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However, if we are right and this is generally across all (or most) antimicrobial resistance mechanisms, we will have to rethink both routine susceptibility testing and a lot of especially in vitro research. I know it is only for two resistance genes, but we find a profound effect of changing pH and temperature on enzymatic activity and encoded susceptibility. Even to an extent where in vivo treatment could be possible in contrast to what would be observed in the clinical microbial laboratory. However, perhaps more importantly this could bring new explanations for evolution and ecology of AMR.