PDF(Pubmed)
Abstract：
Antibiotic resistance has been recognized as a major challenge worldwide for humans. \"One Health\" has been recognized as a key concept for containment of antibiotic resistance. Under the framework, the role of the environment in the development of antibiotic resistance genes (ARGs) has become increasingly obvious. Despite numerous efforts, response to antibiotic resistance is considered to be inadequate, which is probably due to the lack of a clear roadmap. Here, we propose a \"One Health\" roadmap to combat antibiotic resistance in the environment through (1) understanding environmental resistome. The environmental gene pool has long been recognized as the single largest reservoir of both known and novel ARGs. (2) Standardizing ARG quantification. Systematic joint efforts based on standardized quantification are urgently needed to understand the true tempospatial profiles of the environmental resistome. (3) Identifying mechanisms of resistome development. Horizontal gene transfer and co-selection have been recognized as the two main mechanisms contributing to the environmental resistome. (4) Establishing a risk-assessment framework. The first critical step for large-scale cost-effective targeted ARG management in the environment is the risk assessment to identify the priority ARGs for control. (5) Formulating regulatory standards. By correlating the environmental ARG profile with public health, we may identify the indicator ARGs that can be integrated into current environmental quality standards. (6) Developing control strategies. Systematic analysis of available control technologies is required to identify the most feasible ones to curtail the spread of ARGs in the environment. The proposed roadmap under the \"One Health\" framework provides a guide to tackle antibiotic resistance in the environment.
摘要：
抗生素耐药性已被认为是世界范围内人类面临的主要挑战。“一个健康”已被认为是遏制抗生素耐药性的关键概念。在框架下,环境在抗生素抗性基因(ARGs)发育中的作用日益明显。尽管付出了许多努力,对抗生素耐药性的反应被认为是不充分的，这可能是由于缺乏明确的路线图。这里,我们提出了一个“一个健康”路线图，通过（1）了解环境耐药性来对抗环境中的抗生素耐药性。长期以来，环境基因库一直被认为是已知和新型ARG的最大单一水库。(2)规范ARG量化。迫切需要基于标准化定量的系统共同努力，以了解环境抗性组的真实临时分布。(3)鉴定耐药组的发展机制。水平基因转移和共选择已被认为是导致环境抗性的两种主要机制。（四）建立风险评估框架。在环境中进行大规模具有成本效益的针对性ARG管理的第一个关键步骤是进行风险评估，以确定要控制的优先ARG。（五）制定监管标准。通过将环境ARG概况与公共卫生相关联，我们可以确定可以整合到当前环境质量标准中的指标ARGs。（6）制定控制策略。需要对可用的控制技术进行系统分析，以确定最可行的技术来减少ARG在环境中的传播。在“一个健康”框架下提出的路线图为解决环境中的抗生素耐药性提供了指导。
