The World Health Organization (WHO) in 2017 classified some carbapenem-resistant Gram-negative bacteria into a critical criterial group for research and development. This study reviews the need to prioritize the water matrices as hotspot in the development and transfer of antibiotic resistance determinants, where future total resistant superbug may emerge. Published articles on Google Scholars, PubMed/Medline Search and other search tools were selected, with special interest in articles published in indexed journals. Search criteria were based on antibiotic resistance, antibiotic resistance determinants and emerging trend in the reported trend of antibiotic resistance among bacteria from water matrices. Research reports around the globe have identified carbapenem-resistant Gram-negative bacteria (CRGNB) in water matrices. These CRGNB have also been found to be resistant to other antibiotics in the last line of defence. Molecular typing of some carbapenem-resistant Enterobacteriaceae (CRE) in the environment through pulsed-field electrophoresis showed them to be the same as those in the hospital settings. CRGNB from various water matrices have been reported to harbour carbapenem resistance genes with phenotypic expression of carbapenemases’ production. Water habitat provides a conducive environment for the development and spread of carbapenem resistance. Factors like residual antibiotics (RAbs), metals, biocide and water-borne mutagens aid the emergence of the resistance in water matrices. Irrespective of where it was contacted, carbapenem-resistant bacteria have poor prognosis. This is exemplified by resistance to 26 different antibiotics recently in the USA. The human health risk associated with the use of water harbouring these pathogens for irrigating fruits and vegetables may be alarming. The reports of the rising trend of antibiotic resistance also necessitate prioritizing water matrices when addressing the problems from the reservoir. Surveillance and strict isolation, education and enlightenment, strict compliance with multiple barrier approach of the WHO and more search for more potent antibiotics remain some of the antidotes against the development and spread of resistance through the water matrices as discussed in this article.

中文翻译：

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与耐碳青霉烯的革兰氏阴性细菌有关的重大威胁：在解决总抗生素耐药性时优先考虑水基质

2017年，世界卫生组织（WHO）将一些对碳青霉烯类耐药的革兰氏阴性细菌分类为关键的研发标准组。这项研究回顾了在抗生素耐药性决定因素的开发和转移中优先考虑水基质作为热点的必要性，未来可能出现总耐药性超级细菌。选择了在Google学术搜索，PubMed / Medline搜索和其他搜索工具上发表的文章，并对在索引期刊上发表的文章特别感兴趣。搜索标准基于抗生素耐药性，抗生素耐药性决定因素以及水基质细菌中已报告的抗生素耐药性趋势中出现的趋势。全球研究报告已在水基质中鉴定出耐碳青霉烯的革兰氏阴性菌（CRGNB）。在最后一道防线中，还发现这些CRGNB对其他抗生素具有抗性。通过脉冲场电泳对环境中某些耐碳青霉烯的肠杆菌科（CRE）进行分子分型显示，它们与医院环境中的相同。据报道，来自各种水基质的CRGNB带有碳青霉烯抗性基因，并带有碳青霉烯酶生产的表型表达。水生境为碳青霉烯抗性的发展和传播提供了有利的环境。诸如残留抗生素（RAbs），金属，杀生物剂和水性诱变剂等因素有助于水基质中抗药性的出现。无论与何处接触，耐碳青霉烯的细菌的预后均较差。最近在美国，对26种不同的抗生素产生了抗药性。与使用带有这些病原体的水灌溉水果和蔬菜有关的人类健康风险可能令人震惊。关于抗生素耐药性上升趋势的报道还需要在解决水库中的问题时优先考虑水基质。监视和严格隔离，教育和启发，严格遵守WHO的多重屏障方法以及更多地寻找更有效的抗生素仍然是本文中讨论的抵抗药物通过水基质发展和传播的一些解药。关于抗生素耐药性上升趋势的报道还需要在解决水库中的问题时优先考虑水基质。监视和严格隔离，教育和启发，严格遵守WHO的多重屏障方法以及更多地寻找更有效的抗生素仍然是本文中讨论的抵抗药物通过水基质发展和传播的一些解药。关于抗生素耐药性上升趋势的报道还需要在解决水库中的问题时优先考虑水基质。监视和严格隔离，教育和启发，严格遵守WHO的多重屏障方法以及更多地寻找更有效的抗生素仍然是本文中讨论的通过水基质抵抗和发展抗药性的一些解药。