Mobile genetic elements (MGEs), such as plasmids and integrative and conjugative elements (ICEs), are main drivers for the spread of antibiotic resistance (AR). Coevolution between bacteria and plasmids shapes the transfer and stability of plasmids across bacteria. Although ICEs outnumber conjugative plasmids, the dynamics of ICE–bacterium coevolution, ICE transfer rates, and fitness costs are as yet largely unexplored. Conjugative plasmids and ICEs are both transferred by type IV secretion systems, but ICEs are typically immune to segregational loss, suggesting that the evolution of ICE–bacterium associations varies from that of plasmid–bacterium associations. Considering the high abundance of ICEs among bacteria, ICE–bacterium dynamics represent a promising challenge for future research that will enhance our understanding of AR spread in human pathogens.

流动遗传元件（MGE），例如质粒以及整合和结合元件（ICE），是抗生素耐药性（AR）传播的主要驱动力。细菌和质粒之间的共同进化决定了质粒跨细菌的转移和稳定性。尽管ICE的数量超过了结合质粒，但ICE细菌协同进化的动力学，ICE的转移速率和适应性成本尚未得到充分的探索。结合质粒和ICE均通过IV型分泌系统转移，但ICE通常对分离损失免疫，这表明ICE-细菌缔合的进化不同于质粒-细菌缔合的进化。考虑到细菌中ICE的含量很高，