As well as the quantity

The development of antibiotic resistance is a common evolutionary process in microorganisms to ensure their survival against other microorganisms. Antibiotic resistance can appear through a process of spontaneous mutation or be acquired via vertical or, more commonly, horizontal gene transfer. The use and misuse of 17-DMAG over recent decades and the presence of certain concentrations of antibiotics in different environments could have accelerated this phenomenon by exerting a selective pressure. Poor sanitary conditions, inefficient (or the total absence of) sewage treatment, and deficiencies in the control of both human and veterinary infections stimulate the generation and further spread of antibiotic resistant determinants (EFSA-ECDC, 2015 and World Health Organization, 2014). The unfortunate consequences are LTR an estimated 25,000 people in Europe (ECDC/EMEA, 2009) and 23,000 in America die image every year because of antibiotic-resistant infections (The White House, 2014).
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