摘要

抗生素耐药性是多种微生物生态系统的天然特征。虽然最近对抗生素抗性基因组的研究突出显示了栖息地之间抗生素抗性基因水平转移的障碍，但赋予对碳青霉烯，粘菌素和喹诺酮类抗生素抗性的基因的快速全球扩散说明了这些事件的可怕临床和社会后果。随着时间的推移，抗生素耐药性的研究已经从关注单一致病菌的无菌培养，发展到研究微生物群落水平的致病菌，共生菌和环境菌的抗生素耐药性。随着抗生素耐药性研究的不断深入，重要的是要采用这种综合方法来更好地告知全球抗生素耐药监测和抗生素开发。越来越明显的是，虽然并不是所有的抗性基因都可能在地理上和系统发育上传播，但那些所提出的威胁是严重的并且需要跨学科研究焦点。在这篇综述中，我们重点介绍了抗生素领域的开创性工作，讨论了抗生素研究领域的最新进展，并提出了一个抗体模型，可为改进前瞻性鉴定和缓解新出现的抗生素耐药性威胁铺平道路。

Antibiotic resistance is a natural feature of diverse microbial ecosystems. Although recent studies of the antibiotic resistome have highlighted barriers to the horizontal transfer of antibiotic resistance genes between habitats, the rapid global spread of genes that confer resistance to carbapenem, colistin and quinolone antibiotics illustrates the dire clinical and societal consequences of such events. Over time, the study of antibiotic resistance has grown from focusing on single pathogenic organisms in axenic culture to studying antibiotic resistance in pathogenic, commensal and environmental bacteria at the level of microbial communities. As the study of antibiotic resistance advances, it is important to incorporate this comprehensive approach to better inform global antibiotic resistance surveillance and antibiotic development. It is increasingly becoming apparent that although not all resistance genes are likely to geographically and phylogenetically disseminate, the threat presented by those that are is serious and warrants an interdisciplinary research focus. In this Review, we highlight seminal work in the resistome field, discuss recent advances in the studies of resistomes, and propose a resistome paradigm that can pave the way for the improved proactive identification and mitigation of emerging antibiotic resistance threats.

https://www.nature.com/articles/nrmicro.2017.28