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Slowing the Superbugs
減緩超級細菌
Although the pharmaceutical industry has all but abandoned antibiotics, researchers haven't given up hope of finding new ones. The antibiotic revolution was kicked off in 1928, when Alexander Fleming returned from vacation to his London lab only to find a weird-looking mold growing in a dish he had left by an open window. Ever since, researchers have tried to peek into every corner of nature for the next great bacteria-killer. According to recent studies, among the new sources of substances that appear lethal to even resistant bacteria—yet may be safe for human consumption—are insects, seaweed, the mucus on young fish, arsenic-rich dirt in Ireland and even Martian soil. One team at Leiden University in the Netherlands is trying to build an artificial bacterium from scratch in hopes it can be tweaked to manufacture a new antibiotic.
盡管制藥行業(yè)幾乎已經(jīng)放棄了抗生素，但研究人員并沒有放棄尋找新抗生素的希望。抗生素革命始于1928年，當時度假歸來的亞歷山大•弗萊明在倫敦的實驗室里發(fā)現(xiàn)了一種奇怪的霉菌。從那以后，研究人員一直試圖深入自然界的每一個角落，尋找下一個偉大的細菌殺手。根據(jù)最近的研究，在一些新的物質(zhì)來源中，昆蟲、海藻、小魚身上的黏液、愛爾蘭富含砷的泥土，甚至是火星土壤，這些物質(zhì)即使對具有抗藥性的細菌來說也是致命的，但對人類來說可能是安全的。荷蘭萊頓大學的一個研究小組正在嘗試從無到有地制造一種人工細菌，希望能對其進行微調(diào)，從而制造出一種新的抗生素。
Doctors are also trying to make the best use of antibiotics we have now by slowing the development of new resistant strains. That calls for cutting back on rampant overuse of antibiotics, which encourages superbugs to evolve. Doing so has to become an international effort, because the resistant bugs in one part of the world often made their way from elsewhere.
醫(yī)生們還試圖通過減緩新的耐藥菌株的發(fā)展來最大限度地利用我們現(xiàn)有的抗生素。這就要求減少抗生素的過度使用，因為過度使用會促使超級細菌進化。這樣做必須成為一項國際性的努力，因為世界上某一地區(qū)的抗藥性細菌往往是從其他地方傳播過來的。
Developing countries are becoming a particularly frequent source for emergent bacterial threats that end up in the U.S., notes UConn's Banach. Studies have found that in most of the world antibiotics are readily dispensed from community pharmacies without prescriptions, contributing to a 65 percent climb in global antibiotic use between 2000 and 2015. The resulting resistant bugs skip frictionlessly around the world in the guts of millions of international travelers. “The impact of antibiotic overuse in these countries, as well as living and environmental conditions, are facilitating the worldwide spread of resistant organisms,” he says.
康州大學的巴拿赫指出，發(fā)展中國家正成為最終出現(xiàn)在美國的突發(fā)細菌威脅的一個特別頻繁的來源。研究發(fā)現(xiàn)，在世界上大多數(shù)地方，抗生素很容易在沒有處方的情況下從社區(qū)藥店配藥，這使得2000年至2015年間全球抗生素使用量上升了65%。由此產(chǎn)生的耐藥細菌在全球數(shù)百萬國際旅行者的腸道內(nèi)無摩擦地跳過。“這些國家抗生素過度使用的影響，以及生活和環(huán)境條件，正在促進耐藥生物在世界范圍內(nèi)的傳播，”他表示。
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Patients have a role to play too. Pressuring doctors to prescribe antibiotics for mild congestion, urinary tract infections or slow-to-heal wounds contributes to antibiotic overuse and the resulting resistance. Massachusetts public health officials have been pushing physicians and the public to ease up on antibiotics for more than a decade, and the state was rewarded with a 16 percent drop in prescriptions over a four-year period. A small victory, perhaps, in a large war that we have so far been mostly losing.
病人也有責任。對醫(yī)生施加壓力，要求醫(yī)生為輕度充血、尿路感染或傷口愈合緩慢開抗生素處方，這導致了抗生素的過度使用和由此產(chǎn)生的耐藥性。十多年來，馬薩諸塞州的公共衛(wèi)生官員一直在敦促醫(yī)生和公眾減少抗生素的使用，在四年的時間里，該州的處方量減少了16%。也許，在一場我們到目前為止幾乎已經(jīng)輸?shù)舻拇髴?zhàn)中，這是一場小小的勝利。
The cost of our failure to act a decade or more ago to this easily foreseeable crisis will most likely be a spreading tide of severe illness and death. It won't rise to the level of deadly mass outbreak the way a killer virus like Ebola could. But resistant infections will begin to affect more and more of us. Even if medicine, government and industry embarked today on a massive effort to find new approaches to combat resistant infections like the Columbia E. coli —which they aren't close to doing—the payoff wouldn't come for a decade or more.
十多年前，我們未能對這場容易預見的危機采取行動，其代價很可能是嚴重疾病和死亡的蔓延。它不會像埃博拉這樣的致命病毒那樣大規(guī)模爆發(fā)。但是耐藥感染將開始影響越來越多的人。即使醫(yī)藥、政府和工業(yè)界從今天開始就大規(guī)模努力尋找新的方法來對抗耐藥感染，如哥倫比亞大腸桿菌（對抗這種細菌還有很長的路要走），成果回報也要等到十年后甚至更久。
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