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葡萄球菌感染

This Drug-Resistant Bacteria Could Be Hiding in Your Armpits Right Now

Staphylococcus or, as it’s more widely known, staph
葡萄状球菌 或者更广为人知的葡萄球菌
is one of the most common bacterium found on human around the world
是全世界在人类身上发现的最常见的细菌之一
in some cases,
在某些情况下
it can puts a real threat to your body’s immune system
它会威胁到人体的免疫系统
even proving lethal.
甚至是致命的
So, if it’s so widespread
如果它这么常见
why aren’t we all getting infected?
为什么不是所有人都被感染了呢?
Hi, my name is Vance Fowler.
大家好 我是Vance Fowler
I’m an infectious disease doctor
我是一名传染病医生
in the division of infectious diseases at Duke University Medical Center.
在杜克大学医学中心传染病科工作
For the last twenty years or so
在过去的20年左右
I’ve focused on the clinical care, and the research around drug-resistant bacteria
我一直专注于临床护理以及耐药细菌的研究
and staph aureus in particular.
尤其是金黄色葡萄球菌
Staphylococcus is a bacteria that lives on our skin
葡萄球菌是一种生活在我们皮肤上的细菌
And about 40% of people on the planet carry it on their body
地球上大约有40%的人是它的携带者
but are asymptomatic
但没有症状
So almost half of us are walking around
所以我们中有近一半的人
unaware that we’re carriers of staph
没有意识到自己是葡萄球菌携带者
And usually that’s just fine
通常 这并没有什么
There are many different kinds of staph,
葡萄球菌有许多不同的种类
but the one that causes the greatest amount of problems in human medicine
但是 给人类医学带来最大问题的葡萄球菌
is a bacteria called staphylococcus aureus.
叫做金黄色葡萄球菌
This is generally the bacteria that people
人们在谈论葡萄球菌感染时
are referring to when they talk about a staph infection.
一般指的就是金黄色葡萄球菌
Staph aureus can be colonized in the nose, armpits, genital areas,
金黄色葡萄球菌可以定植在鼻子 腋窝 生殖区域
and other parts of the skin.
以及皮肤的其他部分
And this colonization can go on for years
它可以在这些地方定植数年
with a patient being totally asymptomatic throughout much of their lives.
病人一生中的大部分时间都完全没有症状
Sometimes, for reasons that we really don’t completely understand yet
有时 由于我们还不完全了解的原因
this staph will change from being a bystander to being trouble.
这种葡萄球菌会从无害变得有害
And when it makes that change,
当它发生这种转变后
that trouble becomes an infection in your skin or soft tissues.
你的皮肤或者软组织就会受到感染
How this usually happens is with a break in the skin allowing the infection
通常 皮肤的裂口会使葡萄球菌进入体内
to enter the body and the bloodstream.
从而导致身体和血液受到感染
And once you get staph in your blood,
一旦血液中有金黄色葡萄球菌
or staph aureus bacteremia
或者患上金黄色葡萄球菌菌血症
then things get a lot more serious.
情况就变得严重得多
The reason it gets serious is because now it has access to infect
这是因为它现在几乎可以
and cause an infection in virtually any site in the body.
导致身体任何一个部位的感染
For example, it can cause pneumonia and involve the lungs,
例如 引起肺炎并影响肺功能
It can cause infections in your bone, called osteomyelitis,
导致骨骼感染 我们称之为骨髓炎
and it can cause joint infections, cause arthritis,
感染关节 引发关节炎
and it can cause infections in your heart, cause endocarditis.
以及感染心脏 引发心内膜炎
And this is what makes it unique in the bacterial world,
这就是它在细菌界中的独特之处
the ability to cause a wide range of medical concerns.
也因此引起了医学界的广泛关注
This is because staph aureus has what are called virulence factors
因为黄色葡萄球菌含有所谓的毒力因子
or things that allow it to cause infection.
或者能引起感染的物质
Basically, though, all of its virulence factors fall into one of two categories.
不过 它所有的毒力因子一般都归为两类
They’re either adhesions, which are proteins that allow the bacteria
它要么是粘连物 也就是一种蛋白质
to stick to things that it doesn’t need to stick to
能让细菌附着在不必要的地方
like heart valves, spines, bone.
如心脏瓣膜 脊椎和骨头处
or toxins, which, generally speaking,
要么是毒素
are involved in causing local damage to cells and tissue.
一般来说 它们会对细胞和组织造成局部损害
So it will cause cell rupture, cause tissue to break down and die.
所以它会导致细胞破裂 引起组织分解和坏死
With the help of these virulence factors,
这种细菌一旦进入血液
the bacteria can turn lethal once it gets into the bloodstream.
在毒力因子的作用下 它们就是致命的
So wow, I know that sounds scary,
哇 这听起来很可怕
and it is pretty serious.
而且非常严重
How do you know you have a staph infection?
你如何知道自己感染了葡萄球菌呢?
The key thing about a staph infection is you’re going to
识别葡菌球菌感染的关键是
have symptoms in the site that’s involved.
感染部位出现的症状
Because staph mostly impacts the soft tissue
由于葡萄球菌主要感染软组织
infections can look like a boil or abscess
感染的组织看起来像疖子或者脓肿
that’s red, hot, swollen or seeping.
它们会变红 发热 肿胀或渗出脓液
Fortunately, these can mostly be treated with antibiotics.
好在它们大多可以用抗生素治疗
Some of the other forms of infection may be a little more subtle ,
其他一些形式的感染可能会稍微复杂一点
and they may require diagnosis in the hospital or in the emergency room.
病人可能需要在医院或急诊室进行诊断
If you get staph in your bloodstream,
如果你的血液中有葡萄球菌
really the hallmark finding is fever and chills.
最典型的症状是发热和寒战
There’s another type of staph that is even more alarming: MRSA
还有一种葡萄球菌更令人担 即MRSA
or Methicillin-Resistant Staphylococcus Aureus.
也就是耐甲氧西林金黄色葡萄球菌
It’s a concern not just because of it’s resistance to antibiotics,
这不仅仅是因为它对抗生素有耐药性
but also because it’s showing signs of spreading into new territory.
还因为它有向其他地方扩散的迹象
The epidemiology of MRSA has also changed over the years.
多年来 MRSA的流行病学也发生了变化
Traditionally, it was associated almost exclusively with patients who had been in the hospital
历史上 MRSA几乎只会感染住院病人
or patients who had ongoing contact with the medical system.
或者持续接触医疗系统的病人
For example, long-term care facilities,
例如需要长期护理的病人
hemodialysis patients, things like that.
血液透析病人等等
but about fifteen years ago, something happened.
但大约在15年前 情况有些变化
People with absolutely no contact with the health care system began to develop boils
完全没有接触医疗系统的人员由于感染了MRSA
and abscesses due to a MRSA infection.
也开始出现疖子和脓肿
Not only was this happening in the United States,
这不仅出现在了美国
but throughout other parts of the world.
还出现在世界其他地区
Other communities were experiencing basically the same phenomenon,
其他国家也出现了基本一样的情况
community-acquired MRSA infections.
即MRSA的社区感染
So, why in the world did this happen?
那么 究竟为什么会有这种现象呢?
Well, that’s a great question and honestly I wish I could tell you.
这是个很好的问题 老实说 我希望我能解答
It’s probably like most things,a variety of several factors,
它可能和大多数事情一样 牵涉到多个因素
but obviously critical amongst that has got to be the overuse of antibiotics.
但显然 其中最关键的因素是滥用抗生素
And while there’s no commercially available vaccine for staph aureus,
虽然目前市场上还没有金黄色葡萄球菌疫苗
there is some encouraging progress with medical advances.
但我们在医学上也取得了一些令人鼓舞的进展
One of the key elements that we’re just beginning to understand
我们刚刚开始了解到的一个关键因素是
is the role of the host in causing and perpetuating staph infections.
宿主在引起和延续葡萄球菌感染中所起到的作用
The interplay between the bacteria and the host immunity is complex.
细菌和宿主免疫系统之间的相互作用非常复杂
Ultimately, because staph aureus is so common,
总的来说 由于金黄色葡萄球菌很常见
there are three main take ways.
我们主要对它采取三种措施
These are: prevention – washing your hands at home and in medical environments,
分别是 预防:在家及医疗场所中要勤洗手
recognizing the symptoms early: boils, abscesses, and anything red or swollen,
尽早识别症状:即疥子 脓肿和任何红肿的现象
and seeing your healthcare provider as soon as you see signs or feel ill.
当你出现症状或感到不适的时候 要尽快就诊
We understand now
现在我们知道
that there are things that we can do to help patients in the hospital
我们可以采取措施帮助住院病人
have a dramatically lower rate of developing staph infections.
显著降低金黄色葡萄球菌的感染率
So for example, daily chlorhexidine baths
例如当病人在重症病房时
when they’re in the Intensive Care Units.
每天用洗必太来洗澡
While there have been setbacks in terms of
虽然我们在新的流行病学
new epidemiology, new outbreaks, the crisis.
新的疫情以及危机方面遇到了挫折
There’s a lot of reason to have a good deal of optimism as well,
但我们也有新的药物 对疾病有更深入的了解
in terms of new drugs and better understanding.
因此我们有理由保持乐观态度

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视频概述

葡萄球菌如何感染人类?目前对抗药菌的研究情况如何?

听录译者

收集自网络

翻译译者

Spencer

审核员

审核员MS

视频来源

https://www.youtube.com/watch?v=uOZNGvZo5Bs

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