到2050年,将有1000万人死于抗生素耐药!

2017-06-10 陈年老刘 医学界消化频道

如果目前的情况得不到改善,到2050年全球每年将有1000万人因抗生素耐药而死亡。

6月8日下午,国内耐药防控领域首个跨专业跨学科的专业学会“上海市微生物学会微生物耐药防控专委会”正式成立。专委会的成立迈出了抑制细菌耐药多学科合作的重要一步,更填补了国内耐药防控没有一个跨专业跨学科专业学会的空白。

专委会成立会议上,抗生素耐药对临床治疗的挑战引起与会专家的担忧,抑制细菌耐药迫在眉睫。

“后抗生素时代”来了!

抗生素被誉为“20世纪医药领域最伟大的成就之一”

1928年结束休假返回伦敦圣玛丽医院工作后,微生物学家亚历山大?弗莱明意外发现霉菌的一种分泌物能够抑制葡萄球菌的生长,亚历山大?弗莱明把这种分泌物称为“盘尼西林”,也正是这种分泌物在后来的二战中拯救了无数士兵的生命。随着抗生素的发现,人们天真的认为,未来感染疾病的治疗将轻而易举,现实却给了人类狠狠的一巴掌。

越来越多种类的抗生素被发现和使用,感染性疾病却并没有如人类想的那样轻易被打败。致病菌超强的进化能力远远超出了人类的想象,耐药菌、多重耐药菌、超级细菌不断的冲击抗生素所铸就的防线,“后抗生素时代”来了。

中国抗生素一年使用16.2万吨,占到全世界使用量的一半

据瑞金医院临床微生物科、医院感染预防管理科主任倪语星教授介绍,近十年来全球抗生素的使用量增长了36%,2013年中国抗生素一年使用16.2万吨,占到全世界使用量的一半,其中52%应用于畜牧业,48%应用于临床。全世界住院患者使用抗菌药物比例约30%,中国尤其高,占到80%~90%。



全球抗生素使用报告  来源:Nature

伴随而来的是细菌的耐药性快速流行,金黄色葡萄球菌对甲氧西林、肠球菌对万古霉素、铜绿假单胞菌对亚胺培南、不动杆菌对亚胺培南、念珠菌对伏立康唑……同时,由于新药研发难度的增加,研发成本提高,廉价药难以盈利等原因,新药研发逐年减少、枯竭。

到2050年全球每年将有1000万人因此死亡

“中国是世界上抗生素滥用最严重的国家”,倪语星教授说,在中国细菌整体的耐药率要远远高于欧美国家,大约在45%左右。中国每年有超过8万人因耐药性死亡。英国Jim O’Neill发表的《全球抗菌药物耐药回顾》估计,如果目前的情况得不到改善,到2050年全球每年将有1000万人因此死亡,损失GDP100万亿美元,中国每年将有100万人因此死亡,损失GDP20万亿美元。



2050年抗生素耐药每年致死人数数据 来源:Jim O’Neill

细菌还在不断的进化,如果耐多粘菌素细菌和同能抵抗其他抗生素的细菌一旦结合起来,演变出能够对抗所有抗生素的“超级细菌”,那攻破抗生素的最后一道防线或许只是时间问题了。

“后抗生素时代”我们不能无所作为!

近年来,政府先后出台了《药品管理法》、《处方管理办法》等多项法律法规和政策措施;还发布了《抗菌药物临床应用指导原则》、《国家抗微生物治疗指南》等技术性文件;2016年14个部委联合发布了遏制细菌耐药国家行动计划和白皮书,并确定了2016年~2020年六大工作目标。

(1)争取研发上市全新抗菌药物1~2个,新型诊断仪器设备和试剂5~10项;

(2)零售药店凭处方销售抗菌药物的比例基本达到全覆盖。省(区、市)凭兽医处方销售抗菌药物的比例达到50%;

(3)健全医疗机构、动物源抗菌药物应用和细菌耐药监测网络;建设细菌耐药参比实验室和菌种中心;建立医疗、养殖领域的抗菌药物应用和细菌耐药控制评价体系;

(4)全国二级以上医院基本建立抗菌药物临床应用管理机制;医疗机构主要耐药菌增长率得到有效控制;

(5)人兽共用抗菌药物或易产生交叉耐药性的抗菌药物作为动物促生长应用逐步退出;动物源主要耐药菌增长率得到有效控制;

(6)对全国医务人员、养殖一线兽医和养殖业从业人员完成抗菌药物合理应用培训;全面实施中小学抗菌药物合理应用科普教育;开展抗菌药物合理应用宣传周。

而我们也意识到,遏制细菌耐药迫切需要加强多部门多领域协同谋划,共同应对,上海市微生物学会微生物耐药防控专委会应运而生。

未来专委会将以遏制微生物耐药为共同目标,下一步计划通过积极宣传遏制微生物耐药、合理使用抗菌药物的理念,普及科学知识,举办关于抗菌药物合理使用的系列宣传活动,提高各专业人员和民众合理用药的自觉性。并加大与各领域、跨学科专家在新型抗菌药物研发、微生物快速、精准检测技术开发、感染性疾病防控、细菌耐药性监测、细菌耐药机制研究等多领域的交流与合作。同时努力办好每年一次的“上海微生物耐药防控国际论坛”以及“eMIC”细菌耐药监测掌上移动平台。

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    2017-06-12 杨利洪

    学习了,应该引起重视

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1441636, encodeId=dbd21441636ac, content=<a href='/topic/show?id=64655544106' target=_blank style='color:#2F92EE;'>#抗生素耐药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55441, encryptionId=64655544106, topicName=抗生素耐药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1cac4876897, createdName=12498bf3m26暂无昵称, createdTime=Mon Jun 12 14:20:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209648, encodeId=15f5209648f8, content=学习了,应该引起重视, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Mon Jun 12 06:29:39 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209614, encodeId=8cd820961453, content=这么大的数目,太吓人了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2SEXGDldsNfP4rKvY7vJmaHcyvLXicuyaCTJtVOkX3jvd6DwNMD88hDjJwsU7MnUH6zeqC4zt3yGV/0, createdBy=4e701628585, createdName=flyingzyx, createdTime=Mon Jun 12 05:54:11 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209463, encodeId=30c320946354, content=高级领导和资本家没事。。他们吃特供, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/03/49a8b8e59b1110232178c436948997ae.jpg, createdBy=90151681386, createdName=哈夫, createdTime=Sun Jun 11 17:35:00 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209269, encodeId=3575209269d4, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00501987275, createdName=130****4638, createdTime=Sun Jun 11 08:05:50 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209258, encodeId=9b01209258ab, content=学习了,, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sun Jun 11 07:51:26 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209246, encodeId=8d522092464d, content=形势严峻呀, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jun 11 07:40:08 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209178, encodeId=bf002091e812, content=专家们要不要计算一下?如果从今天起禁止使用所有抗菌素,那么2050年会有多少人死亡???, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36431584645, createdName=wwjxx, createdTime=Sun Jun 11 06:17:24 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209146, encodeId=538920914606, content=原来如此。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Sun Jun 11 00:22:53 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-12 flyingzyx

    这么大的数目,太吓人了。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1441636, encodeId=dbd21441636ac, content=<a href='/topic/show?id=64655544106' target=_blank style='color:#2F92EE;'>#抗生素耐药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55441, encryptionId=64655544106, topicName=抗生素耐药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1cac4876897, createdName=12498bf3m26暂无昵称, createdTime=Mon Jun 12 14:20:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209648, encodeId=15f5209648f8, content=学习了,应该引起重视, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Mon Jun 12 06:29:39 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209614, encodeId=8cd820961453, content=这么大的数目,太吓人了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2SEXGDldsNfP4rKvY7vJmaHcyvLXicuyaCTJtVOkX3jvd6DwNMD88hDjJwsU7MnUH6zeqC4zt3yGV/0, createdBy=4e701628585, createdName=flyingzyx, createdTime=Mon Jun 12 05:54:11 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209463, encodeId=30c320946354, content=高级领导和资本家没事。。他们吃特供, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/03/49a8b8e59b1110232178c436948997ae.jpg, createdBy=90151681386, createdName=哈夫, createdTime=Sun Jun 11 17:35:00 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209269, encodeId=3575209269d4, content=学习了谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00501987275, createdName=130****4638, createdTime=Sun Jun 11 08:05:50 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209258, encodeId=9b01209258ab, content=学习了,, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sun Jun 11 07:51:26 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209246, encodeId=8d522092464d, content=形势严峻呀, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jun 11 07:40:08 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209178, encodeId=bf002091e812, content=专家们要不要计算一下?如果从今天起禁止使用所有抗菌素,那么2050年会有多少人死亡???, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36431584645, createdName=wwjxx, createdTime=Sun Jun 11 06:17:24 CST 2017, time=2017-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=209146, encodeId=538920914606, content=原来如此。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=28d72072417, createdName=我是谁??, createdTime=Sun Jun 11 00:22:53 CST 2017, time=2017-06-11, status=1, ipAttribution=)]
    2017-06-11 哈夫

    高级领导和资本家没事。。他们吃特供

    0

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    2017-06-11 130****4638

    学习了谢谢分享。

    0

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    2017-06-11 131****1460

    学习了,

    0

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    2017-06-11 changjiu

    形势严峻呀

    0

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    2017-06-11 wwjxx

    专家们要不要计算一下?如果从今天起禁止使用所有抗菌素,那么2050年会有多少人死亡???

    0

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    2017-06-11 我是谁??

    原来如此。。。。。。

    0

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