摘要
      抗微生物耐药性（AMR）是全球最大的担忧之一，因为它在多个领域具有影响力，这与one Health关于人、动物、植物及其共享环境之间密切联系的概念一致。抗生素抗性细菌（ARB）和抗生素抗性基因（ARGs）在动植物部门的各种生态位、沉积物、水源、土壤和废物中不断循环，并与人类活动有关。不同来源的污水进入污水处理厂（WWTP），在那里ARB和ARG的去除效率仍然不足，导致它们被输送到排放点并进一步扩散。因此，WWTP被认为是ARG的蓄水池，也是AMR传播的来源。根据世界卫生组织的一份报告，对公共卫生最重要的病原体包括对第三代头孢菌素和碳青霉烯类药物（最后选择的药物）具有耐药性的革兰氏阴性菌，它们代表了使用最广泛的抗生素β-内酰胺。因此，本文旨在介绍对β-内酰胺类抗生素产生耐药性的WWTP中ARGs的可用研究数据，特别强调临床上重要的危及生命的耐药性机制，包括超广谱β-内窥酶（ESBLs）和碳青霉烯酶（KPC，NDM）。
Abstract
Antimicrobial resistance (AMR) is one of the largest global concerns due to its influence in multiple areas, which is consistent with One Health’s concept of close interconnections between people, animals, plants, and their shared environments. Antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs) circulate constantly in various niches, sediments, water sources, soil, and wastes of the animal and plant sectors, and is linked to human activities. Sewage of different origins gets to the wastewater treatment plants (WWTPs), where ARB and ARG removal efficiency is still insufficient, leading to their transmission to discharge points and further dissemination. Thus, WWTPs are believed to be reservoirs of ARGs and the source of spreading AMR. According to a World Health Organization report, the most critical pathogens for public health include Gram-negative bacteria resistant to third-generation cephalosporins and carbapenems (last-choice drugs), which represent β-lactams, the most widely used antibiotics. Therefore, this paper aimed to present the available research data for ARGs in WWTPs that confer resistance to β-lactam antibiotics, with a particular emphasis on clinically important life-threatening mechanisms of resistance, including extended-spectrum β-lactamases (ESBLs) and carbapenemases (KPC, NDM).

https://www.mdpi.com/1660-4601/19/21/13829