Consultant, WHO African Partnerships for Patient Safety, 9 rue de la Terrasse, 94000 Créteil, France.
Antimicrob Resist Infect Control. 2012 Feb 14;1(1):11. doi: 10.1186/2047-2994-1-11.
Resistance to antibiotics has increased dramatically over the past few years and has now reached a level that places future patients in real danger. Microorganisms such as Escherichia coli and Klebsiella pneumoniae, which are commensals and pathogens for humans and animals, have become increasingly resistant to third-generation cephalosporins. Moreover, in certain countries, they are also resistant to carbapenems and therefore susceptible only to tigecycline and colistin. Resistance is primarily attributed to the production of beta-lactamase genes located on mobile genetic elements, which facilitate their transfer between different species. In some rare cases, Gram-negative rods are resistant to virtually all known antibiotics. The causes are numerous, but the role of the overuse of antibiotics in both humans and animals is essential, as well as the transmission of these bacteria in both the hospital and the community, notably via the food chain, contaminated hands, and between animals and humans. In addition, there are very few new antibiotics in the pipeline, particularly for Gram-negative bacilli. The situation is slightly better for Gram-positive cocci as some potent and novel antibiotics have been made available in recent years. A strong and coordinated international programme is urgently needed. To meet this challenge, 70 internationally recognized experts met for a two-day meeting in June 2011 in Annecy (France) and endorsed a global call to action ("The Pensières Antibiotic Resistance Call to Action"). Bundles of measures that must be implemented simultaneously and worldwide are presented in this document. In particular, antibiotics, which represent a treasure for humanity, must be protected and considered as a special class of drugs.
在过去的几年中，抗生素的耐药性急剧增加，现在已经达到了使未来的患者面临真正危险的程度。像大肠杆菌和肺炎克雷伯菌这样的微生物，它们既是人类和动物的共生菌，也是病原体，对第三代头孢菌素的耐药性越来越强。此外，在某些国家，它们也对碳青霉烯类抗生素耐药，因此仅对替加环素和黏菌素敏感。耐药性主要归因于位于移动遗传元件上的β-内酰胺酶基因的产生，这使得它们能够在不同物种之间转移。在某些罕见情况下，革兰氏阴性杆菌几乎对所有已知的抗生素都有耐药性。原因很多，但抗生素在人类和动物中的过度使用是至关重要的，此外，这些细菌在医院和社区中的传播也很重要，特别是通过食物链、受污染的手以及动物和人类之间的传播。此外，新抗生素的研发非常少，尤其是针对革兰氏阴性杆菌的抗生素。革兰氏阳性球菌的情况略好一些，因为近年来已经有一些有效的新型抗生素问世。急需制定一项强有力的、协调一致的国际方案。为了应对这一挑战，70 名国际公认的专家于 2011 年 6 月在法国昂西举行了为期两天的会议，会议认可了一项全球性的行动呼吁（“《彭西耶抗生素耐药性行动呼吁》”）。该文件提出了必须同时在全球范围内实施的一整套措施。特别是，抗生素作为人类的宝贵财富，必须得到保护，并被视为一种特殊类别的药物。
