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如何解决抗生素耐药性危机?——格里·赖特 – 译学馆
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如何解决抗生素耐药性危机?——格里·赖特

How can we solve the antibiotic resistance crisis? - Gerry Wright

“如果滥用抗生素 它们就可能无法在真正需要时发挥其作用”
– 汤姆·弗里登博士 美国CDC前主任
Antibiotics
抗生素
behind the scenes, they enable much of modern medicine.
在现代医学中 有着不为人知的广泛用途
We use them to cure infectious diseases,
我们不仅用它们治疗传染病
but also to safely facilitate everything from surgery
而且还用它来确保手术
to chemotherapy to organ transplants.
化疗及器官移植过程中的安全
Without antibiotics,
没有抗生素
even routine medical procedures
哪怕是常规的治疗步骤
can lead to life-threatening infections.
也可能导致致命的感染
And we’re at risk of losing them.
而现在 抗生素的有效性正在受到挑战
Antibiotics are chemicals that prevent the growth of bacteria.
抗生素是抑制细菌生长的化学物
Unfortunately,
不幸的是
some bacteria have become resistant
有些细菌发展出了耐药性
to all currently available antibiotics.
能抵抗所有现有的抗生素
At the same time,
与此同时
we’ve stopped discovering new ones.
我们却没有发现新的抗生素
Still, there’s hope that we can get ahead of the problem.
然而 我们仍有希望能解决问题
But first, how did we get into this situation?
但首先 我们是如何陷入这种情况的?
The first widely used antibiotic was penicillin,
第一个被广泛使用的抗生素是青霉素
discovered in 1928 by Alexander Fleming.
由亚历山大·弗莱明于1928年发现
In his 1945 Nobel Prize acceptance speech,
1945年 在他获得诺贝尔奖的演讲中
Fleming warned
弗莱明警告
that bacterial resistance had the potential
细菌的耐药性可能会毁掉
to ruin the miracle of antibiotics.
抗生素的神奇效果
He was right.
他说对了
in the 1940s and 50s,
在20世纪40至50年代
resistant bacteria already began to appear.
耐药菌已经开始出现
From then until the 1980s,
从那时起 到20世纪80年代
pharmaceutical companies countered the problem of resistance
制药公司通过研发新的抗生素
by discovering many new antibiotics.
来解决耐药性的问题
At first this was a highly successful –
起初这项事业不仅非常成功
and highly profitable – enterprise.
而且利润丰厚
Over time, a couple things changed.
随着时间推移 一些事情发生了变化
Newly discovered antibiotics
新研发的抗生素
were often only effective for a narrow spectrum of infections,
往往只对小部分传染病有效
whereas the first ones had been broadly applicable.
而最初的抗生素的应用范围却很广
This isn’t a problem in itself,
这本身不是问题
but it does mean that fewer doses of these drugs could be sold –
但这确实意味着 这些药物的销量会更少
making them less profitable.
从而导致其利润的减少
In the early days, antibiotics were heavily overprescribed,
早期 医生严重过量地开具抗生素处方
including for viral infections
抗生素对病毒感染无效
they had no effect on.
但医生仍会开抗生素
Scrutiny around prescriptions increased,
对开具抗生素处方的监管加强了
which is good, but also lowered sales.
这是好事 但也减少了其销量
At the same time, companies began to develop more drugs
与此同时 公司开始研发更多
that are taken over a patient’s lifetime,
能让病人终生服用的药物
like blood pressure and cholesterol medications,
如血压药 胆固醇药
and later anti-depressants and anti-anxiety medications.
之后还有抗抑郁药和抗焦虑药
Because they are taken indefinitely,
由于人们会长期服用这些药物
these drugs more profitable.
因此它们的利润会更高
By the mid-1980s,
到20世纪80年代
no new chemical classes of antibiotics were discovered.
都没有发现新的抗生素化学分类
But bacteria continued to acquire resistance
而细菌没有停止发展耐药性的脚步
and pass it along by sharing genetic information between individual bacteria
并通过细菌间的基因信息分享传递耐药性
and even across species.
这甚至跨越了物种
Now bacteria that are resistant to many antibiotics are common,
现在 对很多抗生素有耐药性的细菌很常见
and increasingly
而且逐渐地
some strains are resistant to all our current drugs.
一些菌株对现有的所有药物都发展出耐药性
So, what can we do about this?
那么对此 我们能做些什么?
We need to control the use of existing antibiotics,
我们需要控制现有抗生素的使用
create new ones,
开发新的抗生素
combat resistance to new and existing drugs,
对抗对新药物及现有药物的耐药性
and find new ways to fight bacterial infections.
以及寻找治疗细菌感染的新途径
The largest consumer of antibiotics is agriculture,
农业生产是最大的抗生素消费者
which uses antibiotics not only to treat infections
使用抗生素不仅能治疗感染
but to promote the growth of food animals.
还能促进食用肉畜的生长
Using large volumes of antibiotics
大量使用抗生素
increases the bacteria’s exposure to the antibiotics
会增加细菌与抗生素的接触
and therefore their opportunity to develop resistance.
细菌从而更可能发展出耐药性
Many bacteria that are common in animals,
动物中常见的很多细菌
like salmonella, can also infect humans,
如沙门氏菌 也能感染人类
and drug-resistant versions
而含耐药性的菌体
can pass to us through the food chain
会通过食物链传递给我们
and spread through international trade and travel networks.
并通过国际贸易和旅游网络扩散
In terms of finding new antibiotics,
在寻找新抗生素的方面
nature offers the most promising new compounds.
自然能提供最有前景的新化合物
Organisms like other microbes and fungi
和其它微生物及真菌一样
have evolved over millions of years
有机生物为了适应竞争环境
to live in competitive environments –
在数百万年间不断进化
meaning they often contain antibiotic compounds
这意味着它们往往含有抗生素化合物
to give them a survival advantage over certain bacteria.
能使其拥有消灭特定细菌的生存优势
We can also package antibiotics
我们也可以将含有能抑制耐药性的分子
with molecules that inhibit resistance.
注入到抗生素中
One way bacteria develop resistance
细菌发展出耐药性的途径之一
is through proteins of their own
是通过自身的蛋白质
that degrade the drug.
来降解药物
By packaging the antibiotic
通过将能阻断降解物的分子
with molecules that block the degraders,
注入到抗生素中
the antibiotic can do its job.
抗生素就能发挥其作用
Phages, viruses that attack bacteria
噬菌体是一种会侵袭细菌
but don’t affect humans,
但不会感染人类的病毒
are one promising new avenue to combat bacterial infections.
这是对抗细菌感染的前瞻性新途径
Developing vaccines for common infections meanwhile,
同时 研发针对常见传染病的疫苗
can help prevent disease in the first place.
能从源头上预防疾病
The biggest challenge to all these approaches is funding,
所有这些方法面临的最大挑战是资金
which is woefully inadequate across the globe.
这是全球都极其缺乏的
Antibiotics are so unprofitable
因为抗生素无利可图
that many large pharmaceutical companies
以至于很多大型制药公司
have stopped trying to develop them.
都不再尝试研发抗生素
Meanwhile, smaller companies that successfully bring new antibiotics to market
而像美国Achaogen这样能将新型抗生素
often still go bankrupt,
推出市场的创业型公司
like the American start up Achaogen.
往往会破产
New therapeutic techniques like phages and vaccines
新的医疗手段 如噬菌体和疫苗
face the same fundamental problem as traditional antibiotics:
则面临和传统抗生素一样的根本问题:
if they’re working well, they’re used just once,
如果它们很有效 那就只会被使用一次
which makes it difficult to make money.
这就很难赚钱
And to successfully counteract resistance in the long term,
长远来看 为了成功对抗耐药性
we’ll need to use new antibiotics sparingly –
我们需要谨慎地使用新的抗生素
lowering the profits for their creators even further.
而这会进一步降低它们创造者的利润
One possible solution is to shift profits away
一个可能的解决方案是
from the volume of antibiotics sold.
不要将利润与抗生素销量挂钩
For example, the United Kingdom is testing a model
例如 英国正在测试一种模型
where healthcare providers purchase antibiotic subscriptions.
通过这种模型 医疗服务供应商可以订购抗生素
While governments are looking for ways
尽管政府正在寻找
to incentivize antibiotic development,
鼓励抗生素发展的方法
these programs are still in the early stages.
这些项目仍处于初始阶段
Countries around the world will need to do much more –
世界各国还需要做的有很多
but with enough investment in antibiotic development
但若抗生素研发有了足够的资金
and controlled use of our current drugs,
加上控制现有药物的使用
we can still get ahead of resistance.
我们仍可能解决耐药性
The world is full of accidental inventions
这个世界充满了对我们的生活
that has major impacts on our lives.
有重大影响的偶然发明
the potato chip, the microwave oven, post-it notes
薯片 微波炉 便利贴
But did you know that the first antibiotic
但是你知道第一个抗生素
was invented by accident?
是偶然发明的吗?
Has any mistake in human history
在人类历史上还有什么错误
saved more lives
拯救了更多的生命呢?
learn more about this fascinating story with this video.
想要了解更多 就看这个视频吧

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视频概述

长期以来,细菌具有了抗生素耐药性。我们一起去了解一下如何解决这个危机。

听录译者

收集自网络

翻译译者

ericaeureka

审核员

审核员XY

视频来源

https://www.youtube.com/watch?v=ZvhFeGEDFC8

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