摘要

       世界正面临着严重的全球健康问题，这是由越来越多的抗生素抗性细菌 (ARB) 和周围环境传播的抗生素抗性基因 (ARG) 引起的。由于耐药性增加，抗生素现在被认为是导致灭绝的“濒危物种”。抗微生物药物耐药性 (AMR) 导致的全球死亡率估计每年接近 700,000 人，预计到 2050 年每年还会增加 1000 万人。 抗生素耐药性的威胁需要更好地了解 ARGs 和 ARBs 及其在周边地区的传播环境。抗生素的使用和滥用支持 ARB 的起源和传播，导致微生物进化和死亡率增加以及医疗费用。自第一例耐药性病例出现以来，这种机制迅速发展，美国 70% 的医院病例对至少一类抗生素产生耐药性。 AMR 的其他主要储存库是农业和人类废物处理厂。此外，环境水库，包括抗生素耐药性决定因素的河流和湖泊等水生水库，由于 ARG 和抗生素的运输，支持了 ARB 的生长促进。有大量证据支持这样一个事实，即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 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素需要对生物和非生物因素进行适当的管理和调节。为了应对这一新出现的问题，本综述旨在了解抗生素耐药性，包括 ARG 的起源、进化和系统发育关系，并定义耐药基因以及多重耐药细菌。

       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