摘要
      中国政府正在大力推动农村地区的厕所改造，以降低人类粪便暴露的风险，因为人类粪便暴露会导致传染病，尤其是抗生素耐药性基因和病原体。然而，ARGs在中国不同地区人类粪便中的分布仍然不明确。目前尚不清楚ARGs在如厕治疗后的存活率与区域感染率之间的关系。在这里，我们首次大规模调查了中国农村地区人类粪便中ARGs的流行情况及其与传染病的潜在关系。结果表明，经过农村厕所处理后，人类粪便中仍存在较高的ARGs残留，尤其是tetM-01和ermB，其平均相对丰度分别高达1.21×10−1（东部）和1.56×10−2（北部）。在大的区域范围内，人类粪便抵抗力的显著差异主要由厕所类型、TN、NH3-N和细菌群落决定。一个关键的发现是，厕所仍然不能有效降低人类粪便中的致病风险。传染病和ARGs之间的显著正相关关系（P<0.05）可以推断，人类粪便暴露中的ARGs可能是提高疾病发病率的关键途径，因为这些ARGs阻碍了抗生素的有效性。
Abstract
Chinese government is vigorously promoting toilet renovation in rural areas to reduce the risk of human feces exposure, which would cause infectious diseases, especially antibiotic resistance genes (ARGs) and pathogens. However, the distribution of ARGs in human feces from different regions of China remained ill-defined. It is not yet known how the survival of ARGs after toilet treatment is associated with the regional infection rates. Here, we investigated the prevalence of ARGs in human feces in rural areas of China and their potential relationship with infectious diseases for the first large-scale. The results showed that there were still high ARGs residues in human feces after rural toilet treatment, especially tetM-01 and ermB with average relative abundance as high as 1.21 × 10−1 (Eastern) and 1.56 × 10−1 (Northern), respectively. At a large regional scale, the significant differences in human feces resistomes were mainly shaped by the toilet types, TN, NH3-N, and the bacterial community. A critical finding was that toilets still cannot effectively decrease the pathogenicity risk in human feces. The significant positive relationship (P<0.05) between infectious diseases and ARGs can infer that ARGs in human feces exposure might be a critical path for enhancing the incidence of diseases, as these ARGs hinder the effectiveness of antibiotics.

https://www.sciencedirect.com/science/article/abs/pii/S1001074222003175