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Antibiotic Resistance Mechanisms in Bacteria: Relationships Between Resistance Determinants of Antibiotic Producers Environmental Bacteria and Clinical Pathogens

机译：细菌中的抗生素耐药机制：抗生素生产者环境细菌和临床病原体耐药决定因素之间的关系。

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摘要

Emergence of antibiotic resistant pathogenic bacteria poses a serious public health challenge worldwide. However, antibiotic resistance genes are not confined to the clinic; instead they are widely prevalent in different bacterial populations in the environment. Therefore, to understand development of antibiotic resistance in pathogens, we need to consider important reservoirs of resistance genes, which may include determinants that confer self-resistance in antibiotic producing soil bacteria and genes encoding intrinsic resistance mechanisms present in all or most non-producer environmental bacteria. While the presence of resistance determinants in soil and environmental bacteria does not pose a threat to human health, their mobilization to new hosts and their expression under different contexts, for example their transfer to plasmids and integrons in pathogenic bacteria, can translate into a problem of huge proportions, as discussed in this review. Selective pressure brought about by human activities further results in enrichment of such determinants in bacterial populations. Thus, there is an urgent need to understand distribution of resistance determinants in bacterial populations, elucidate resistance mechanisms, and determine environmental factors that promote their dissemination. This comprehensive review describes the major known self-resistance mechanisms found in producer soil bacteria of the genus Streptomyces and explores the relationships between resistance determinants found in producer soil bacteria, non-producer environmental bacteria, and clinical isolates. Specific examples highlighting potential pathways by which pathogenic clinical isolates might acquire these resistance determinants from soil and environmental bacteria are also discussed. Overall, this article provides a conceptual framework for understanding the complexity of the problem of emergence of antibiotic resistance in the clinic. Availability of such knowledge will allow researchers to build models for dissemination of resistance genes and for developing interventions to prevent recruitment of additional or novel genes into pathogens.
机译：抗生素抗性病原菌的出现对全世界构成了严重的公共卫生挑战。但是，抗生素抗性基因并不局限于临床。相反，它们在环境中的不同细菌种群中普遍流行。因此，要了解病原体中抗生素抗性的发展，我们需要考虑重要的抗性基因库，其中可能包括在产生抗生素的土壤细菌中赋予自抗性的决定因素以及编码所有或大多数非生产者环境中存在的内在抗性机制的基因菌。虽然土壤和环境细菌中存在抗药性决定因素不会对人类健康构成威胁，但它们在新环境中的动员和在不同环境下的表达（例如它们在致病细菌中转移至质粒和整合素的表达）可能会转化为正如本文所讨论的那样。人类活动带来的选择压力进一步导致细菌群体中此类决定簇的富集。因此，迫切需要了解抗性决定簇在细菌种群中的分布，阐明抗性机制，并确定促进其传播的环境因素。这篇全面的综述描述了链霉菌属生产者土壤细菌中发现的主要已知自耐药机制，并探讨了生产者土壤细菌，非生产者环境细菌和临床分离物中发现的耐药决定因素之间的关系。还讨论了突出显示病原性临床分离株可能从土壤和环境细菌获得这些抗性决定簇的潜在途径的具体实例。总体而言，本文提供了一个概念框架，用于了解临床中出现的抗生素耐药性问题的复杂性。这些知识的可获得性将使研究人员能够建立抗性基因的传播模型，并制定干预措施，以防止将更多或新的基因招募到病原体中。

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