Levy Stuart B
Departments of Molecular Biology and Microbiology and of Medicine, Tufts University School of Medicine, Boston, Massachusetts 02111.
J Food Prot. 1987 Jul;50(7):616-620. doi: 10.4315/0362-028X-50.7.616.
Antibiotics have successfully treated infectious diseases in man, animals and agricultural plants. However, one consequence of usage at any level, subtherapeutic or therapeutic, has been selection of microorganisms resistant to these valuable agents. Today clinicians worldwide face singly resistant and multiply resistant bacteria which complicate treatment of even common infectious agents. This situation calls for a critical evaluation of the numerous ways in which antibiotics are being used so as to evaluate benefits and risks. About half of the antibiotics produced in the United States arc used in animals, chiefly in subtherapeutic amounts for growth promotion. This usage is for prolonged periods leading to selection of multiply-resistant bacteria which enter a common environmental pool. From there, resistance determinants from different sources spread from one bacterium to another, from one animal host to another, from one area to another. The same resistance determinants have been traced to many different genera associated with humans, animals and foods where they pose a continued threat to public health. Since alternative measures for growth promotion, such as antimicrobials which are not used for human therapy and which do not select for multiple-resistances are available, their use, instead of antibiotics, would remove a major factor contributing to the environmental pool of transferable resistance genes.
抗生素已成功治疗人类、动物和农作物的传染病。然而，无论在亚治疗水平还是治疗水平使用抗生素，都会产生一个后果，即选择出对这些宝贵药物具有抗性的微生物。如今，全球临床医生都面临着单一耐药和多重耐药的细菌，这使得即使是常见传染病原体的治疗也变得复杂。这种情况需要对使用抗生素的众多方式进行批判性评估，以权衡利弊。美国生产的抗生素约有一半用于动物，主要是以亚治疗剂量用于促进生长。这种使用方式持续时间很长，导致选择出多重耐药细菌，这些细菌进入一个共同的环境库。从那里，来自不同来源的耐药决定因子从一种细菌传播到另一种细菌，从一个动物宿主传播到另一个动物宿主，从一个地区传播到另一个地区。相同的耐药决定因子已被追踪到与人类、动物和食物相关的许多不同属，它们对公众健康构成持续威胁。由于有促进生长的替代措施，如不用于人类治疗且不会选择多重耐药性的抗菌剂，使用这些替代措施而非抗生素，将消除导致可转移耐药基因环境库的一个主要因素。
