Ekwanzala Mutshiene Deogratias, Dewar John Barr, Kamika Ilunga, Momba Maggy Ndombo Benteke
Department of Environmental, Water and Earth Sciences, Tshwane University of Technology, Pretoria, South Africa,
Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa.
Infect Drug Resist. 2018 Oct 17;11:1907-1920. doi: 10.2147/IDR.S170715. eCollection 2018.
A systematic review was conducted to determine the distribution and prevalence of antibiotic-resistant bacteria (ARB), antimicrobial-resistant genes (ARGs), and antimicrobial-resistant gene determinants (ARGDs) in clinical, environmental, and farm settings and to identify key knowledge gaps in a bid to contain their spread. Fifty-three articles were included. The prevalence of a wide range of antimicrobial-resistant bacteria and their genes was reviewed. Based on the studies reviewed in this systematic review, mutation was found to be the main genetic element investigated. All settings shared 39 ARGs and ARGDs. Despite the fact that ARGs found in clinical settings are present in the environment, in reviewed articles only 12 were found to be shared between environmental and clinical settings; the inclusion of farm settings with these two settings increased this figure to 32. Data extracted from this review revealed farm settings to be one of the main contributors of antibiotic resistance in healthcare settings. ARB, ARGs, and ARGDs were found to be ubiquitous in all settings examined.
进行了一项系统综述，以确定临床、环境和农场环境中抗生素耐药菌（ARB）、抗微生物耐药基因（ARGs）和抗微生物耐药基因决定因素（ARGDs）的分布和流行情况，并找出关键的知识空白，以遏制它们的传播。纳入了53篇文章。综述了多种抗微生物耐药菌及其基因的流行情况。基于本系统综述中所回顾的研究，发现突变是主要研究的遗传因素。所有环境共有的抗微生物耐药基因和抗微生物耐药基因决定因素有39种。尽管在临床环境中发现的抗微生物耐药基因也存在于环境中，但在所回顾的文章中，仅发现12种在环境和临床环境中共有；将农场环境与这两种环境纳入后，这一数字增至32种。从本综述中提取的数据显示，农场环境是医疗保健环境中抗生素耐药性的主要来源之一。在所有检查的环境中，抗生素耐药菌、抗微生物耐药基因和抗微生物耐药基因决定因素均普遍存在。
