In addition, co-infection of plasmids sharing the same incompatibility group such as pDCVA3-NDM-5 and pIncFII-M19736 in E. coli M19736::pDCVA3-NDM-5 or pDCAG1-CTX-M-15 and pIncFII-M19736 in evolved MDR-E. The gene discussed is CYP27A1; the disease is coinfection.