College of Veterinary Medicine, Qingdao Agricultural University, Qingdao 266109, China.
Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark.
J Antimicrob Chemother. 2022 Feb 23;77(3):556-567. doi: 10.1093/jac/dkab450.
The emergence and spread of antimicrobial resistance (AMR) among pathogenic bacteria constitute an accelerating crisis for public health. The selective pressures caused by increased use and misuse of antimicrobials in medicine and livestock production have accelerated the overall selection of resistant bacteria. In addition, horizontal gene transfer (HGT) plays an important role in the spread of resistance genes, for example mobilizing reservoirs of AMR from commensal bacteria into pathogenic ones. Antimicrobials, besides antibacterial function, also result in undesirable effects in the microbial populations, including the stimulation of HGT. The main aim of this narrative review was to present an overview of the current knowledge of the impact of antimicrobials on HGT in bacteria, including the effects of transformation, transduction and conjugation, as well as other less well-studied mechanisms of HGT. It is widely accepted that conjugation plays a major role in the spread of AMR in bacteria, and the focus of this review is therefore mainly on the evidence provided that antimicrobial treatment affects this process. Other mechanisms of HGT have so far been deemed less important in this respect; however, recent discoveries suggest their role may be larger than previously thought, and the review provides an update on the rather limited knowledge currently available regarding the impact of antimicrobial treatment on these processes as well. A conclusion from the review is that there is an urgent need to investigate the mechanisms of antimicrobial-induced HGT, since this will be critical for developing new strategies to combat the spread of AMR.
抗菌药物耐药性（AMR）在致病菌中的出现和传播对公共卫生构成了加速危机。抗菌药物在医学和畜牧业中的使用增加和滥用所导致的选择压力加速了耐药细菌的总体选择。此外，水平基因转移（HGT）在耐药基因的传播中起着重要作用，例如将 AMR 的储库从共生菌转移到致病菌中。抗菌药物除了具有抗菌作用外，还会对微生物种群产生不良影响，包括刺激 HGT。本综述的主要目的是概述当前对抗生素对细菌中 HGT 的影响的认识，包括转化、转导和 conjugation 以及其他研究较少的 HGT 机制的影响。人们普遍认为 conjugation 在细菌中 AMR 的传播中起主要作用，因此本综述的重点主要是提供证据表明抗菌治疗会影响这一过程。其他 HGT 机制在这方面迄今为止被认为不太重要；然而，最近的发现表明，它们的作用可能比以前认为的更大，综述提供了对抗生素治疗对这些过程的影响的最新认识，而目前对此类过程的了解相当有限。综述得出的结论是，迫切需要研究抗菌药物诱导的 HGT 机制，因为这对于制定新的策略来对抗 AMR 的传播至关重要。
