摘要

抗生素耐药性的出现和扩散目前被视为继抗生素使用后细菌发展的必然特征。这一壮观的事件完全可以通过耐药性的表现和抗生素的消耗之间的联系来澄清。在机制上，抗生素耐药菌（ARB）的增加主要归因于敏感群体中存在的耐药性变异的选择。最近，Merlin[1]发表了一篇关于抗生素在亚抑制水平和微量金属元素方面的次要影响的优秀综述，这显然提醒人们注意，抗生素耐药性的危险与唯一的抗生素治疗应用无关，在某种程度上必须被视为一个多因素问题，其中共同选择和基因水平转移的促进同样适用。本文主要研究了Merlin[1]报告的主要结论。更深入的流行病学调查必须在培养皿现场之外来确定这些次要影响的范围，并可能解释为什么许多抗生素耐药性会在降低相应抗生素消耗的同时会没有任何减少。此外，彻底确定哪些抗生素分子表现出次要影响，以及在何种水平上，将是抗生素危害评估的一个补充阶段，无论是用于治疗应用还是抗生素一旦在下游媒介中释放出来的影响。

The appearance and diffusion of antibiotic resistance are at the moment seen as an inevitable characteristic of bacterial development succeeding the consumption of antibiotics. This spectacular event is completely clarified by the link present among the manifestation of resistances and the consumption of antibiotics. In terms of mechanisms, the augmenting appearance of antibiotic-resistant bacteria (ARB) has been largely assigned to the selection of resistant variants that pre-exist in sensitive communities. Lately, Merlin [1] published an excellent review on the secondary influences of antibiotics at sub-inhibitory levels and trace metal elements, which obviously call attention to the reality that the antibiotic resistance danger has not to be related to the only antibiotic therapy applications, and must to some extent be viewed as a multifactorial issue where co-selection and stimulation of horizontal gene transfer as well completely applies. This work focuses on the main conclusions of Merlin [1] report. More in-depth epidemiological investigations have to let defining the range of these secondary impacts outside the scene of a Petri dish and may interpret why many antibiotic resistances run away any decrease of presence while lowering the corresponding antibiotic consumption. In addition, defining thoroughly which antibiotic molecules manifest secondary influences, and at which levels, would be a supplementary stage toward antibiotic hazard evaluation, whether for therapeutic applications or for the impact of antibiotics once liberated in the downstream mediums.

https://www.scirp.org/journal/paperinformation.aspx?paperid=98419