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1、The spread of superbugs超级病菌肆虐What can be done about the rising risk of antibiotic resistance？抗生素耐药性的危机不断增加，我们能做些什么呢？ON DECEMBER 11th 1945, at the end of his Nobel lecture, Alexander Fleming sounded a warning. Flemings chance observation of the antibiotic effects of a mould called Penicillium on one
2、of his bacterial cultures had inspired his co-laureates, Howard Florey and Ernst Chain, two researchers based in Oxford, to extract the moulds active principal and turn it into the miracle cure now known as penicillin. But Fleming could already see the future of antibiotic misuse. “There is the dang
3、er”, he said, “that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”1945 年 12 月 11 日，在其诺贝尔获奖演说尾声，亚历山大弗莱明（Alexander Fleming）向世人发出了警告。他在观某一实验菌落时偶然发现了青霉菌的(霉菌的一种) 抗菌作用。正是这一发现启发了与他一同获奖的霍华德. 弗劳雷(Howard Florey)和恩斯特.钱恩(Erns
4、t Chain)(两名牛津大学的研究员)，他们提取出这种霉菌中的有效物质并制成了具有奇迹般治疗效果的青霉素。但是，弗莱明可能已经预料到了抗生素的滥用，他说：“不知情的人很可能会服用不足剂量的抗生素，这不仅杀不死细菌，反倒会使他们产生抗性，这是非常危险的。 ”Penicillin and the other antibiotics that its discovery prompted stand alongside vaccination as the greatest inventions of medical science. Yet Flemings warning has always
5、 haunted them. Antibiotic resistance has now become a costly and dangerous problem. Some people fear there may be worse to come: that a strain of resistant bacterium might start an epidemic for which no treatment was available. Yet despite Flemings warning and despite a fair understanding of the cau
6、ses of resistance and how they could be dealt with, dealing with them has proved elusive. Convenience, laziness, perverse financial incentives and sheer bad luck have conspired to nullify almost every attempt to stop the emergence of resistance.青霉素以及此后发现的各种抗生素与预防注射一起并称医学界最重要的发现。然而弗莱明的警告却让人无法释怀。抗生素抗药
7、性不仅代价高昂，也非常危险。一些人担心还会有更糟糕的事情发生：某一品种的抗药细菌可能导致一种无法治愈的疾病。尽管弗莱明发出了警告，人们了解抗生素抗药性的起因，也知道怎么应对这一问题，对抗抗生素抗药性仍然困难重重。在贪图方便，过于懒惰的生活态度，错误的财政刺激措施以及纯粹的背运共同阻碍之下，人类所有抗击抗药性的努力都功亏一篑。There are good reasons to hope that the extreme threat of a resistant epidemic will never come to passnot least that 65 years of routine
8、antibiotic use have failed to prompt one. Even so, the lesser problems of resistance continue to gnaw away at medicine, hurting people and diverting resources from more productive uses, often in the countries that can least afford it.人们有理由希望抗药疾病所带来的极端威胁将永不发生,特别是 65 年来人们习惯性的使用抗生素，而这种疾病并未产生。即使如此，抗药性所导
9、致的一些次要问题正在损害人们的健康并使药物得不到充分利用，这通常发生在那些无力承担的国家之中。Irresistible无法抵御之势Convenience and laziness top the list of causes of antibiotic resistance. That is because those who misuse these drugs mostly do not pay the cost. Antibiotics work against bacteria, not viruses, yet patients who press their doctors to
10、prescribe them for viral infections such as colds or influenza are seldom harmed by their self-indulgence. Nor are the doctors who write useless prescriptions in order to rid their surgeries of such hypochondriacs. The hypochondriacs can, though, act as breeding grounds for resistant bacteria that m
11、ay infect others. Even when the drug has been correctly prescribed, those who fail to finish the course are similarly guilty of promoting resistance. In some parts of the world, even prescription is unnecessary. Many antibiotics are bought over the counter, with neither diagnosis nor proper recommen
12、dations for use, multiplying still further the number of human reaction vessels from which resistance can emerge. 贪图方便和过于懒惰在导致抗生素抗药性的原因中高居榜首。因为大多误用抗生素的人无需承担风险。抗生素只对细菌起作用，而非病毒。虽然那些因病毒感染而患上感冒或流感的病人经常要求医生给他们开抗生素，但他们很少因为这一放纵行为受太大影响。那些开了无用处方，打发无事臆想的病人的医生也无须负责。但是这种心理却为抗药细菌的产生提供了机会，使其可以波及更多的人。即便处方正确，那些不遵照医
13、嘱的人也难逃罪责。无需诊断或正确建议，人们就可以在柜台买到抗生素，不断增长的人口也为这些抗药病菌提供了滋生场所。Nor is the problem confined to people. Analysing official figures, Louise Slaughter, an American congresswoman who is also a microbiologist, calculates that four-fifths of the antibiotics used in America are given to livestock, often to get per
14、fectly healthy animals to grow faster. That is convenient, because it produces cheaper meat, but it creates yet more opportunities for bugs to evolve resistance.这一问题不仅发生在人身上。身为微生物学家的美国议员 Louise Slaughter 通过分析官方数据发现，美国有 80%的抗生素用于牲畜，目的是使一些健康情况良好的牲畜加速生长。虽然此举简单易行，也可以降低成本，但这却为病菌进化出抗药性提供了机会。All this matte
15、rs because antibiotic resistance has both medical and financial costs. It causes longer and more serious illnesses, lengthening peoples stays in hospital and complicating their treatment. Sometimes people die unnecessarily. In one study, which sampled almost 1,400 patients at Cook County hospital in
16、 Chicago, researchers found resistant strains of bacteria infecting 188 people, 12 of whom died because they could not be treated adequately. At the moment, resistant bacteria threaten mostly children, the old, cancer patients and the chronically ill (especially those infected with HIV). However, there could be worse to come. Nearly 450,000 new cases of multidrug-resistant tuberculosis are recorded each year; one-third of these people die from the disease. More than a quarter of new
