Antibiotic resistance in the environment.
Antibiotic resistance in the environment.
复制标题
环境中的抗生素耐药性。
DOI：
10.1038/s41579-021-00649-x
复制
发表时间：
2022-05
期刊：
影响因子：
--
通讯作者：
Flach CF
中科院分区：
文献类型：
--
作者：
Larsson DGJ;Flach CF
抗生素耐药性是一个全球性的健康挑战，涉及细菌和基因在人类、动物和环境之间的转移。虽然多重障碍限制了细菌和基因的流动，但病原体会从其他物种获得新的耐药因子，从而降低了我们预防和治疗细菌感染的能力。导致病原体中出现新的耐药因子的进化事件是罕见的，难以预测，但可能与巨大的后果有关。另一方面，已经广泛传播的耐药菌株的传播事件是常见的、可量化的和更可预测的，但每次事件的后果是有限的。量化途径并确定环境演变和抗生素耐药性传播的驱动因素和瓶颈是理解和管理整个耐药性危机的关键组成部分。在这篇综述中，我们提出了我们目前对环境（包括抗生素污染）在耐药性演变、传播中的作用的理解，并将其仅仅反映了临床中区域抗生素耐药性的情况。我们提供了对当前证据的看法，描述了风险情景，讨论了监测和评估潜在驱动因素的方法，并最终确定了一些缓解风险的措施。在这篇综述中，Larsson和Flach讨论了环境演变和抗生素耐药性传播的驱动因素和瓶颈，并探索了可以补充临床监测系统的环境监测策略。
Antibiotic resistance is a global health challenge, involving the transfer of bacteria and genes between humans, animals and the environment. Although multiple barriers restrict the flow of both bacteria and genes, pathogens recurrently acquire new resistance factors from other species, thereby reducing our ability to prevent and treat bacterial infections. Evolutionary events that lead to the emergence of new resistance factors in pathogens are rare and challenging to predict, but may be associated with vast ramifications. Transmission events of already widespread resistant strains are, on the other hand, common, quantifiable and more predictable, but the consequences of each event are limited. Quantifying the pathways and identifying the drivers of and bottlenecks for environmental evolution and transmission of antibiotic resistance are key components to understand and manage the resistance crisis as a whole. In this Review, we present our current understanding of the roles of the environment, including antibiotic pollution, in resistance evolution, in transmission and as a mere reflection of the regional antibiotic resistance situation in the clinic. We provide a perspective on current evidence, describe risk scenarios, discuss methods for surveillance and the assessment of potential drivers, and finally identify some actions to mitigate risks. In this Review, Larsson and Flach discuss the drivers of and bottlenecks for environmental evolution and transmission of antibiotic resistance, and they explore environmental surveillance strategies that could complement clinical surveillance systems.
登录
查看更多内容
影响因子：
15.5
作者：
Berglund F;Marathe NP;Österlund T;Bengtsson-Palme J;Kotsakis S;Flach CF;Larsson DGJ;Kristiansson E
通讯作者：
Kristiansson E
影响因子：
10.4
作者：
Ashbolt NJ;Amézquita A;Backhaus T;Borriello P;Brandt KK;Collignon P;Coors A;Finley R;Gaze WH;Heberer T;Lawrence JR;Larsson DG;McEwen SA;Ryan JJ;Schönfeld J;Silley P;Snape JR;Van den Eede C;Topp E
通讯作者：
Topp E
影响因子：
5.2
作者：
Bengtsson-Palme J;Boulund F;Fick J;Kristiansson E;Larsson DG
通讯作者：
Larsson DG
影响因子：
12.8
作者：
Bielen, Ana;Simatovic, Ana;Udikovic-Kolic, Nikolina
通讯作者：
Udikovic-Kolic, Nikolina
影响因子：
9.8
作者：
Bengtsson-Palme, Johan;Hammaren, Rickard;Larsson, D. G. Joakim
通讯作者：
Larsson, D. G. Joakim