摘要

    根据世界卫生组织（WHO）的数据，估计每年全球抗菌素耐药性细菌的感染导致700,000人死亡。在2016年联合国大会上，世界各国领导人承认抗菌素耐药性（AMR）与滥用抗生素在公共卫生，动物，食品，农业和水产养殖部门之间的联系，承诺采取一种统一的针对AMR的卫生方法，涉及各种捍卫人类，动物和环境健康的部门和参与者。抗生素的使用促进了AMR的发展，并影响了细菌群落中的共选过程，从而导致了抗生素，AMR细菌和抗生素抗性基因（ARG）在人类，宠物，牲畜，野生动物和自然环境中的传播。考虑到细菌基因转移系统的混杂性，越来越多地认为环境中存在ARGs是一个生态问题。因此，迫切需要了解AMR的动态，并且“一种健康”方法对于评估AMR和ARG的起源，传播和流动机制至关重要。一些AMR细菌和ARGs的传播速度比其他细菌和ARG更快，成为大流行病。耐甲氧西林的金黄色葡萄球菌（MRSA）是一种重要的病原体，具有很高的发病率和死亡率。 MRSA菌株曾经与医院感染有关，但现在已经传播到社区，动物和环境中。此外，MRSA菌株不断变化，在不同地理区域出现了新的不同克隆。因此，全球公认有必要监测和更好地了解MRSA菌株中AMR和ARG的特征和传播途径。

    According to the World Health Organization (WHO), infections with antimicrobial resistant bacteria result in an estimated number of 700,000 human deaths globally per year. In the 2016 United Nations General Assembly, world leaders acknowledged the link between antimicrobial resistance (AMR) and the misuse of antibiotics in public health, animal, food, agriculture, and aquaculture sectors, committing to a concerted One Health approach to AMR involving the various sectors and actors in defense of human, animal, and environmental health. The use of antibiotics promotes the development of AMR and influences co-selection processes in bacterial communities leading to the dissemination of antibiotics, AMR bacteria, and antibiotic resistance genes (ARGs) among humans, pets, livestock, wild animals, and the natural environment. Considering the promiscuity of bacterial gene transfer systems, the presence of ARGs in the environment is increasingly beheld as an ecological problem. Hence, there is an urgent need to understand the dynamics of AMR and a One Health approach is essential to evaluate the origin, spread, and flow mechanisms of AMR and ARGs. Some AMR bacteria and ARGs are spreading more rapidly than others, becoming pandemic. Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen with serious morbidity and mortality. MRSA strains used to be associated with nosocomial infections but have now disseminated to the community, animals, and environment. Besides, MRSA strains are constantly changing with new different clones emerging in different geographical areas. Thus, it is globally recognized the urgency to monitor and better understand the characteristics and transmission routes of AMR and ARGs in MRSA strains.

    https://link.springer.com/chapter/10.1007/978-3-030-40422-2_13