摘要

       抗生素耐药性被认为是对全球公共卫生的最大威胁之一。耐药性通常是由抗生素抗性基因 (ARG) 的存在赋予的，这些基因在口腔微生物组中很容易找到。通过宏基因组学技术对口腔微生物组进行深入的遗传分析揭示了 ARG（包括新型 ARG）在最近未接触抗生素的个体中的广泛分布，包括孤立的土著人群中的人类。这导致范式转变，从关注病原菌中抗生素耐药性的携带转向更广泛的口腔耐药组概念，其中包括微生物组中的所有耐药基因。宏基因组学开始证明在没有选择压力（如抗生素）的情况下，口腔抗性组和水平基因转移在共生体内部和之间的作用。在主席席上，宏基因组数据加强了我们遵守当前抗生素指南以最大程度地减少耐药性传播的必要性，因为这些数据揭示了 ARGs 的程度，而不暴露于抗菌素，以及即使单剂量抗生素也会对口腔微生物群产生的生态变化.本综述的目的是讨论宏基因组学在口腔耐药组研究中的作用，包括抗生素耐药性在口腔微生物组中的传播。还考虑了未来的前景，包括口服 ARG 宏基因组研究结果的临床意义。

       Antibiotic resistance is considered one of the greatest threats to global public health. Resistance is often conferred by the presence of antibiotic resistance genes (ARGs), which are readily found in the oral microbiome. In-depth genetic analyses of the oral microbiome through metagenomic techniques reveal a broad distribution of ARGs (including novel ARGs) in individuals not recently exposed to antibiotics, including humans in isolated indigenous populations. This has resulted in a paradigm shift from focusing on the carriage of antibiotic resistance in pathogenic bacteria to a broader concept of an oral resistome, which includes all resistance genes in the microbiome. Metagenomics is beginning to demonstrate the role of the oral resistome and horizontal gene transfer within and between commensals in the absence of selective pressure, such as an antibiotic. At the chairside, metagenomic data reinforce our need to adhere to current antibiotic guidelines to minimize the spread of resistance, as such data reveal the extent of ARGs without exposure to antimicrobials and the ecologic changes created in the oral microbiome by even a single dose of antibiotics. The aim of this review is to discuss the role of metagenomics in the investigation of the oral resistome, including the transmission of antibiotic resistance in the oral microbiome. Future perspectives, including clinical implications of the findings from metagenomic investigations of oral ARGs, are also considered.

https://journals.sagepub.com/doi/abs/10.1177/0022034516648944