Генетические маркеры антибиотикорезистентности в экспериментальных моделях и системах эпидемиологического надзора

Актуальность. Антибиотикорезистентность (АМР) имеет высокую медико-социальную значимость, поскольку формируется на пересечении клинического применения антимикробных препаратов, ветеринарной практики, пищевого производства, экологического загрязнения и горизонтального переноса мобильных генетических элементов. Анализ АМР требует оценки не только отдельных генов устойчивости, но и моделей, диагностических подходов и систем эпиднадзора, прослеживающих распространение генов антибиотикорезистентности (antibiotic resistance genes, ARG) между клиническими, животными и экологическими резервуарами.

Цель. Обобщить данные об экспериментальных и вычислительных моделях распространения ARG, охарактеризовать выбранные генетические маркеры АМР и оценить современные подходы к их выявлению.

Материал и методы. Выполнен нарративный обзор с прозрачной методологией поиска и тематическим синтезом. Поиск проводился в PubMed/MEDLINE, Scopus, Web of Science и Google Scholar; последний поиск выполнен 2 мая 2026 г. После полнотекстовой оценки включено 46 источников.

Результаты. Рассмотрены маркеры blaCTX-M-15, blaNDM, blaKPC, blaOXA-23, floR и intI1, а также мобильные генетические элементы, участвующие в их распространении. Обобщены возможности и ограничения in vitro-моделей, моделей кишечника, мышиных моделей, биоплёночных систем, математического моделирования, AST, ПЦР/qPCR, WGS, mNGS, ML и CRISPR-Cas12a-диагностики.

Заключение. CRISPR-Cas12a-платформы могут использоваться для быстрого целевого скрининга заранее выбранных ARG, но не заменяют фенотипическое тестирование и геномный анализ. Наиболее обоснованным направлением является интеграция AST, WGS/mNGS, целевой молекулярной диагностики, ML и One Health-надзора.

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