摘要
      全球致病菌抗微生物耐药性的上升已被证明是对公共健康的主要威胁，耐多药细菌感染率随着时间的推移而增加。肠道微生物组已被研究为抗生素抗性基因（ARGs）的库，这些基因可以通过结合质粒和移动遗传元件（肠道抗性组）的水平基因转移（HGT）转移到细菌病原体。宏基因组测序的进展促进了耐药性调节剂的鉴定，包括活微生物疗法，如益生菌和粪便微生物组移植，它们可以扩大或减少肠道中携带ARG的细菌的丰度。虽然许多不同的肠道微生物编码ARG，但它们并不是均匀分布在微生物组的不同成员之间或由其传播，也不是所有微生物都具有同等的临床相关性。微生物生态学中的实验和理论方法都已被应用于了解共生微生物之间以及共生微生物和病原体之间ARG水平转移的不同频率。在这篇评论中，我们评估了共生肠道微生物在编码抗微生物耐药性基因中的作用的证据，它们与其他共生菌和病原体共享的程度，以及可能影响耐药性动态的宿主和环境因素。我们进一步讨论了新的基于测序的方法，用于识别ARGs和预测临床相关ARGs从共生体到病原体的未来转移事件。
ABSTRACT
A global rise in antimicrobial resistance among pathogenic bacteria has proved to be a major public health threat, with the rate of multidrug-resistant bacterial infections increasing over time. The gut microbiome has been studied as a reservoir of antibiotic resistance genes (ARGs) that can be transferred to bacterial pathogens via horizontal gene transfer (HGT) of conjugative plasmids and mobile genetic elements (the gut resistome). Advances in metagenomic sequencing have facilitated the identification of resistome modulators, including live microbial therapeutics such as probiotics and fecal microbiome transplantation that can either expand or reduce the abundances of ARG-carrying bacteria in the gut. While many different gut microbes encode for ARGs, they are not uniformly distributed across, or transmitted by, various members of the microbiome, and not all are of equal clinical relevance. Both experimental and theoretical approaches in microbial ecology have been applied to understand differing frequencies of ARG horizontal transfer between commensal microbes as well as between commensals and pathogens. In this commentary, we assess the evidence for the role of commensal gut microbes in encoding antimicrobial resistance genes, the degree to which they are shared both with other commensals and with pathogens, and the host and environmental factors that can impact resistome dynamics. We further discuss novel sequencing-based approaches for identifying ARGs and predicting future transfer events of clinically relevant ARGs from commensals to pathogens.

https://www.tandfonline.com/doi/full/10.1080/19490976.2022.2055944