Emergence of plasmid-mediated fosfomycin resistance among <i>Escherichia coli</i> harboring <i>fosA4</i> , <i>tet</i> (X4), and <i>mcr-1</i> genes in wild birds

The global spread of the plasmid-mediated fosfomycin resistance gene <i>fosA4</i> bearing <i>Escherichia coli</i> strains incurs a public health concern. However, research focusing on the pervasiveness of <i>fosA4</i>-positive isolates in wild birds is still rare, and to the best of our knowledge, this is the first documentation from South Asia highlighting the concurrent presence of the <i>fosA4</i>, <i>mcr-1</i>, and <i>tet</i>(X4) genes within <i>E. coli</i> isolates recovered from fecal samples of wild birds in Pakistan. This co-existence of ARGs along with phylogenetic analysis revealed that MDR plasmids carried by <i>E. coli</i> isolates have the ability to spread horizontally between wild birds, food animals, and humans. Co-existence of <i>fosA4</i>, <i>tet</i>(X4), and <i>mcr-1</i>-carrying plasmids is worrying and warrants further investigation.