Multiple plasmid origin-of-transfer substrates enable the spread of natural antimicrobial resistance to human pathogens

Antimicrobial resistance poses a great danger to humanity, in part due to the widespread horizontal transfer of plasmids via conjugation. Modeling of plasmid transfer is essential to uncovering the fundamentals of resistance transfer and for development of predictive measures to limit the spread of resistance. However, a major limitation in the current understanding of plasmids is the inadequate characterization of the DNA transfer mechanisms, which conceals the actual potential for plasmid transfer in nature. Here, we consider that the plasmid-borne origin-of-transfer substrates encode specific DNA structural properties that can facilitate finding these regions in large datasets, and develop a DNA structure-based alignment procedure for typing the transfer substrates that outperforms mere sequence-based approaches. We identify thousands of yet undiscovered DNA transfer substrates, showing that actual plasmid mobility can in fact be 2-fold higher and span almost 2-fold more host species than is currently known. Over half of all mobile plasmids contain the means to transfer between different mobility groups, which links previously confined host ranges across ecological habitats into a robust plasmid transfer network. We show that this network in fact serves to transfer antimicrobial resistance from the environmental genetic reservoirs to human pathogens, which might be an important driver of the observed rapid resistance development in humans and thus an important point of focus for future prevention measures.