摘要

       近几十年来，病原菌中抗生素耐药性的出现和传播一直是公共卫生面临的一个日益严重的问题。人们越来越认识到，不仅临床病原体中遇到的抗生素抗性基因 (ARG) 具有相关性，而且所有致病菌、共生菌和环境细菌——以及可移动的遗传元件和噬菌体——都形成了 ARG 的储存库（耐药组），病原菌可以通过水平基因转移（HGT）获得耐药性。 HGT 已导致抗生素耐药性从共生和环境物种传播到致病物种，正如一些临床上重要的 ARG 所显示的那样。在 HGT 的三种典型机制中，共轭被认为对 ARG 的传播影响最大。虽然转化和转导被认为不太重要，但最近的发现表明它们的作用可能比以前认为的要大。了解抗性组的范围及其向致病细菌的动员是如何发生的，对于控制这些基因的传播至关重要。在这里，我们将讨论抗性组的概念，提供临床相关 ARG 的 HGT 示例，并概述各种 HGT 机制对抗生素抗性传播的贡献的当前知识。

       The emergence and spread of antibiotic resistance among pathogenic bacteria has been a rising problem for public health in recent decades. It is becoming increasingly recognized that not only antibiotic resistance genes (ARGs) encountered in clinical pathogens are of relevance, but rather, all pathogenic, commensal as well as environmental bacteria—and also mobile genetic elements and bacteriophages—form a reservoir of ARGs (the resistome) from which pathogenic bacteria can acquire resistance via horizontal gene transfer (HGT). HGT has caused antibiotic resistance to spread from commensal and environmental species to pathogenic ones, as has been shown for some clinically important ARGs. Of the three canonical mechanisms of HGT, conjugation is thought to have the greatest influence on the dissemination of ARGs. While transformation and transduction are deemed less important, recent discoveries suggest their role may be larger than previously thought. Understanding the extent of the resistome and how its mobilization to pathogenic bacteria takes place is essential for efforts to control the dissemination of these genes. Here, we will discuss the concept of the resistome, provide examples of HGT of clinically relevant ARGs and present an overview of the current knowledge of the contributions the various HGT mechanisms make to the spread of antibiotic resistance.

https://www.frontiersin.org/articles/10.3389/fmicb.2016.00173/full