Skandalis Nicholas, Maeusli Marlène, Papafotis Dimitris, Miller Sarah, Lee Bosul, Theologidis Ioannis, Luna Brian
Department of Medicine, Keck School of Medicine at USC, Los Angeles, CA 90033, USA.
Department of Molecular Microbiology and Immunology, Keck School of Medicine at USC, 1441 Eastlake Ave, NTT 6419, Los Angeles, CA 90033, USA.
Antibiotics (Basel). 2021 May 27;10(6):640. doi: 10.3390/antibiotics10060640.
Antibiotic resistance represents a global health concern. Soil, water, livestock and plant foods are directly or indirectly exposed to antibiotics due to their agricultural use or contamination. This selective pressure has acted synergistically to bacterial competition in nature to breed antibiotic-resistant (AR) bacteria. Research over the past few decades has focused on the emergence of AR pathogens in food products that can cause disease outbreaks and the spread of antibiotic resistance genes (ARGs), but One Health approaches have lately expanded the focus to include commensal bacteria as ARG donors. Despite the attempts of national and international authorities of developed and developing countries to reduce the over-prescription of antibiotics to humans and the use of antibiotics as livestock growth promoters, the selective flow of antibiotic resistance transmission from the environment to the clinic (and vice-versa) is increasing. This review focuses on the mechanisms of ARG transmission and the hotspots of antibiotic contamination resulting in the subsequent emergence of ARGs. It follows the transmission of ARGs from farm to plant and animal food products and provides examples of the impact of ARG flow to clinical settings. Understudied and emerging antibiotic resistance selection determinants, such as heavy metal and biocide contamination, are also discussed here.
抗生素耐药性是一个全球健康问题。由于农业使用或污染，土壤、水、牲畜和植物性食品直接或间接接触到抗生素。这种选择压力与自然界中的细菌竞争协同作用，从而滋生出抗生素耐药（AR）细菌。过去几十年的研究主要集中在食品中可导致疾病暴发的AR病原体的出现以及抗生素耐药基因（ARG）的传播，但“同一健康”方法最近将重点扩大到包括共生细菌作为ARG供体。尽管发达国家和发展中国家的国家及国际当局试图减少抗生素对人类的过度处方以及将抗生素用作牲畜生长促进剂，但抗生素耐药性从环境到临床（反之亦然）的选择性传播正在增加。本综述重点关注ARG传播机制以及导致随后ARG出现的抗生素污染热点。它追踪了ARG从农场到植物和动物食品的传播，并提供了ARG流入临床环境的影响示例。本文还讨论了研究不足和新出现的抗生素耐药性选择决定因素，如重金属和杀菌剂污染。
