“…CTX-M-15 was found to be the most prevalent ESBL genotype in wastewater and sewage studies in most regions worldwide including the Americas, Europe and the Middle East [74]. Additionally, the CTX-M-15 was previously detected in Enterobacteriaceae recovered from seawater, rivers and effluents of wastewater treatment plants and hospitals [75], and similar to our findings, was associated with TEM-1 and/or OXA-1 [73]. Additionally, sequencing of gyrA and parC genes in this study revealed a single substitution D87V and S83T in GyrA and a single S80I or double substitutions S80I and E84V in ParC conferring resistance to fluoroquinolones [73].…”