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抗菌药物耐药性:应对微生物挑战日益加剧的行动。

Antimicrobial resistance: action to combat the rising microbial challenges.

机构信息

Intensive Care Unit, Nicosia General Hospital, 22 Athinon Street, Latsia 2222, Nicosia, Cyprus.

出版信息

Int J Antimicrob Agents. 2013 Jun;42 Suppl:S25-8. doi: 10.1016/j.ijantimicag.2013.04.007. Epub 2013 May 16.

Abstract

Antimicrobial therapy transformed medical practice from a merely diagnosis-focused approach 80 years ago to a treatment-focused approach, saving millions of lives in the years to follow. Today, numerous medical advances made possible by effective antibiotics are being threatened by the relentlessly rising rates of bacteria resistant to all currently available antibiotics. This phenomenon is a consequence of antibiotic misuse, which exerts undue selective pressure on micro-organisms, combined with defective infection control practices that accelerate their spread. Its impact on societies worldwide is immense, resulting in loss of human life and money. An alarming pattern of resistance involving multidrug-resistant and sometimes pandrug-resistant Gram-negative bacteria is currently emerging. In response to the global public health threat posed by antimicrobial resistance (AMR), a number of national and international actions and initiatives have been developed in recent years to address this issue. Although the optimally effective and cost-effective strategy to reduce AMR is not known, a multifaceted approach is most likely to be successful. It should include actions aiming at optimising antibiotic use, strengthening surveillance and infection control, and improving healthcare worker and public education with regard to antibiotics. Research efforts to bring new effective antibiotics to patients need to be fostered in order to negate the consequences of the current lack of antimicrobial therapy options. A holistic view of AMR as well as intersectoral collaboration between human and veterinary medicine is required to best address the problem.

摘要

抗菌治疗在 80 年前将医学实践从单纯的诊断为中心转变为以治疗为中心,在随后的几年中挽救了数百万人的生命。如今,由于有效抗生素的许多医学进步受到所有现有抗生素耐药细菌的比率不断上升的威胁。这种现象是抗生素滥用的结果,它对微生物施加了不当的选择性压力,再加上有缺陷的感染控制措施加速了它们的传播。它对世界各国社会的影响是巨大的,导致生命和金钱的损失。目前,一种涉及多药耐药甚至泛耐药革兰氏阴性细菌的令人震惊的耐药模式正在出现。为应对抗菌药物耐药性(AMR)对全球公共卫生构成的威胁,近年来制定了一些国家和国际行动和倡议来解决这一问题。尽管降低 AMR 的最佳有效和具有成本效益的策略尚不清楚,但多方面的方法最有可能取得成功。它应包括旨在优化抗生素使用、加强监测和感染控制以及提高医护人员和公众对抗生素的教育的行动。需要促进为患者带来新的有效抗生素的研究工作,以抵消目前缺乏抗菌治疗选择的后果。需要从整体上看待 AMR,并在人类医学和兽医医学之间开展部门间合作,以最佳地解决这一问题。

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