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來源于《封面》
The Death of Antibiotics: We’re Running Out of Effective Drugs to Fight Off an Army of Superbugs
抗生素的死亡：我們正在耗盡對抗超級細菌大軍的有效藥物
By David H. Freedman
作者：戴維·H.弗里德曼
In January, Columbia University revealed that four patients at its Irving Medical Center in New York had been sick with an unusual version of E. coli, a common gut bacterium. Although the news largely escaped attention in the media, it ricocheted through the world of infectious disease experts. E. coli is a relatively common bacterium and benign when it's in the gut, where it usually lives, but in the wrong places—such as in lettuce or ground beef, or our bloodstream—it can turn deadly. When antibiotics prove ineffective against an E. coli infection, as many as half the patients with it die within two weeks.
今年1月，哥倫比亞大學披露，其位于紐約歐文醫學中心的四名患者感染了一種不同尋常的大腸桿菌，這是一種常見的腸道細菌。盡管這條消息在很大程度上沒有引起媒體的注意，但它卻在傳染病專家的圈子里引起了軒然大波。大腸桿菌是一種相對常見的細菌，當它生活在腸道時是良性的，但在錯誤的地方，比如生菜、碎牛肉或我們的血液中，它可能會致命。當抗生素被證明對大腸桿菌感染無效時，多達一半的患者會在兩周內死亡。
That's exactly why the Columbia E. coli was so worrying. Over the past decade or two, E. coli has developed resistance to one antibiotic after another. For some infected patients, their last hope is the antibiotic colistin, a toxic substance with potential side effects that include kidney and brain damage. The Columbia E. coli had a mutation in a gene, MCR-1, that confers a terrifying attribute: imperviousness to colistin.
這正是哥倫比亞大腸桿菌如此令人擔憂的原因。在過去的一二十年里，大腸桿菌對一種又一種抗生素產生了抗藥性。對一些受感染的病人來說，他們最后的希望是抗生素粘菌素，這是一種有潛在副作用的有毒物質，包括腎臟和大腦損傷。哥倫比亞大腸桿菌的一種基因發生了突變，即MCR-1，這給它帶來了一個可怕的特性:粘菌素的不滲透性。
“We're looking to the shelf for the next antibiotic, and there's nothing there,” says Erica Shenoy, associate chief of the infection control unit at Massachusetts General Hospital. “We're facing the specter of patients with infections we can't treat.”
“我們正在貨架上尋找下一種抗生素，但那里什么都沒有，”馬薩諸塞州總醫院感染控制部門的副主任艾麗卡·謝諾說。“我們面臨著感染我們無法治療的病人的幽靈。”
Ever since an experimental miracle drug called penicillin was rushed to a Boston hospital in 1942 to save the lives of 13 victims of a nightclub fire, medical researchers have discovered more than 100 new antibiotics. We've needed each and every one of them—and they're not enough. It's not just E. coli. Drug-resistant strains of Staphylococcus, Enterobacteriaceae and Clostridium difficile have been steadily overcoming antibiotics; one study found that the number of deaths due to resistant infections quintupled between 2007 and 2015. Recently, treatment-resistant versions of the fungus Candida auris have shown up in hospitals in New York City and Chicago, killing half of infected patients.
1942年，一種名為盤尼西林的實驗性神奇藥物被緊急送往波士頓一家醫院，以挽救夜總會火災中13名受害者的生命。自那以來，醫學研究人員已經發現了100多種新的抗生素。我們需要這些抗生素，但還遠遠不夠。不僅僅是大腸桿菌。葡萄球菌、腸桿菌科、艱難梭菌等耐藥菌株穩步戰勝抗生素；一項研究發現，2007年至2015年間，死于耐藥感染的人數翻了五倍。最近，耐治療的真菌念珠菌出現在紐約和芝加哥的醫院，殺死了一半的感染者。
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