[Comment] Impact of bacterial secondary resistome on antimicrobial susceptibility

Antimicrobial resistance (AMR) is a major global public health burden1 and is mediated through five principal mechanisms: reduced permeability, active efflux, target modification, drug inactivation, and target bypass.2 Each mechanism is primarily driven by specific resistance genes; however, the interplay between AMR determinants and other genetic elements within the bacterial genome remains poorly understood.