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Urban streams are heavily impacted by slum untreated sewage.
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Polluted urban waterways accelerate the dispersion of antibiotic resistance.
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Co-occurrence of antimicrobials, resistant bacteria and resistance genes is alarming.
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Klebsiella pneumoniae and Serratia marcescens showed high chlorhexidine MICs.
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Stream bacterial community shows fecal and antibiotic bacterial family’s indicator.
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Bacterial pathogens can drive immune exhaustion, a concept traditionally studied in viral and oncologic contexts but increasingly recognized in chronic bacterial infections.
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Biofilms, immune-privileged niches, and regulatory T-cell expansion are major contributors to persistent immune dysfunction, creating barriers to effective immune responses.
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Immune exhaustion exacerbates secondary infections, antibiotic resistance, and microbiome dysbiosis, underscoring its broader impact beyond direct bacterial persistence.
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Targeting exhaustion pathways through immune checkpoint blockade, metabolic reprogramming, and microbiome modulation offers promising therapeutic strategies beyond conventional antimicrobial approaches.



