摘要
      耐药性分析的发展，即抗生素耐药性基因的综合分析，使人们能够更好地了解抗生素耐药性出现的机制。呼吸道微生物组是一个动态和互动的细菌网络，具有一组ARG，可以影响对抗生素的反应。噬菌体等病毒，ARGs的潜在携带者，也可能形成这种呼吸抵抗体的一部分。慢性呼吸道疾病（CRDs），如囊性纤维化、严重哮喘、慢性阻塞性肺病和支气管扩张症，在长期抗生素治疗下会导致多药耐药性。抗生素敏感性测试提供了细菌在复杂肺部环境中对抗生素反应的部分视图。根据个体耐药性和微生物组特征，评估ARG网络将允许CRD中的个性化、靶向治疗策略和适当的抗生素管理。这篇综述总结了肺部抗生素方案对呼吸道微生物组的影响，详细说明了根据抗生素类别和治疗持续时间的可变后果。对不同的耐药性分析方法进行了解释，以阐明它们在肺部抗生素耐药性分析中的各自位置。最后，这篇综述详细介绍了与治疗策略相关的呼吸耐药组的最新知识，并深入了解了耐药组分析在对抗耐多药呼吸道病原体出现方面的应用。
Abstract
The development of resistome analysis, i.e. the comprehensive analysis of antibiotic-resistance genes (ARGs), is enabling a better understanding of the mechanisms of antibiotic-resistance emergence. The respiratory microbiome is a dynamic and interactive network of bacteria, with a set of ARGs that could influence the response to antibiotics. Viruses such as bacteriophages, potential carriers of ARGs, may also form part of this respiratory resistome. Chronic respiratory diseases (CRDs) such as cystic fibrosis, severe asthma, chronic obstructive pulmonary disease and bronchiectasis, managed with long-term antibiotic therapies, lead to multidrug resistance. Antibiotic susceptibility testing provides a partial view of the bacterial response to antibiotics in the complex lung environment. Assessing the ARG network would allow personalised, targeted therapeutic strategies and suitable antibiotic stewardship in CRDs, depending on individual resistome and microbiome signatures. This review summarises the influence of pulmonary antibiotic protocols on the respiratory microbiome, detailing the variable consequences according to antibiotic class and duration of treatment. The different resistome-profiling methods are explained to clarify their respective place in antibiotic-resistance analysis in the lungs. Finally, this review details current knowledge on the respiratory resistome related to therapeutic strategies and provides insight into the application of resistome analysis to counter the emergence of multidrug-resistant respiratory pathogens.

https://err.ersjournals.com/content/31/164/210259.abstract