Antimicrobial resistance (AMR) is one of the greatest threats to human health with a growing body of evidence demonstrating that selection for AMR can occur at environmental antimicrobial concentrations. Understanding the concentrations at which selection for resistance may occur is critical to help inform environmental risk assessments and highlight where mitigation strategies are required. A variety of experimental and data approaches have been used to determine these concentrations. However, there is minimal standardisation of existing approaches and no consensus on the relative merits of different methods. We conducted a semi-systematic literature review to collect and critically appraise available minimal selective concentration (MSC) and predicted no effect concentration for resistance (PNECR) data and the approaches used to derive them. There were 21 relevant articles providing 331 selective concentrations, ranging from 0.00087 µg/L (ciprofloxacin) to 2000 µg/L (carbenicillin). Meta-analyses of these data found that selective concentrations are highly compound-dependent, and only a subset of all antimicrobials have been the focus of most of the research. The variety of approaches that have been used, knowledge gaps and future research priorities were identified, as well as recommendations for those considering the selective risks of antimicrobials in the environment.

中文翻译：

---

对环境中抗菌素耐药性选择的预测无影响浓度的关键荟萃分析


抗菌素耐药性 （AMR） 是人类健康面临的最大威胁之一，越来越多的证据表明，在环境抗菌素浓度下，可以进行 AMR 的选择。了解可能发生耐药性的选择的浓度对于帮助为环境风险评估提供信息并突出需要缓解策略的地方至关重要。已使用各种实验和数据方法来确定这些浓度。然而，现有方法的标准化程度最低，并且对不同方法的相对优点没有达成共识。我们进行了半系统文献综述，以收集和批判性评价可用的最小选择性浓度 （MSC） 和预测耐药性无影响浓度 （PNECR） 数据以及用于得出它们的方法。有 21 篇相关文章提供了 331 种选择性浓度，范围从 0.00087 μg/L（环丙沙星）到 2000 μg/L（羧苄青霉素）。对这些数据的荟萃分析发现，选择性浓度高度依赖于化合物，并且只有所有抗菌剂的一个子集是大多数研究的重点。确定了已使用的各种方法、知识差距和未来的研究重点，并为那些考虑环境中抗菌素选择性风险的人提供了建议。