In addition to blaCTX-M-3, pIncFII_CTXM3_221–24 carries a variety of other resistance genes, including blaTEM-1, sul2, aph(3’’)-Ib, aph(6)-Id, aph(3’)-Ia, aac(3)-IId, aac(6’)-Ib-D181Y, arr-3, dfrA27, aadA16, sul1 (2), qnrB91, mph(A), tet(A), floR, and qnrS1. These genes confer resistance to a broad range of antibiotics, including sulfonamides, aminoglycosides, tetracyclines, and quinolones, further complicating treatment strategies for infections caused by these strains. Here, APEH is linked to infection.