Department of Microbiology, Panjab University, Chandigarh, India.
J Appl Microbiol. 2022 Jun;132(6):4058-4076. doi: 10.1111/jam.15492. Epub 2022 Feb 25.
Antibiotic resistance is recognized as a global threat to public health. The selection and evolution of antibiotic resistance in clinical pathogens were believed to be majorly driven by the imprudent use of antibiotics. However, concerns regarding the same, through selection pressure by a multitude of other antimicrobial agents, such as heavy metals, are also growing. Heavy metal contamination co-selects antibiotic and metal resistance through numerous mechanisms, such as co-resistance and cross-resistance. Here, we have reviewed the role of heavy metals as antimicrobial resistance driving agents and the underlying concept and mechanisms of co-selection, while also highlighting the scarcity of studies explicitly inspecting the process of co-selection in clinical settings. Prospective strategies to manage heavy metal-induced antibiotic resistance have also been deliberated, underlining the need to find specific inhibitors so that alternate medicinal combinations can be added to the existing therapeutic armamentarium.
抗生素耐药性被公认为是对公众健康的全球性威胁。人们认为，临床病原体中抗生素耐药性的选择和进化主要是由于抗生素的不当使用。然而，人们越来越担心，由于多种其他抗菌剂（如重金属）的选择压力，也会产生同样的问题。重金属污染通过多种机制（如共同耐药性和交叉耐药性）共同选择抗生素和金属耐药性。在这里，我们回顾了重金属作为抗菌耐药性驱动因素的作用，以及共同选择的基本概念和机制，同时还强调了在临床环境中明确检查共同选择过程的研究很少。还审议了管理重金属诱导的抗生素耐药性的前瞻性策略，强调需要找到特定的抑制剂，以便在现有治疗武器库中添加替代药物组合。
