Munro Nancy
Nancy Munro is Senior Acute Care Nurse Practitioner, Critical Care Medicine Department, National Institutes of Health, 10 Center Dr, Bldg 10-CRC Room 3-3677, Bethesda, MD 20892 (
AACN Adv Crit Care. 2015 Jul-Sep;26(3):225-30; quiz 231-2. doi: 10.1097/NCI.0000000000000102.
The health care system is challenged by another serious issue: antimicrobial resistance. Clostridium difficile is the most common infection in health care institutions and is becoming resistant to standard treatment. Carbapenem-resistant enterobacteriaceae can be found in almost every state in the United States. Confounding the antimicrobial resistance issue is the fact that few new antimicrobials are being developed by pharmaceutical companies. The situation is so critical that the White House issued a strategic plan in September 2014 to deal with antimicrobial resistance. One challenge in that plan is to better understand how microbes have become resistant. Microbes have developed defense mechanisms such as bacteriophages and bacteriocins to survive for thousands of years. If science can start to use these mechanisms to help combat resistant organisms in combination with antimicrobials and strong epidemiological interventions, the battle against antimicrobial resistance may succeed.
抗菌药物耐药性。艰难梭菌是医疗机构中最常见的感染病菌，并且正变得对标准治疗产生耐药性。耐碳青霉烯类肠杆菌科细菌在美国几乎每个州都能发现。使抗菌药物耐药性问题更为复杂的是，制药公司几乎没有研发新的抗菌药物。形势如此严峻，以至于白宫在2014年9月发布了一项应对抗菌药物耐药性的战略计划。该计划中的一项挑战是更好地了解微生物是如何产生耐药性的。微生物已经进化出诸如噬菌体和细菌素等防御机制，以存活数千年。如果科学界能够开始利用这些机制，结合抗菌药物和强有力的流行病学干预措施来对抗耐药生物，那么对抗抗菌药物耐药性的战斗可能会取得成功。
