Adegoke Anthony Ayodeji, Faleye Adekunle Christopher, Singh Gulshan, Stenström Thor Axel
SARChI, Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa.
Department of Microbiology, University of Uyo, 520211 Uyo, Akwa Ibom State, Nigeria.
Molecules. 2016 Dec 27;22(1):29. doi: 10.3390/molecules22010029.
The increasing threat to global health posed by antibiotic resistance remains of serious concern. Human health remains at higher risk due to several reported therapeutic failures to many life threatening drug resistant microbial infections. The resultant effects have been prolonged hospital stay, higher cost of alternative therapy, increased mortality, etc. This opinionated review considers the two main concerns in integrated human health risk assessment (i.e., residual antibiotics and antibiotic resistant genes) in various compartments of human environment, as well as clinical dynamics associated with the development and transfer of antibiotic resistance (AR). Contributions of quorum sensing, biofilms, enzyme production, and small colony variants in bacteria, among other factors in soil, water, animal farm and clinical settings were also considered. Every potential factor in environmental and clinical settings that brings about AR needs to be identified for the summative effects in overall resistance. There is a need to embrace coordinated multi-locational approaches and interrelationships to track the emergence of resistance in different niches in soil and water versus the hospital environment. The further integration with advocacy, legislation, enforcement, technological innovations and further research input and recourse to WHO guidelines on antibiotic policy would be advantageous towards addressing the emergence of antibiotic resistant superbugs.
抗生素耐药性对全球健康构成的威胁日益增加，仍然令人严重担忧。由于许多危及生命的耐药微生物感染出现了治疗失败的报道，人类健康面临的风险更高。其后果包括住院时间延长、替代疗法成本增加、死亡率上升等。这篇观点性综述考虑了人类环境各部分综合人类健康风险评估中的两个主要问题（即残留抗生素和抗生素耐药基因），以及与抗生素耐药性（AR）发展和转移相关的临床动态。还考虑了群体感应、生物膜、酶产生以及细菌中的小菌落变体在土壤、水、养殖场和临床环境等其他因素中的作用。需要识别环境和临床环境中导致AR的每一个潜在因素，以了解其对总体耐药性的累积影响。有必要采用协调的多地点方法和相互关系，来追踪土壤和水中不同生态位与医院环境中耐药性的出现情况。与宣传、立法、执法、技术创新以及进一步的研究投入相结合，并参考世界卫生组织关于抗生素政策的指南，将有利于应对抗生素耐药超级细菌的出现。
