摘要
      抗微生物耐药性（AMR）具有阻碍临床治疗和提高死亡率的能力，正成为全球最紧迫的健康和环境问题之一。城市河流作为环境的重要子系统，为城市居民提供了丰富的生态服务。然而，随着城市化、工业化的加剧，以及含有抗生素、重金属、杀虫剂、抗生素抗性基因（ARGs）和抗生素抗性细菌（ARB）的人为废物的大量排放，城市河流正成为ARGs的主要储存库和加速选择ARB的热点。城市河流中的这些ARGs有可能被转移到临床上重要的病原体。此外，城市河流也是AMR传播的重要媒介。这主要是由于人类和动物直接暴露在严重污染的河水中，生物（水生动物、病原菌、非病原菌）以及河流中的遗传元素（包括ARGs和流动遗传元素）具有高度流动性。然而，尽管最近提倡开展综合研究计划，旨在调查全球城市河流中AMR的发生、程度和主要驱动因素，但此类研究在很大程度上缺失。这篇综述涵盖了AMR问题、主要驱动因素及其在ARB演变和传播中的重要作用，重点是城市河流中各种ARG的来源和热点，这些ARG和MGE共同出现。此外，还讨论了导致抗生素负荷对河流生物产生不利影响的原因，并详细阐述了目前从城市河流生态系统中根除ARB、ARGs和去除抗生素的措施。对城市河流生态系统中具有对抗AMR潜力的当前和新兴战略的前瞻性审查，包括先进的水处理方法和浮岛或人工湿地。
Abstract
Antimicrobial resistance (AMR) with the ability to thwart clinical therapies and escalate mortality rates is emerging as one of the most pressing global health and environmental concerns. Urban rivers as an important subsystem of the environment offer galore of ecological services which benefit the city dwellers. However, with increased urbanization, industrialization, and heavy discharge of anthropogenic waste harboring antibiotics, heavy metals, pesticides, antibiotic resistance genes (ARGs), antibiotic resistant bacteria (ARB), urban rivers are becoming major reservoirs of ARGs and a hotspot for accelerated selection of ARB. These ARGs in urban rivers have the potential of being transferred to clinically important pathogens. In addition, urban rivers also act as important vectors for AMR spread. This is mainly due to the direct exposure of humans and animals to the heavily contaminated river water and high mobility of organisms (aquatic animals, pathogenic, non-pathogenic bacteria) as well as the genetic elements including ARGs and mobile genetic elements (MGEs) in the river. However, in spite of recent advocacy for comprehensive research programs aimed to investigate the occurrence, extent and major drivers of AMR in urban rivers globally, such studies are missing largely. This review encompasses the issues of AMR, major drivers and their vital roles in the evolution and spread of ARB with an emphasis on sources and hotspots of diverse ARGs in urban rivers contributing to co-occurrence of ARGs and MGEs. Further, the causal factors leading to adverse effects of antibiotic-load to river organisms with an elaboration on the current measures to eradicate the ARB, ARGs, and remove antibiotics from the urban river ecosystems are also discussed. A perspective review of current and emerging strategies with potentials of combating AMR in urban river ecosystems including advanced water treatment methodologies and floating islands or constructed wetlands.

https://www.sciencedirect.com/science/article/abs/pii/S0944501322001756