摘要
      抗生素耐药性基因（ARGs）对环境的污染一直是公众关注的焦点。整合子作为可移动的遗传元件，具有多功能的基因获取系统，有助于ARGs的水平基因转移（HGT）和污染传播。然而，人们对整合素介导的ARGs的特征知之甚少，这阻碍了我们对移动抗微生物耐药性风险的监测和控制。为了解决这些问题，我们回顾了3322篇关于检测方法和管道、ARG多样性和进化进展、环境和地理分布、细菌宿主、基因盒排列的出版物，并在此基础上识别由整合子介导的高风险水平的ARG。属于12种类型的516个亚型的多种ARG能够由整合子携带，其中62个核心ARG亚型在污染源、自然和人类相关环境中普遍存在。携带ARG整合子的宿主达到271种细菌，最常见的是机会致病菌大肠杆菌、铜绿假单胞菌和肺炎克雷伯菌。此外，观察到的ARGs的出现及其多重排列表明了由整合子介导的ARG的积累，从而在现代选择性药物下增加了HGT的风险。出于公众健康的担忧，我们迫切呼吁对这些高风险ARG进行更好的监测和控制。我们确定了具有高流动性的风险等级I ARG（aacA7、blaOXA10、catB3、catB8、dfrA5），回顾了关键趋势和值得注意的进展，并提出了未来的方向，可作为标准制定的参考和指导。
Abstract
Environmental pollution of antibiotic resistance genes (ARGs) has been a great public concern. Integrons, as mobile genetic elements, with versatile gene acquisition systems facilitate the horizontal gene transfer (HGT) and pollution disseminations of ARGs. However, little is understood about the characteristics of ARGs mediated by integrons, which hampers our monitoring and control of the mobile antimicrobial resistance risks. To address these issues, we reviewed 3,322 publications concerning detection methods and pipeline, ARG diversity and evolutionary progress, environmental and geographical distribution, bacterial hosts, gene cassettes arrangements, and based on which to identify ARGs with high risk levels mediated by integrons. Diverse ARGs of 516 subtypes attributed to 12 types were capable of being carried by integrons, with 62 core ARG subtypes prevalent in pollution source, natural and human-related environments. Hosts of ARG-carrying integrons reached 271 bacterial species, most frequently carried by opportunistic pathogens Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. Moreover, the observed emergence of ARGs together with their multiple arrangements indicated the accumulation of ARGs mediated by integrons, and thus pose increasing HGT risks under modern selective agents. With the concerns of public health, we urgently call for a better monitoring and control of these high-risk ARGs. Our identified Risk Rank I ARGs (aacA7, blaOXA10, catB3, catB8, dfrA5) with high mobility, reviewed key trends and noteworthy advancements, and proposed future directions could be reference and guidance for standard formulation.

https://www.sciencedirect.com/science/article/abs/pii/S0043135423000647