摘要
      人类胃肠道是一个复杂而动态的微生物群落，即肠道微生物群，为宿主提供重要的代谢、信号传导和免疫调节功能。肠道微生物组的共生和致病成员都是抗微生物耐药性基因（ARG）的宿主，这可能对宿主的健康造成潜在威胁，并将ARG转移到易感微生物和环境中。抗微生物耐药性正在成为人类健康的主要负担，并被广泛认为是一项全球性挑战。肠道微生物组中ARG的多样性和丰度是可变的，取决于与医疗保健相关的抗生素的暴露、兽医和农业中抗生素的使用以及人口的迁移。与其他微生物生态系统相比，生活在胃肠道中的细菌在质粒、转座子或噬菌体等可移动遗传元件（MGE）的帮助下通过水平基因转移（HGT）转移ARGs的频率要高得多。肠道细菌中的HGT是通过多种基因转移机制促进的，包括转化、结合、转导和囊泡融合。现在需要实施严格的政策，在需要时限制滥用抗生素。研发部门应优先考虑开发用于耐药性测定的快速诊断测试和抗生素替代品，如疫苗接种、益生菌和噬菌体疗法。通过跨学科研究和发现促进内源性肠道微生物的生长和多样性，为对抗耐药性病原体的可持续发展采取集体行动，是克服当前抗微生物耐药性危机的关键。
Abstract
The human gastrointestinal tract is home to a complex and dynamic community of microorganisms known as gut microbiota, which provide the host with important metabolic, signaling, and immunomodulatory functions. Both the commensal and pathogenic members of the gut microbiome serve as reservoirs of antimicrobial-resistance genes (ARG), which can cause potential health threats to the host and can transfer the ARGs to the susceptible microbes and into the environment. Antimicrobial resistance is becoming a major burden on human health and is widely recognized as a global challenge. The diversity and abundance of ARGs in the gut microbiome are variable and depend on the exposure to healthcare-associated antibiotics, usage of antibiotics in veterinary and agriculture, and the migration of the population. The transfer frequency of the ARGs through horizontal gene transfer (HGT) with the help of mobile genetic elements (MGEs) like plasmids, transposons, or phages is much higher among bacteria living in the GI tract compared to other microbial ecosystems. HGT in gut bacteria is facilitated through multiple gene transfer mechanisms, including transformation, conjugation, transduction, and vesicle fusion. It is the need of the hour to implement strict policies to limit indiscriminate antibiotic usage when needed. Developing rapid diagnostic tests for resistance determination and alternatives to antibiotics like vaccination, probiotics, and bacteriophage therapy should have the highest priority in the research and development sectors. Collective actions for sustainable development against resistant pathogens by promoting endogenous gut microbial growth and diversity through interdisciplinary research and findings are key to overcoming the current antimicrobial resistance crisis.

https://pubmed.ncbi.nlm.nih.gov/36280316/