肠杆菌科细菌耐药基因表达的遗传和环境调控

细菌耐药性是21世纪国际关注的重要问题，也是全球面临的重大挑战。肠杆菌科细菌是医院感染的重要病原菌之一。近年来，随着抗生素的大量使用，多种肠杆菌科耐药菌，尤其是多重耐药肠杆菌开始大量出现，对人类健康形成了日益严重的威胁。细菌可以通过耐药基因突变或水平转移的方式获得耐药性，通常情况下，可以通过已知的耐药机制预测相应的耐药表型。然而，最近有研究表明，遗传背景和环境因素能够影响耐药基因的表达，给定的基因型并不一定总是产生预期的耐药表型。这种基因型-表型分离的现象极大程度上限制了从遗传学角度预测耐药表型的能力。文中结合最新文献，从遗传背景和环境条件两个方面探讨了多种肠杆菌科细菌耐药基因的表达调控机制，以期为遗传学预测耐药表型以及临床指导用药提供一定的支持。

The impact of genetic and environmental regulation on the expression of antibiotic resistance genes in Enterobacteriaceae

Antibiotic resistance is a major global concern and challenge in the 21st century. Enterobacteriaceae are one of the important pathogens of hospital-acquired infections. With the increasing use of antibiotics in clinical practice, a variety of drug-resistant Enterobacteriaceae, especially multidrug-resistant Enterobacteriaceae have emerged, posing an increasingly serious threat to human health. Bacteria can acquire antibiotic resistance by mutation or horizontal transfer of antibiotic resistance genes, and it is often possible to predict the corresponding resistance phenotype from known mechanism. However, recent findings suggest that genetic background and environmental factors could alter the expression of specific resistance genes and that a given genotype does not always generate the expected resistance phenotype. The genotype-phenotype segregation greatly hampers our ability to predict antibiotic resistance phenotype from a genetic perspective. In this review, we explore the genetic and environmental regulation of the expression of antibiotic resistance genes in a variety of Enterobacteriaceae, with the aim to provide scientific evidence for genetic prediction of antibiotic resistance phenotype and clinical guidance on drug use.