Abstract

Development of antibiotic resistance in bacteria is one of the major issues in the present world and one of the greatest threats faced by mankind. Resistance is spread through both vertical gene transfer (parent to offspring) as well as by horizontal gene transfer like transformation, transduction and conjugation. The main mechanisms of resistance are limiting uptake of a drug, modification of a drug target, inactivation of a drug, and active efflux of a drug. The highest quantities of antibiotic concentrations are usually found in areas with strong anthropogenic pressures, for example medical source (e.g., hospitals) effluents, pharmaceutical industries, wastewater influents, soils treated with manure, animal husbandry and aquaculture (where antibiotics are generally used as in-feed preparations). Hence, the strong selective pressure applied by antimicrobial use has forced microorganisms to evolve for survival. The guts of animals and humans, wastewater treatment plants, hospital and community effluents, animal husbandry and aquaculture runoffs have been designated as “hotspots for AMR genes” because the high density of bacteria, phages, and plasmids in these settings allows significant genetic exchange and recombination. Evidence from the literature suggests that the knowledge of antibiotic resistance in the population is still scarce. Tackling antimicrobial resistance requires a wide range of strategies, for example, more research in antibiotic production, the need of educating patients and the general public, as well as developing alternatives to antibiotics (briefly discussed in the conclusions of this article).

摘要

细菌对抗生素耐药性的发展是当今世界的主要问题之一，也是人类面临的最大威胁之一。抗性通过垂直基因转移（对后代的父母）以及水平基因转移（如转化，转导和结合）传播。抗药性的主要机制是限制药物的摄取，药物靶标的修饰，药物的失活以及药物的主动流出。通常在人为压力强的地区发现最高浓度的抗生素，例如医疗源（例如医院）的废水，制药行业，废水流入，经过粪肥处理的土壤，畜牧业和水产养殖（通常在-饲料准备）。因此，抗菌剂施加的强大选择性压力迫使微生物进化以求生存。动物和人类的内脏，废水处理厂，医院和社区的污水，畜牧业和水产养殖的径流被指定为“ AMR基因的热点”，因为在这些环境中细菌，噬菌体和质粒的高密度可实现大量的遗传交换和重组。文献证据表明，该人群对抗生素耐药性的知识仍然匮乏。解决抗菌素耐药性需要多种策略，例如，对抗生素生产进行更多研究，对患者和公众进行教育的需求以及开发抗生素替代品（在本文的结论中进行了简要讨论）。