摘要

    由于抗生素抗性细菌（ARBs）和周围环境传播性抗生素抗性基因（ARGs）的增加，世界正面临着严重的全球健康问题。由于耐药性增加的事实，抗生素现在被认为是导致灭绝的“濒危物种”。全球因抗菌素耐药性导致的死亡率估计每年接近700,000，预计到2050年每年将进一步增加1,000万。抗生素耐药性的威胁需要对ARG和ARB及其在周围的传播有更好的了解。环境。抗生素的使用和滥用支持ARB的起源和传播，导致微生物进化，增加的死亡率以及医疗费用。自从第一例耐药性病例发生以来，这种机制迅速发展起来，在美国，有70％的医院病例对至少一种抗生素具有耐药性。 AMR的其他主要水库是农业和人类废物处理厂。另外，由于ARG和抗生素的运输，环境水库，包括水生水库，例如抗生素抗性决定簇的河流和湖泊，已经促进了ARBs的生长促进。有大量证据支持以下事实：临床相关细菌已通过抗性和持久的进化保守基因转移从环境细菌中遗传获得了ARM。在农业，养蜂业，水产养殖，家禽和牲畜等不同领域使用抗菌剂需要对生物和非生物因素进行适当的管理和调节。为了解决这个新出现的问题，对本综述进行了综述，以了解其抗药性，包括它们的起源，进化和ARG的系统发育关系，并定义抗药性基因和耐多药细菌。

    The world is facing a serious global health issue caused by both increasing antibiotic-resistant bacteria (ARBs) and the surrounding environmental disseminating antibiotic-resistant genes (ARGs). Owing to the fact of increased resistance, antibiotics are now considered as “endangered species” leading to extinction. Global mortality as a result of antimicrobial resistance (AMR) is estimated to be near 700,000 per year and is expected to further rise by 10 million annually by 2050. The threat of antibiotic resistance requires better understanding of ARGs and ARBs and their dissemination in the surrounding environment. The use and misuse of antibiotics supports the origin and spread of ARBs leading to microbial evolution and increased mortality as well as medical costs. Since the incidence of the first case of resistance, this mechanism has flourished rapidly with 70% of hospital cases resistant to at least one class of antibiotics in the United States. Other major reservoirs of AMR are agricultural and human waste treatment plants. Additionally, environmental reservoirs, including aquatic ones such as rivers and lakes of antibiotic resistance determinants, have supported growth promotion of ARBs due to transportation of ARGs and antibiotics. There is substantial evidence supporting the fact that clinically relevant bacteria have acquired ARMs from environmental bacteria genetically via resistant and long-lasting evolutionary conserved gene transfer. Use of antimicrobials in different fields such as agriculture, apiculture, aquaculture, poultry, and livestock require proper management and regulation of biotic and abiotic factors. To confront this emerging problem, this review was summarized to understand the antibiotic resistance, including their origins, evolution, and phylogenetic relationship of ARGs and to define resistant genes as well as multidrug-resistant bacteria.

    https://www.sciencedirect.com/science/article/pii/B9780128188828000073