摘要

       正如 2013 年八国集团科学部和 2015 年 Elmau 峰会 (https://www.g7germany.de/Webs/ G7/EN/Home_en/home_node.html）。虽然大部分注意力继续集中在临床和开发新药的需求上，但人们越来越认识到需要了解抗生素耐药性的起源和生态，以减缓其传播并最大限度地延长我们抗生素库的使用寿命（Wright , 2010)。特别是，水生环境既可以作为抗生素耐药性的天然储存库，也可以作为传播主要关注的临床耐药性特征的渠道（Michael 等，2013）。水体，包括湖泊、河流、溪流甚至海岸线，接收来自废水处理厂 (WWTP) 的污水、农业活动的径流以及其他可能有助于提高抗生素抗性基因 (ARG) 自然背景水平的人类输入和影响并刺激它们转移到病原体或其他生物体中，或作为传播抗生素抗性病原体和相关临床 ARG 的渠道（Michael 等，2013）。当前的病原体风险模型无法考虑抗生素耐药性带来的独特挑战，包括非致病性抗生素耐药细菌 (ARB) 可以作为将其 ARG 转移给病原体的储存库或选择剂的作用，例如抗生素和金属，以放大这种潜力。控制抗生素耐药性传播的挑战在发达国家或发展中国家可能有不同的面貌，这取决于当地的政策、实践、技术和限制。

       The spread of antibiotic-resistant pathogens and their resistance traits is an epic global challenge, as recognized by various international bodies, including the G8 Science Ministry in 2013 and the Elmau summit in 2015 (https://www.g7germany.de/Webs/G7/EN/Home_en/home_node.html). While most attention continues to be devoted to the clinic and the need to develop new drugs, there is growing recognition of the need to understand the origin and ecology of antibiotic resistance in order to slow its spread and maximize the lifespan of our antibiotic arsenal (Wright, 2010). In particular, the aquatic environment can serve both as a natural reservoir of antibiotic resistance and a conduit for the spread of clinical resistance traits of major concern (Michael et al., 2013). Aquatic bodies, including lakes, rivers, streams and even coastlines, receive effluent from wastewater treatment plants (WWTP), runoff from agricultural activity, and other human inputs and influences that may either serve to elevate natural background levels of antibiotic resistance genes (ARGs) and stimulate their transfer into pathogens or other organisms, or as a conduit for the propagation of antibiotic resistant pathogens and clinical ARGs of concern (Michael et al., 2013). Current pathogen risk models are not equipped to factor in unique challenges that antibiotic resistance poses, including the potential that non-pathogenic antibiotic resistant bacteria (ARB) can serve as a reservoir to transfer their ARGs to pathogens or the role of selective agents, such as antibiotics and metals, in amplifying this potential. The challenge of controlling the spread of antibiotic resistance can have a different face in developed or developing countries, depending on local policies, practices, technologies and constraints.

https://www.frontiersin.org/articles/10.3389/fmicb.2017.00014/full