环境抗生素耐药性风险评价中最小抑菌浓度的研究进展

Advancements in minimum inhibitory concentration (MIC) for risk assessment of environmental antimicrobial resistance

摘要:

环境中抗生素耐药性(antimicrobial resistance, AMR)的产生和传播对人类健康构成了严重威胁，最小抑菌浓度(minimum inhibitory concentration, MIC)是评价环境中抗生素耐药性风险的关键指标。本研究基于文献梳理，发现常用的MIC测试方法中大部分采用肉汤微稀释法，其次是琼脂稀释法和E-test法，测试方法的不同对MIC值的影响不明显。基于EUCAST数据库，梳理了目前针对不同菌种和抗生素的MIC测试数据，发现革兰氏阴性菌(G⁻)的AMR问题得到了更多关注，其MIC数据量远大于革兰氏阳性菌(G⁺)，然而，G⁺对抗生素的耐药性比G⁻更强。鲍曼不动杆菌(Acinetobacter baumannii)和屎肠球菌(Enterococcus faecium)分别是G⁻和G⁺中耐药性最强的细菌。有关AMR的研究主要集中于β-内酰胺类抗生素，而磺胺类和多肽类研究相对较少。在所研究的抗生素中，细菌对氨苄西林钠、链霉素和夫西地酸的耐药性最强。本研究梳理和总结了MIC测试方法与数据研究现状，指出目前数据远远不足，建议持续扩大MIC研究的覆盖面，并促进耐药信息共享。

关键词:抗生素;抗生素耐药性;最小抑菌浓度;最小选择浓度;风险评价

Abstract:

The generation and spread of antimicrobial resistance (AMR) in the environment pose a serious threat to human health. The minimum inhibitory concentration (MIC) is a key indicator for assessing the risk of AMR in environmental settings. Based on a literature review, this study found that among the commonly employed MIC testing methods, broth microdilution was the most prevalent, followed by agar dilution and E-test, and the MIC values observed showed no differences among different testing methods. Furthermore, we collected and analyzed the MIC data of different strains and antibiotics from the EUCAST database. According to the data, the available AMR studies mainly focused on Gram-negative bacteria (G⁻), which had a larger amount of MIC data than Gram-positive bacteria (G⁺). Notably, we observed that G⁺ bacteria exhibited stronger resistance to antibiotics than G⁻. Acinetobacter baumanniiand Enterococcus faecium demonstrated the strongest resistance among G⁻ and G⁺, respectively. Additionally, we found that the research on AMR primarily focused on β-lactams, with limited attention to sulfonamides and peptides. Bacteria displayed the strongest resistance to ampicillin-sulbactam, streptomycin, and fusidic acid among the antibiotics tested. This study reviews the current status of MIC testing methods and data. It emphasizes that existing data are insufficient and recommends expanding the scope of MIC research while promoting the sharing of AMR information.

Key words:antibiotics;antimicrobial resistance;minimum inhibitory concentration;minimum selective concentration;risk assessment