摘要

抗生素被认为是历史上重大的医学突破之一。尽管如此，过去四十年来，抗生素耐药性在全球范围内已达到令人震惊的水平，并且这一趋势预计将继续增加，导致一些专家预测“后抗生素”时代即将到来。虽然传统上病原体对抗生素的耐药性与临床环境有关，但人们越来越担心，抗生素耐药性的全球传播也与与诸如畜牧业，农艺学和废水处理等人为活动有关的环境水库相关。据推测，环境微生物群落内和环境微生物群落之间抗生素抗性细菌（ARB）和抗生素抗性基因（ARG）的出现和传播最终有助于获得人类病原体中的抗生素抗性。尽管如此，由于环境中微生物群落的复杂性和限制了对微生物基因组的全面原位评估的方法学限制，这种现象的范围并不明确。本综述总结了目前关于非临床环境中抗生素耐药性的知识状况，特别侧重于跨生态界限传播抗生素耐药性以及该现象对全球抗生素耐药性的贡献。

Antibiotics are considered to be one of the major medical breakthroughs in history. Nonetheless, over the past four decades, antibiotic resistance has reached alarming levels worldwide and this trend is expected to continue to increase, leading some experts to forecast the coming of a ‘post-antibiotic’ era. Although antibiotic resistance in pathogens is traditionally linked to clinical environments, there is a rising concern that the global propagation of antibiotic resistance is also associated with environmental reservoirs that are linked to anthropogenic activities such as animal husbandry, agronomic practices and wastewater treatment. It is hypothesized that the emergence and dissemination of antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs) within and between environmental microbial communities can ultimately contribute to the acquisition of antibiotic resistance in human pathogens. Nonetheless, the scope of this phenomenon is not clear due to the complexity of microbial communities in the environment and methodological constraints that limit comprehensive in situ evaluation of microbial genomes. This review summarizes the current state of knowledge regarding antibiotic resistance in non-clinical environments, specifically focusing on the dissemination of antibiotic resistance across ecological boundaries and the contribution of this phenomenon to global antibiotic resistance.

http://essays.biochemistry.org/content/61/1/11