摘要
      三氯生（TCS）和三氯卡班（TCC）是一种抗菌剂，广泛应用于个人护理产品、纺织品和塑料中。低剂量接触TCS和TCC可能会干扰激素水平，甚至促进细菌对抗生素的耐药性。在后冠状病毒疾病大流行时代，与TCS和TCC暴露相关的慢性健康影响和抗生素耐药性基因的传播越来越令人担忧。本研究旨在筛选和审查接触水平、来源和新冠肺炎疫情爆发后的变化、潜在健康后果、细菌耐药性和交叉耐药性，以及与TCS和TCC接触相关的健康风险评估工具。日常使用抗菌产品是观察到的内部暴露与疾病之间的大多数关联，而微量二次暴露主要导致抗生素耐药性基因的传播。改变的肠道微生物群在多系统毒性中的作用值得进一步关注。亚致死剂量的TCC选择ARGs而不会明显增加对TCC的耐受性。但TCS会诱导持续的TCS耐药性，并可逆地选择抗生素耐药性，这突出了最大限度地减少其使用的好处。为了得出人类的参考剂量（RfDs），需要使用毒理学测试来确认在人群研究中观察到的更敏感的终点。此外，建议将人体等效剂量纳入健康风险评估，以减少推断的不确定性。
Abstract
Triclosan (TCS) and triclocarban (TCC) are antimicrobials that are widely applied in personal care products, textiles, and plastics. TCS and TCC exposure at low doses may disturb hormone levels and even facilitate bacterial resistance to antibiotics. In the post-coronavirus disease pandemic era, chronic health effects and the spread of antibiotic resistance genes associated with TCS and TCC exposure represent an increasing concern. This study sought to screen and review the exposure levels and sources and changes after the onset of the coronavirus disease (COVID-19) pandemic, potential health outcomes, bacterial resistance and cross-resistance, and health risk assessment tools associated with TCS and TCC exposure. Daily use of antimicrobial products accounts for most observed associations between internal exposure and diseases, while secondary exposure at trace levels mainly lead to the spread of antibiotic resistance genes. The roles of altered gut microbiota in multi-system toxicities warrant further attention. Sublethal dose of TCC selects ARGs without obviously increasing tolerance to TCC. But TCS induce persistent TCS resistance and reversibly select antibiotic resistance, which highlights the benefits of minimizing its use. To derive reference doses (RfDs) for humans, more sensitive endpoints observed in populational studies need to be confirmed using toxicological tests. Additionally, the human equivalent dose is recommended to be incorporated into the health risk assessment to reduce uncertainty of extrapolation.

https://www.sciencedirect.com/science/article/abs/pii/S0048969723007301