Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, CB2 0AW, UK.
Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.
Genome Med. 2022 Feb 16;14(1):15. doi: 10.1186/s13073-022-01020-2.
Antimicrobial resistance (AMR) is a major global public health threat, which has been largely driven by the excessive use of antimicrobials. Control measures are urgently needed to slow the trajectory of AMR but are hampered by an incomplete understanding of the interplay between pathogens, AMR encoding genes, and mobile genetic elements at a microbial level. These factors, combined with the human, animal, and environmental interactions that underlie AMR dissemination at a population level, make for a highly complex landscape. Whole-genome sequencing (WGS) and, more recently, metagenomic analyses have greatly enhanced our understanding of these processes, and these approaches are informing mitigation strategies for how we better understand and control AMR. This review explores how WGS techniques have advanced global, national, and local AMR surveillance, and how this improved understanding is being applied to inform solutions, such as novel diagnostic methods that allow antimicrobial use to be optimised and vaccination strategies for better controlling AMR. We highlight some future opportunities for AMR control informed by genomic sequencing, along with the remaining challenges that must be overcome to fully realise the potential of WGS approaches for international AMR control.
抗微生物药物耐药性（AMR）是一个主要的全球公共卫生威胁，主要是由于抗微生物药物的过度使用。需要采取控制措施来减缓 AMR 的发展轨迹，但由于对病原体、AMR 编码基因和微生物水平上的移动遗传元件之间相互作用的理解不完整，这些措施受到了阻碍。这些因素，加上人类、动物和环境相互作用，是 AMR 在人群水平传播的基础，构成了一个高度复杂的景观。全基因组测序（WGS），以及最近的宏基因组分析，极大地增强了我们对这些过程的理解，这些方法正在为我们如何更好地理解和控制 AMR 提供缓解策略。本综述探讨了 WGS 技术如何推进全球、国家和地方 AMR 监测，以及这种理解的提高如何被应用于为新型诊断方法提供信息，这些方法可以优化抗菌药物的使用，并制定更好控制 AMR 的疫苗接种策略。我们强调了基因组测序为 AMR 控制提供的一些未来机会，以及为充分发挥 WGS 方法在国际 AMR 控制中的潜力而必须克服的剩余挑战。
