Abstract

Antibiotic resistance has been considered a major human health threat that may endanger the success of medicine. Recent studies have unveiled worldwide asymmetries of antibiotic resistance occurrence, being factors as diverse as climate, socioeconomic, or antibiotic use possible drivers of such asymmetric distribution. In Europe, where clinical antibiotic resistance is surveyed for more than 20 years, the European Center for Disease Prevention and Control (ECDC) consistently describes an increasing gradient from North-to-South and from West-to-East. This observation motivated the current perspective paper aiming to qualitatively compare two countries located at the extreme latitude of Europe and also at distant longitude – Poland in the Central-East region and Portugal in the South-West. Both countries have been among those with the highest prevalence of antibiotic resistance in clinical settings, although as it is discussed, climate, socioeconomic factors, and antibiotic use are different. In general, in Poland higher antibiotic consumption and resistance prevalence is observed, mainly at the community level, when compared to Portugal. However, in Portugal, treated wastewater may hold identical or slightly higher resistance loads. Based on these observations, it is discussed how different factors may influence the abundance of antibiotics, antibiotic resistant bacteria, and genes in wastewater before and after treatment.

摘要

抗生素耐药性被认为是可能危及医学成功的主要人类健康威胁。最近的研究揭示了世界范围内抗生素耐药性发生的不对称性，这些因素包括气候、社会经济或抗生素使用等多种因素，可能是这种不对称分布的驱动因素。在欧洲，对临床抗生素耐药性进行了 20 多年的调查，欧洲疾病预防和控制中心 (ECDC) 始终如一地描述了从北到南和从西到东的梯度增加。这一观察促使当前的观点论文旨在定性地比较位于欧洲极端纬度和遥远经度的两个国家——中东部地区的波兰和西南地区的葡萄牙。这两个国家都是临床环境中抗生素耐药性最高的国家之一，尽管正如所讨论的那样，气候、社会经济因素和抗生素使用是不同的。总的来说，与葡萄牙相比，波兰的抗生素消费和耐药率较高，主要是在社区一级。然而，在葡萄牙，经过处理的废水可能具有相同或略高的阻力负荷。基于这些观察结果，讨论了不同因素如何影响废水处理前后抗生素、抗生素抗性细菌和基因的丰度。与葡萄牙相比，波兰的抗生素消费量和耐药率较高，主要是在社区一级。然而，在葡萄牙，经过处理的废水可能具有相同或略高的阻力负荷。基于这些观察结果，讨论了不同因素如何影响废水处理前后抗生素、抗生素抗性细菌和基因的丰度。与葡萄牙相比，波兰的抗生素消费量和耐药率较高，主要是在社区一级。然而，在葡萄牙，经过处理的废水可能具有相同或略高的阻力负荷。基于这些观察结果，讨论了不同因素如何影响废水处理前后抗生素、抗生素抗性细菌和基因的丰度。