Scoping review synthesizes evidence on plasmid-mediated antimicrobial resistance in the human microbiome, indicating critical implications for clinical interventions.
Key Points
This review aims to synthesize evidence on mechanisms of plasmid persistence and horizontal gene transfer (HGT) related to antimicrobial resistance (AMR).
Comprehensive literature search in five databases (PubMed, Embase, Web of Science, Scopus, Global Health) from January 2010 to December 2025.
Screened 1,200 records yielding 223 unique studies, with 35 meeting inclusion criteria for analysis.
Data extraction focused on plasmid maintenance, mobilization pathways, and clinical relevance.
Sixteen studies reported that plasmid maintenance is supported by factors like host-plasmid co-adaptation and stability systems.
Eight studies indicated that horizontal gene transfer may be influenced by stressors such as metabolic disruption and SOS responses.
Eleven clinical studies highlighted the underdetection of plasmid-mediated AMR and early evidence for microbiome-informed interventions.