Antibiotic Resistance Risk and Ecosystem

Antibiotic Resistance

Abstract

Antibiotics are among the most prescribed drugs in human medicine. However, antibiotic resistance is a continuing global human health problem. Ecosystems and clinical practices play equally important roles in the emergence, evolution, and spread of antibiotic resistance. High doses and inappropriate antibiotic use result in large amounts of antibiotics being released into the ecosystem, leading to the selection of large numbers of resistant bacteria and the spread of antibiotic resistance genes (ARGs). Accelerated selection of antibiotic-resistant strains and increasing numbers of antibiotic-resistant bacteria (ARB) result in increased infection-related patient mortality rates. Hosts of environmental resistomes are largely restricted to the core of the environmental microbiome. Because of the phylogenetic barriers to horizontal transfer of ARGs, gene transfer occurs more frequently within species than between species. Horizontal gene transfer (HGT) drives the evolution of untreatable “superbugs” by concentrating ARGs within individual cells. Decreasing the colonization capacity of exogenous ARB, increasing human resistance to colonization, reducing horizontal transmission of ARG, and reversing antibiotic resistance in ARB are the most important strategies to combat antibiotic resistance by preventing transmission of ARB and ARG to humans.