摘要

       水生环境被认为是获得和传播抗生素抗性的理想环境，人类在水生环境中接触抗生素抗性细菌 (ARB) 和抗生素抗性基因 (ARG) 可能会带来额外的健康风险。定量微生物风险评估 (QMRA) 已被建议作为评估和量化这种健康风险的合适方法。然而，在许多情况下缺乏有关水生环境中 ARB 和 ARGs 暴露的信息，并且尚未开发关于 ARB 感染的剂量反应模型。本综述总结了目前关于水环境中 ARB 和 ARGs 的知识，并强调了仍有待回答的挑战性问题，以更好地预测水环境中 ARB 和 ARGs 造成的健康风险。问题包括量化在水生环境中暴露于 ARB 和 ARG 所造成的人类健康风险所需的缺失信息是什么？评估水生环境中 ARB/ARGs 污染的合适标志物是什么？ ARG 选择和繁殖在水生环境中发生的频率如何？有什么未知的热点吗？对上述主题的研究将有助于更好地管理水环境中抗生素耐药性的传播及其对人类健康的风险。

       Aquatic environments are identified as an ideal setting for acquisition and dissemination of antibiotic resistance, and human exposure to antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in aquatic environments may pose an additional health risk. Quantitative microbial risk assessment (QMRA) has been suggested as a suitable method to evaluate and quantify this health risk. However, information about the exposure to ARB and ARGs in aquatic environments is lacking for many scenarios and dose-response models regarding the ARB infections are not developed yet. This review summarizes the current knowledge regarding the ARB and ARGs in aquatic environments and highlights the challenging questions remaining to be answered to better forecast the health risks caused by ARB and ARGs in water environments. The questions include what are the missing information needed to quantify the human health risks caused by exposing to ARB and ARGs in aquatic environments? what are the suitable markers to evaluate the ARB/ARGs contamination in aquatic environments? how frequently do the ARG selection and propagation occur in aquatic environments? and are there any unknown hot spots? Studies on the above topics will contribute to better management of antibiotic resistance dissemination in water environments and its risks on human health.

https://www.tandfonline.com/doi/full/10.1080/10643389.2019.1692611