新闻周刊:对抗耐药菌(1)（在线收听）

From Cover

来源于《封面》

The Death of Antibiotics: We’re Running Out of Effective Drugs to Fight Off an Army of Superbugs

抗生素的死亡：我们正在耗尽对抗超级细菌大军的有效药物

By David H. Freedman

作者：戴维·H.弗里德曼

In January, Columbia University revealed that four patients at its Irving Medical Center in New York had been sick with an unusual version of E. coli, a common gut bacterium. Although the news largely escaped attention in the media, it ricocheted through the world of infectious disease experts. E. coli is a relatively common bacterium and benign when it's in the gut, where it usually lives, but in the wrong places—such as in lettuce or ground beef, or our bloodstream—it can turn deadly. When antibiotics prove ineffective against an E. coli infection, as many as half the patients with it die within two weeks.

今年1月，哥伦比亚大学披露，其位于纽约欧文医学中心的四名患者感染了一种不同寻常的大肠杆菌，这是一种常见的肠道细菌。尽管这条消息在很大程度上没有引起媒体的注意，但它却在传染病专家的圈子里引起了轩然大波。大肠杆菌是一种相对常见的细菌，当它生活在肠道时是良性的，但在错误的地方，比如生菜、碎牛肉或我们的血液中，它可能会致命。当抗生素被证明对大肠杆菌感染无效时，多达一半的患者会在两周内死亡。

That's exactly why the Columbia E. coli was so worrying. Over the past decade or two, E. coli has developed resistance to one antibiotic after another. For some infected patients, their last hope is the antibiotic colistin, a toxic substance with potential side effects that include kidney and brain damage. The Columbia E. coli had a mutation in a gene, MCR-1, that confers a terrifying attribute: imperviousness to colistin.

这正是哥伦比亚大肠杆菌如此令人担忧的原因。在过去的一二十年里，大肠杆菌对一种又一种抗生素产生了抗药性。对一些受感染的病人来说，他们最后的希望是抗生素粘菌素，这是一种有潜在副作用的有毒物质，包括肾脏和大脑损伤。哥伦比亚大肠杆菌的一种基因发生了突变，即MCR-1，这给它带来了一个可怕的特性:粘菌素的不渗透性。

“We're looking to the shelf for the next antibiotic, and there's nothing there,” says Erica Shenoy, associate chief of the infection control unit at Massachusetts General Hospital. “We're facing the specter of patients with infections we can't treat.”

“我们正在货架上寻找下一种抗生素，但那里什么都没有，”马萨诸塞州总医院感染控制部门的副主任艾丽卡·谢诺说。“我们面临着感染我们无法治疗的病人的幽灵。”

Ever since an experimental miracle drug called penicillin was rushed to a Boston hospital in 1942 to save the lives of 13 victims of a nightclub fire, medical researchers have discovered more than 100 new antibiotics. We've needed each and every one of them—and they're not enough. It's not just E. coli. Drug-resistant strains of Staphylococcus, Enterobacteriaceae and Clostridium difficile have been steadily overcoming antibiotics; one study found that the number of deaths due to resistant infections quintupled between 2007 and 2015. Recently, treatment-resistant versions of the fungus Candida auris have shown up in hospitals in New York City and Chicago, killing half of infected patients.

1942年，一种名为盘尼西林的实验性神奇药物被紧急送往波士顿一家医院，以挽救夜总会火灾中13名受害者的生命。自那以来，医学研究人员已经发现了100多种新的抗生素。我们需要这些抗生素，但还远远不够。不仅仅是大肠杆菌。葡萄球菌、肠杆菌科、艰难梭菌等耐药菌株稳步战胜抗生素；一项研究发现，2007年至2015年间，死于耐药感染的人数翻了五倍。最近，耐治疗的真菌念珠菌出现在纽约和芝加哥的医院，杀死了一半的感染者。