Abstract
<em>mdr</em> genes in association with many drug efflux and metal efflux genes are creating pathogenesis due to antibiotic void. However, most dangerous step occurred when R-plasmids and integrons (~2-9kb) were combined with F’-conjugative plasmid (62.5kb) creating large <em>mdr</em> conjugative plasmids that easily donated 6-15 <em>mdr</em> genes to gut microbiota as well as environmental bacteria.
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