新闻周刊:对抗耐药菌(3)（在线收听）

Medical experts are pinning their hopes on entirely new strategies for dealing with infection. To find novel ways of killing bugs, they're looking in exotic places—in viruses and fish slime and even on other planets. They're using insights gained in genomics and other fields to come up with new technologies to kill bugs and keep them from spreading. And they are re-examining practices in hospitals and other spreading-grounds for bacteria, putting in place more holistic strategies for managing the bacteria in our bodies and in our hospitals and doctors' offices.

医学专家把希望寄托在应对感染的全新策略上。为了找到杀死细菌的新方法，他们在奇异的地方寻找——病毒和鱼胶，甚至在其他星球上。他们利用从基因组学和其他领域获得的洞见，提出了杀死细菌并阻止它们传播的新技术。他们正在重新检查医院和其他细菌传播场所的做法，制定更全面的策略来管理我们体内、医院和医生办公室的细菌。

The alternatives sound promising, but they are far off. It's not clear that we can invent new weapons before the superbugs, like a zombie army at the gates, overwhelm our defenses.

其他选择听起来很有希望，但它们还很遥远。目前还不清楚我们能否在超级细菌(如同门口的僵尸大军)击溃我们的防御系统之前发明出新的武器。

“We need to make a huge investment in other approaches,” says Margaret Riley, a drug-resistance researcher at the University of Massachusetts. “And we need to make it 15 years ago.”

“我们需要在其他方法上进行巨额投资，” 马萨诸塞大学的耐药性研究员玛格丽特·莱利表示。“我们需要在15年前做到这一点。”

The New Bug-Hunters

新的漏洞发现者

Part of the problem with drug resistance is that microbes evolve with alarming speed into new species. Whereas a human needs 15 or more years to mature enough to have offspring, microbes like E. coli reproduce every 20 minutes. In a few years, they can go through evolutionary change that would have taken humankind millions of years to accomplish—change that can include acquiring genetic attributes that allow them to withstand drugs. A human on antibiotics is the perfect lab for developing resistant microbes. “Research shows that whenever a new antibiotic comes into use, we start to see the first resistant microbes emerge about a year later,” says Mass General's Shenoy.

耐药性的部分问题在于微生物以惊人的速度进化成新物种。人类需要15年或更长时间才能成熟到有后代，而像大肠杆菌这样的微生物每20分钟就繁殖一次。几年之内，它们就能完成人类需要数百万年才能完成的进化变化——包括获得能够抵抗药物的基因属性。服用抗生素的人是培养耐药微生物的完美实验室。“研究表明，每当一种新的抗生素开始使用，我们就会在大约一年后开始看到第一批耐药微生物出现，”马萨诸塞综合医院的谢诺伊如此表示。

There's little in the pharmaceutical pipeline to replace the antibiotics to which bugs are becoming resistant. That's because development of a new antibiotic runs about $2 billion and takes about 10 years—with little hope of ending up with the sort of blockbuster drug that justifies such an investment. “The point of having a new antibiotic would be to use it as infrequently as possible, for as short a time as possible,” says Jonathan Zenilman, chief of the division of infectious diseases at Johns Hopkins Bayview Medical Center in Baltimore. “Why would a pharma company want to develop a drug for a market like that?”

在药物研发过程中，几乎没有什么东西可以替代细菌变得具有耐药性的抗生素。这是因为一种新型抗生素的研发耗资约20亿美元，耗时约10年，几乎不可能研制出能够证明这种投资合理的畅销药物。“拥有一种新的抗生素的意义在于尽可能少地使用它，使用的时间尽可能短，”巴尔的摩约翰霍普金斯湾景医疗中心传染病科主任乔纳森泽尼曼说。“制药公司为什么要为这样的市场开发药物呢？”