">36975832</pub-id></mixed-citation></ref>
<ref id="ref41"><label>41.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yi</surname> <given-names>L</given-names></name> <name><surname>Yu</surname> <given-names>K</given-names></name> <name><surname>Gao</surname> <given-names>G</given-names></name> <name><surname>Zhang</surname> <given-names>R</given-names></name> <name><surname>Lv</surname> <given-names>L</given-names></name> <name><surname>Yu</surname> <given-names>D</given-names></name> <etal/></person-group>. <article-title>Successful spread of <italic>mcr-1</italic>-bearing IncX4 plasmids is associated with variant in replication protein of IncX4 plasmids</article-title>. <source>J Glob Antimicrob Resist</source>. (<year>2024</year>) <volume>36</volume>:<fpage>365</fpage>&#x2013;<lpage>70</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jgar.2024.01.012</pub-id>, <pub-id pub-id-type="pmid">38280721</pub-id></mixed-citation></ref>
<ref id="ref42"><label>42.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Li</surname> <given-names>R</given-names></name> <name><surname>Xie</surname> <given-names>M</given-names></name> <name><surname>Zhang</surname> <given-names>J</given-names></name> <name><surname>Yang</surname> <given-names>Z</given-names></name> <name><surname>Liu</surname> <given-names>L</given-names></name> <name><surname>Liu</surname> <given-names>X</given-names></name> <etal/></person-group>. <article-title>Genetic characterization of <italic>mcr-1</italic>-bearing plasmids to depict molecular mechanisms underlying dissemination of the colistin resistance determinant</article-title>. <source>J Antimicrob Chemother</source>. (<year>2017</year>) <volume>72</volume>:<fpage>393</fpage>&#x2013;<lpage>401</lpage>. doi: <pub-id pub-id-type="doi">10.1093/jac/dkw411</pub-id>, <pub-id pub-id-type="pmid">28073961</pub-id></mixed-citation></ref>
<ref id="ref43"><label>43.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sun</surname> <given-names>J</given-names></name> <name><surname>Fang</surname> <given-names>L-X</given-names></name> <name><surname>Wu</surname> <given-names>Z</given-names></name> <name><surname>Deng</surname> <given-names>H</given-names></name> <name><surname>Yang</surname> <given-names>R-S</given-names></name> <name><surname>Li</surname> <given-names>X-P</given-names></name> <etal/></person-group>. <article-title>Genetic analysis of the IncX4 plasmids: implications for a unique pattern in the <italic>mcr</italic>-1 acquisition</article-title>. <source>Sci Rep</source>. (<year>2017</year>) <volume>7</volume>:<fpage>424</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-017-00095-x</pub-id>, <pub-id pub-id-type="pmid">28336940</pub-id></mixed-citation></ref>
<ref id="ref44"><label>44.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zurfluh</surname> <given-names>K</given-names></name> <name><surname>N&#x00FC;esch-Inderbinen</surname> <given-names>M</given-names></name> <name><surname>Klumpp</surname> <given-names>J</given-names></name> <name><surname>Poirel</surname> <given-names>L</given-names></name> <name><surname>Nordmann</surname> <given-names>P</given-names></name> <name><surname>Stephan</surname> <given-names>R</given-names></name></person-group>. <article-title>Key features of <italic>mcr-1</italic>-bearing plasmids from <italic>Escherichia coli</italic> isolated from humans and food</article-title>. <source>Antimicrob Resist Infect Control</source>. (<year>2017</year>) <volume>6</volume>:<fpage>91</fpage>. doi: <pub-id pub-id-type="doi">10.1186/s13756-017-0250-8</pub-id>, <pub-id pub-id-type="pmid">28878890</pub-id></mixed-citation></ref>
<ref id="ref45"><label>45.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Zhang</surname> <given-names>X</given-names></name> <name><surname>Zhang</surname> <given-names>B</given-names></name> <name><surname>Guo</surname> <given-names>Y</given-names></name> <name><surname>Wang</surname> <given-names>J</given-names></name> <name><surname>Zhao</surname> <given-names>P</given-names></name> <name><surname>Liu</surname> <given-names>J</given-names></name> <etal/></person-group>. <article-title>Colistin resistance prevalence in <italic>Escherichia coli</italic> from domestic animals in intensive breeding farms of Jiangsu Province</article-title>. <source>Int J Food Microbiol</source>. (<year>2019</year>) <volume>291</volume>:<fpage>87</fpage>&#x2013;<lpage>90</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.ijfoodmicro.2018.11.013</pub-id>, <pub-id pub-id-type="pmid">30476737</pub-id></mixed-citation></ref>
<ref id="ref46"><label>46.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kim</surname> <given-names>ES</given-names></name> <name><surname>Chong</surname> <given-names>YP</given-names></name> <name><surname>Park</surname> <given-names>S-J</given-names></name> <name><surname>Kim</surname> <given-names>M-N</given-names></name> <name><surname>Kim</surname> <given-names>S-H</given-names></name> <name><surname>Lee</surname> <given-names>S-O</given-names></name> <etal/></person-group>. <article-title>Detection and genetic features of MCR-1-producing plasmid in human <italic>Escherichia coli</italic> infection in South Korea</article-title>. <source>Diagn Microbiol Infect Dis</source>. (<year>2017</year>) <volume>89</volume>:<fpage>158</fpage>&#x2013;<lpage>60</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.diagmicrobio.2017.06.020</pub-id>, <pub-id pub-id-type="pmid">28780246</pub-id></mixed-citation></ref>
<ref id="ref47"><label>47.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tsakmakidis</surname> <given-names>I</given-names></name> <name><surname>Parisi</surname> <given-names>A</given-names></name> <name><surname>Papadopoulos</surname> <given-names>DK</given-names></name> <name><surname>Alvanou</surname> <given-names>MV</given-names></name> <name><surname>Papageorgiou</surname> <given-names>KV</given-names></name> <name><surname>Petridou</surname> <given-names>E</given-names></name> <etal/></person-group>. <article-title>Stray dogs as carriers of <italic>E. coli</italic> resistant strains for the retracted and re-emerged antibiotic colistin, based on the <italic>mcr-1</italic> gene presence</article-title>. <source>AIMS Mol Sci</source>. (<year>2024</year>) <volume>11</volume>:<fpage>367</fpage>&#x2013;<lpage>78</lpage>. doi: <pub-id pub-id-type="doi">10.3934/molsci.2024022</pub-id></mixed-citation></ref>
<ref id="ref48"><label>48.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Stalder</surname> <given-names>T</given-names></name> <name><surname>Rogers</surname> <given-names>LM</given-names></name> <name><surname>Renfrow</surname> <given-names>C</given-names></name> <name><surname>Yano</surname> <given-names>H</given-names></name> <name><surname>Smith</surname> <given-names>Z</given-names></name> <name><surname>Top</surname> <given-names>EM</given-names></name></person-group>. <article-title>Emerging patterns of plasmid-host coevolution that stabilize antibiotic resistance</article-title>. <source>Sci Rep</source>. (<year>2017</year>) <volume>7</volume>:<fpage>4853</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-017-04662-0</pub-id>, <pub-id pub-id-type="pmid">28687759</pub-id></mixed-citation></ref>
</ref-list>
<fn-group>
<fn fn-type="custom" custom-type="edited-by" id="fn0001">
<p>Edited by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/701406/overview">Md. Shafiullah Parvej</ext-link>, University of Missouri, United States</p>
</fn>
<fn fn-type="custom" custom-type="reviewed-by" id="fn0002">
<p>Reviewed by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/591134/overview">Juliana Menezes</ext-link>, Lusofona University, Portugal</p>
<p><ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/3301923/overview">Ioannis Tsakmakidis</ext-link>, University of Western Macedonia, Greece</p>
</fn>
</fn-group>
</back>
</article>