Werner G H
Membre Associé Libre de l'Académie nationale de Pharmacie.
Ann Pharm Fr. 2001 Jul;59(4):246-77.
In the first part of this review, AIDS, prion diseases, Hantavirus and arbovirus infections, Ebola hemorrhagic fever, legionellosis, hepatitis C, enterotoxigenic Escherichia coli infections, Lyme disease, tuberculosis have provided alarming examples of emerging or reemerging infectious diseases. In this second part, the stress is placed on the reemergence of diphtheria and of serious streptococcal infections, on bartonelloses, Chlamydia infections, fungal infections, while malaria and cholera are still prevalent in several areas. The increasing resistance of too many pathogens to antimicrobial agents is a major source of concern, directly related to the challenge of nosocomial infections. An infectious cause has been demonstrated (or strongly suspected) for various diseases and the scope of infectiology keeps widening, while the threat of bioterrorism cannot be neglected. The causes of the emergence or reemergence of infectious diseases are multiple and diverse, often in direct relation with human activities (population migrations, changes in husbandry or farming practices, worldwide exchanges of goods and foods, inadequate uses of antibiotics) but also with climatic variations in several areas. The challenge represented by this unexpected comeback of infections to the forefront of human and animal pathology can only be met with a significant improvement of hygienic practices, cessation of certain dangerous behaviors and also, of course, with the development of novel antimicrobial molecules (acting on original targets) as well as of a whole series of new specific vaccines.
在本综述的第一部分,艾滋病、朊病毒病、汉坦病毒和虫媒病毒感染、埃博拉出血热、军团病、丙型肝炎、产肠毒素大肠杆菌感染、莱姆病、结核病已成为新发或再发传染病的惊人实例。在第二部分,重点关注白喉和严重链球菌感染的再度出现、巴尔通体病、衣原体感染、真菌感染,而疟疾和霍乱在多个地区仍然流行。太多病原体对抗菌药物的耐药性不断增加,这是一个主要的担忧来源,与医院感染的挑战直接相关。已证实(或强烈怀疑)各种疾病存在感染性病因,传染病学的范围不断扩大,同时生物恐怖主义的威胁也不容忽视。传染病出现或再发的原因多种多样,往往与人类活动(人口迁移、畜牧或耕作方式的变化、全球货物和食品交换、抗生素使用不当)直接相关,但也与一些地区的气候变化有关。要应对感染在人类和动物病理学前沿意外卷土重来所带来的挑战,只能通过显著改善卫生习惯、停止某些危险行为,当然,还需要开发新型抗菌分子(作用于原始靶点)以及一系列新的特异性疫苗。