并非危言耸听,抗生素耐药性可能导致现代医学的终结

2017-06-12 佚名 生物探索

“世界正走向一个后抗生素时代,在这个时代,普通的感染可能会再次致命。如果目前的趋势继续下去,复杂的医疗干预措施,如器官移植、关节置换、癌症化疗和照顾早产儿,将会变得十分困难危险。这甚至可能导致现代医学的终结。”

“世界正走向一个后抗生素时代,在这个时代,普通的感染可能会再次致命。如果目前的趋势继续下去,复杂的医疗干预措施,如器官移植、关节置换、癌症化疗和照顾早产儿,将会变得十分困难危险。这甚至可能导致现代医学的终结。”

这是世界卫生组织总干事陈冯富珍去年4月在联合国发表演讲时所说的话。她再次提醒人们,抗生素耐药性问题已经成为当今全球卫生面临的最大威胁之一。

这并非危言耸听。全世界的抗生素药效正在快速衰弱,能用来治疗感染的药物越来越少。如果任其发展,最终我们会发现没有任何抗生素能对抗那些超级细菌。一个小小的擦伤可能就会导致死亡。

好在,全世界都意识到了这个问题。许多组织、政府和忧心忡忡的公民都在努力防止这种情况发生。然而,这个问题极其复杂和广泛。并且,由于细菌的特质,细菌工作的方式以及我们已经造成的破坏,人类将永远不能完全消除抗生素耐药性。

什么是抗生素耐药性?

和人类一样,细菌也有DNA。当我们使用抗生素杀死细菌时,在某些情况下,这些细菌可以自发地突变基因以响应外界刺激,改变自身构造,从而使抗生素不能杀死它们。并且,细菌可以通过杂交将这些耐药基因传递给其他菌种,而这些具有耐药性的细菌不仅能在宿主体内传播,也能从一种生物传播到另一种生物。


近年来,全球抗生素消费量增长了30%。图片来源:BBC

这个问题有多严重?

根据美国疾病预防控制中心(CDC)估计,仅在美国,每年就有大约23,000人死于抗生素耐药性感染。

与此同时,2015年发表在《自然》杂志上的一项研究发现,2000年至2010年间,全球抗生素消费量增长了30%。

而根据世界卫生组织(WHO)的估计,仅肺结核,全世界就有大约48万人感染了耐药菌株。2014年,WHO估计有3.3%的结核病新病例对多种药物有耐药性,在复发病例中,有20%的人具有耐药性。

英国公共卫生组织的报告说,“英国政府认为抗生素耐药性的威胁与流感大流行和大洪水一样严重。”如果任其发展,到2050年抗生素耐药性可能将导致全世界1000万人死亡,£6600万经济损失。

我们为何会落到这个地步?

答案很简单——人类过度使用抗生素。

几十年来,医生将抗生素开给那些但凡提出要求的患者(不管他们是否真的需要),一些国家仍然认为抗生素是非处方药,各国对抗生素的态度差异甚至已经成了一种文化现象,而并非与疾病有关。

最重要的是,几十年来,全世界范围内的畜牧业向家畜和食用动物提供了大量的抗生素,不仅是为了减少感染,也成为一种增加产量的方法。因此,即使人类不主动摄取抗生素,也会吸收并加工这些食用动物体内的细菌。如果它们携带耐药菌,那我们也难逃一劫。

怎样做才能摆脱这种状况?

两年前,WHO在世界卫生大会由各国共同签署并正式发布了“控制细菌耐药全球行动计划”,而在今年5月,20国集团领导人也签署了一份包括应对抗生素耐药性在内的全球卫生宣言。这都标志着全世界已经加入到了对抗耐药菌的行列中。

CDC也正与美国医院密切合作,为安全合理的抗生素处方提供指导和教育。目前,这些工作取得了一些进展,医生已经逐渐减少了开给患者的抗生素处方。

接下来就是改变农业相关的规章制度。十年前,欧盟禁止抗生素作为生长促进剂。就在今年1月,FDA宣布新的畜用抗生素规则生效。新规则彻底禁止使用任何被认为“医用”的抗生素来帮助动物增重,规则还要求药物只有在动物实际生病时才能在兽医的监督下用于动物。

此外,应对耐药性的一个重要步骤就是进行追踪。CDC建立了一个国家抗菌监测系统(NARMS)。研究人员监测感染负荷和耐药类型,从而更好地制定预防耐药性的决策。

最后,鼓励新抗生素的开发也十分重要。

美国国家卫生研究院和生物医学高级研究与发展管理局已经建立了一个名为CARB-X的生物制药加速器。该基金拨出4800万美元用于支持抗生素药物开发项目。

随着这些计划协同工作,以及全世界人类对耐药性给予的高度关注。人类人就有希望克服这个问题。但是,我们只能减缓耐药性的发展,却不能完全制止。只要有人类和人类携带并传播的细菌存在,我们就要永远与耐药性斗争。

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    2017-06-12 哈夫

    我们吃的肉肉类可都是抗生素养大的!

    0

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    2017-06-12 raymi

    抗生素确实需要严格管理

    0

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    2017-06-12 139****5926

    好文章学习了

    0

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