Fig. 4

Azithromycin resistance emergence in Bangladesh is associated with different mutations in AcrB, arising in at least six different genotype backgrounds. A Resistance trends plot showing that ciprofloxacin non-susceptibility has remained near-universal since 2005, while MDR declined. Azithromycin emerged circa 2014, reaching 4–5% in 2017–2019. B Resistance determinants plot shows that two different types of azithromycin resistance mutations were detected (AcrB-R717L and AcrB-R717Q), in six different genotypes