娌℃绱界ュ锛杩ㄧ煎锛绱婊ョㄥ辨

绱婊ョㄥ辨猴璇ヤ璇ョ

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杩娌℃绱叉ㄥ勾浠ｏ绂绘浠苟涓ヨ灏ユ病绱ㄧュ锛涔宸茶ㄧ煎

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浜虹被诲涓涓や釜浼澶х杩浜绱浜

绱 绉藉姝荤浠┿瀹骞挎浣跨ㄥ府╀板浜夸汉娲诲撮垮锛村ュ悍惰锛浠朵瑕涓鸿绉浜轰负骞叉惰寰琛涓轰轰唬浠凤浜虹被瓒渚璧绱锛浣跨ㄥ瓒澶锛灏变村缁瀵瑰浠骇с绱杩搴娇ㄤ瀵硅韩浣浜璁稿涓濂界褰卞

绱у凡缁涓哄ㄤ绱ц揩ュ悍涔涓褰绱瀵规绉缁涓讹杩浜缁琚涓哄锋瀵硅绉绱с

涓浜剧璁や负不缁╃寰寰宸跺虫规璧蜂ㄣ杩30骞撮琚瑰涓甯版绱芥1985骞翠互у绉绫讳技┿澶х害40澶涓绱ㄤ复搴娴璇涓朵腑扮绉浠舵ゆ楹瑙

杩灏辨崇锛ㄤ涔灏ワ浜虹被涔璁稿娌℃ㄧ绱锛村浜轰姝讳

1锛绱т骇堕磋〃 锛淇瑰俱炬ヨgov.uk锛

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ㄦ绱涔锛浜虹被娌℃浠讳瀵硅虹缁娌荤规婚㈤ゆ弧浜蹭激浼よｄ璐ヨｈ锛荤浠ㄦ绛锛借瀵锛甯ｈ借繁

1928骞达绗涓姝ｇ绱绱琚卞芥浜灞卞ぇ路寮Alexander Fleming锛

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寮姹藉姝诲绉瀹崇锛濡剧藉浠浠╂浠句姹涓绂绘绾互绉颁负绱绱锛浣涓洪绱澶绋冲锛浠浠芥垮板涓绾绮┿寮1929骞6ㄣ卞藉楠瀛蹇涓琛ㄤ浠绌剁锛涓浜绱娼ㄦ不澶

村1939-1944骞达绉瀛浠寮濮灏璇澶ц妯℃绾绱涓讹姘ㄩ涓村绌朵璇瀹浜绱20涓绾50骞翠唬锛版绱杩ヤ榛朵唬锛涓绯诲拌骞朵瑰涓甯绱娓ㄤㄥ绉绘版不椋╀腑姣绛绉剧涓濮ュ涓灏浣ㄣ

惰锛寰╅戒杩浠撮搴瀛澧

浠娇ㄦ绱瓒澶锛缁浜хх搴氨瓒蹇ｄ浜х绱х缁浼瀛娲讳ワ娌℃х浼琚绱姝汇

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2锛2050骞达澶ф床姣勾涓哄绱х缁姝讳骸浜烘帮ヨ[1]锛

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杩搴娇ㄥ婊ョㄦ绱存绱х抽绱

01

绱婊ョㄤ归㈡汉婊ョㄣ

甯歌灏辨ㄦ绱ユ不涓辩寮璧风剧规界剧跺棰蹭腑蹇版楂杈句涔涓颁浜虹被绱浣跨ㄦ蹇瑕涓

绱ㄦユ不缁锛瀵圭姣娌℃ㄥ渚濡锛绱浠ョㄦユ不涓哄ч剧锛Streptococcus pyogenes锛寮璧风剧у藉浣瀵逛澶у扮辩姣寮璧风

朵甯歌变姣寮璧风锛绱剧锛娴绠＄ユц绛

ㄦ绱ユ不姣锛浣涓借韬搴峰锛戒涓蹇瑕瀹崇ㄣ渚濡绱╂у版浣缁锛浣缁骞朵芥锛涔寰澶瀵瑰ュ悍浜虹绯荤绾39涓浜跨锛澶чㄥ瀛ㄤぇ涓杩15骞寸绌跺锛璁稿杩浜浜哄辩寰╁ュ悍冲抽瑕瀹浠藉渚靛ヤ汉浣瀹崇寰╂よ蛋锛灏浜浜轰娉娑绾ょ淮瑙ｆ存告剁浠斤骞惰戒骇澶绉缁寸绱锛渚濡缁寸绱KB12杩搴娇ㄦ绱锛浼瀵艰磋寰╃澧澶辫锛寮璧蜂绯诲浠ｈ阿剧锛冲奖娌荤[2-8]

02

涓涓村ぇ锛涔父琚ぇ浼蹇借锛╅绱ㄨヨ澶茬楗插绘ㄦユょ存锛涓剧эㄨ绉ユょ绘′欢涓锛涓ㄧ╃锛灏变寰蹇缁ㄧ┿涓轰棰插ぇ㈢Н浼锛寰澶楗插诲哄氨缁瀹剁椋绱浠ヤ杩匡澧浣浠ュ娌荤锛跺棰茬剧杩绉ョ娉瀵艰翠杩浜瀹剁韬╀芥绱涓姝荤缁浜虹被澶椋ㄨ浜瀹剁跺锛х缁灏变浠浼颁汉

4锛甯26绉绱瀵瑰х骞翠唤琛瑰绘ョ澶у撅

板绉绱伴惧绋

涓涓绱宸茬澶浜1940骞磋1962骞撮达20澶绉板绱涓甯惰锛浠ｄ互涓や釜ㄦ扮绉杩ュ恒10-20骞村锛绉瀛浠扮绱绫讳技╋扮╋浣灞浜凡缁绉绫伙瑙5锛姝ヤ杩寮鸿藉璺涓缁т骇搴宸茬病瓒冲板绉绱绫讳技╄ュ烘ユ姝诲ぇ逛骇х缁锛灏ゅ舵╁版存ц

5锛绫绘浠ｈ〃х绱

娉浠父ㄧ绱绫诲澶村绱绫绘绱藉浜-拌虹被锛杩剁缁澹璧蜂ㄣ杩涓ょ╃箍璋辩绱锛瀵归╁版撮虫у姘х芥涔姝ｅ涓鸿涓ょ绱杈╋ч甯告宸插濂藉绉х哄讹朵腑甯歌浜х浜涓涓讹尾-lactamase, 尾-拌洪讹浠ュ瑙ｈ绫绘绱澶чㄥ颁浠ｇ尾-拌虹被绱宸茬В充变-拌洪跺璧风ч姣浠ｇ绱绫诲澶村绱绫绘绱ㄩ戒瀹ㄧ稿澶村绱甯歌璁や负绱硅扮琛╋浣瀹涓浠浠绉澶╃剁╄川锛骞朵ㄩ绱虹涓硅浠ュㄥ╅瑕规釜浜虹靛锛绱寰澶锛绫诲涓ラ绋搴芥эｈュ悍跺碉渚濡舵剧锛╄绛锛锛╃娌荤璐圭ㄥｈ藉锛讳跨绛绛[9]

绉瀛姝ｅㄥ瀵绘炬扮绐村锛涓浠浠ㄥ楠瀹ら寮扮╋杩璇惧ㄤ互瑙寰し绉版瑰炬璇扮ユ锛渚濡锛

1. 绉澶宸ㄨュ藉涓绉芥不浼ゅ[10]

6锛绉澶宸ㄨ 锛ヨ缁锛

2. 浜椹板虹韬辩缁浼娉涓浜寰寮烘绱[11]

7锛浜椹板虹锛Tim Flach/Getty Images锛

3. 浠涓澹ゅ娴峰浠舵版╃瑕ユ[12]

8: 澹ゅ娴峰

4. 浜虹榧诲㈠浜涓绉浠ュ涓浜瓒绾х绱[13]

5. 卞藉箍板箍ぇㄥDalek锛绉骞荤佃Doctor Who涓娲惧浜猴妯″琚绉娼ㄧ板绱

9锛ュ瀛＄背2014骞磋卞藉箍惰矾杩Dalek锛宸竟锛

ㄥ诲濡姝ゅ杈剧骞翠唬锛涓轰涔浜虹被杩瑕绱村姝ゅ伴鹃锛

惧拌藉姝荤╁瀹规ㄤ濡瑕涓鸿杩浜╁ㄨ藉姝荤娴搴锛惰瑕瀵逛汉浣瀹筹娴搴浜锛澶чㄥ╅藉浜轰瀹筹

棣瑕浠虹绌跺濮锛绛烘芥缁ц川┿杩涓绋韩介瑕板勾堕淬

惧板浜轰互瑕娴璇瀹藉姝诲凡ョ浼х藉剁瀛浠浼璇剧绌跺宸ヤ虹锛浜戒璇炬诲荤缁澹; 浜浼骞叉扮芥浠ｈ阿瑰

濡杩浜缁借涓锛瑕娴璇瀹瀵逛汉绫诲界姣э骞朵蹇椤昏藉ぇ瑙妯＄浜с

杩瑕缁跺骞寸涓村璇楠锛纭瀵逛汉浣骞朵澶фф借瑰涓甯杩翠釜杩绋澶х害瑕1020骞达澶辫触楂

杩杩涓涓昏锛澶у伴瀵瑰剧╃涔瑕缁绫讳技杩绋

村ぇ杩涓涓锛锛璧锛锛

峰版х版绱涓介究ㄥ姝ｅ涓烘ф姝ゆ锛扮绱寰澶跺浼琚捣ワ涓颁涓寰宸茬跺涓寰寰蹇氨缁瀵瑰浜хс

瀵逛璧浜烘ヨ锛杩涓涓稿浜虹棰锛ョ澶椋╁お澶э浜杩涓涓瀹界绘剁ㄨ30骞撮锛惰澶уぇ浜版娉

杩30骞磋瑰涓甯绱芥1984骞村绉绫荤绫讳技┿浠や汉蹇х1962骞翠互绉瀛浠氨娌℃浠讳扮藉娌荤╁版存ц绾х绱

绱芥涓姝荤瓒绾х

濡浠瑰浣跨ㄦ绱瑰寰蹇汉绫诲娌℃浠讳ㄧ绱棰瑷骞朵镐汉汇Doomsday锛ワ涔璁稿凡缁濮浜

2016骞818ワ涓浣缇藉揪宸70宀濡濂冲涓哄ㄦ寮璧风ㄨ韩搴琚版ョｈ寰蹇虹т锛濂圭缁瀵圭藉26绉绱芥э冲垮勾琚涓颁涓寰宸茬瀵逛ㄧ绮绱锛Colistin锛涓烘病绱ユ姝绘濂圭缁锛杩浣ｈ缁浜涓[14]

ㄥ涓涓ゅ勾锛杩浣ｈ寰跨堕村浣ㄥ板害涓娆℃垮濂归瑕缁父板害婚㈡娌荤ㄨ杩绋涓涓绉虹蜂集锛Klebsiella pneumoniae锛缁浜濂圭楠ㄩ跺╂ｅ拌ㄣ

褰濂瑰扮斤琚版ョ婚㈢朵警锛宸茬甯镐弗锛郴缁瓒璐疯浣璇炬垫锛瀵艰村ㄨ韩涓烘病╋靛锛缁濂规浜ㄥ琛扮璐ヨт

10锛虹蜂集锛Klebsiella pneumoniae锛 锛ヨsciencemag.org锛

浠ュ涔浜烘浜璋瓒绾х锛superbug infection锛缇界剧棰叉朵腑蹇浼拌锛缇芥勾23,000浜烘浜澶绉绱х缁澶у版涓虹у寰澶浜锛杩娌℃惧颁绉绱浜哄氨宸茬涓ㄨ传绌峰藉锛涓昏涓哄杩娌℃ｄ扮璐电绱

惰锛缇藉揪宸杩涓渚浠ュ戒涓凤娌荤╂灏辩‘璁や缁эㄥ绉绱藉浠ヤ拱扮缇斤浣充娇ㄤ琚涓烘茬嚎绮绱涔澶╂

杩涔璁告涓绔渚瀛浣浜绗璧锋渚锛灏变绗璧凤绗璧枫

浠藉灏辨ㄤ汉ㄧ╀借皑颁娇ㄦ绱锛缁骇х轰锛骞剁户缁ぇユ版绱褰扮绱虹跺锛涔蹇椤绘╁颁娇涓娆插版互ㄣ

绱浣跨ㄧ涓涓

涓互ㄦ绱稿锛寰澶浜轰负浜绱浣跨垮浜хэ浼杩ュ涓涓猴涓靛ソ杞灏辩诲姝㈡ㄦ绱杩绉瑰涓ㄦ绱锛灏卞璇ュ瀹翠釜绋锛浠ョ‘淇100%姝诲璧风剧缁村寮璧峰锛骞跺戒杩瀹崇涓绱х浼

绱绋充釜ｈ绫诲澶у版绱搴714澶╋浣涔靛瑕5澶╋瑕28澶╃璇峰蜂ㄨ荤ュ冲浣虫不堕村姝ｇ‘绱绫诲

界2017骞存涓涓扮绌讹璁や负瀹翠釜绋村寮璧锋э浣杩椤圭绌剁锛杩杩涓界О涓虹璁恒姣釜浜烘ｇ浠ュ甸戒涓锛瑙濂戒互涔浠ュ瑕杩涓姝ョ绌躲姝ょ充绱浣跨ㄧ瀵兼归杩病锛纭浠ュㄦ绱锛涓ㄥ氨搴璇ュ瀹翠釜绋

璁

惰芥垮藉璇ュ卞锛扮瀵规缁娉

撮瑕浠藉璇ュ骞朵淇ゆ绱杩涓璐电璧婧

绱锛璁烘版эㄥ瑕朵警浣跨ㄦ藉ユ澶х浣淇ゅ瑰浜虹被ュ悍

浣充绱版锛

娆㈣ㄢ杩粹寰俊瑷烘轰板借甯绛妗锛

1.https://amr-review.org/home.html

2. L. Cuthbertson et al., Respiratory microbiota resistance and resilience to pulmonary exacerbation and subsequent antimicrobial intervention. ISME J 10, 1081-1091 (2016).

3. S. M. Teo et al., The infant nasopharyngeal microbiome impacts severity of lower respiratory infection and risk of asthma development. Cell Host Microbe 17, 704-715 (2015).

4. E. Y. Hsiao et al., Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders. Cell 155, 1451-1463 (2013).

5. A. T. Stefka et al., Commensal bacteria protect against food allergen sensitization. Proc Natl Acad Sci U S A 111, 13145-13150 (2014).

6. M. I. Smith et al., Gut microbiomes of Malawian twin pairs discordant for kwashiorkor. Science 339, 548-554 (2013).

7. E. Holmes et al., Human metabolic phenotype diversity and its association with diet and blood pressure. Nature 453, 396-400 (2008).

8. S. Becattini, Y. Taur, E. G. Pamer, Antibiotic-Induced Changes in the Intestinal Microbiota and Disease. Trends Mol Med 22, 458-478 (2016).

9. K. B. Holten, E. M. Onusko, Appropriate prescribing of oral beta-lactam antibiotics. Am Fam Physician 62, 611-620 (2000).

10. E. M.C. Chung, S. N. Dean, C. N. Propst, B. M. Bishop, M. L. van Hoek, Komodo dragon-inspired synthetic peptide DRGN-1 promotes wound-healing of a mixed-biofilm infected wound. npj Biofilms and Microbiomes 3, 9 (2017).

11. T. R. Schultz, Ants, plants and antibiotics. Nature 398, 747-748 (1999).

12. S. I. Maffioli et al., Antibacterial Nucleoside-Analog Inhibitor of Bacterial RNA Polymerase. Cell 169, 1240-1248 e1223 (2017).

13. A. Zipperer et al., Human commensals producing a novel antibiotic impair pathogen colonization. Nature 535, 511-516 (2016).

14. https://www.cdc.gov/mmwr/volumes/66/wr/mm6601a7.htm

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杩淬锛村濂界介╃瀛灏涓╁瀹堕瀹琚浠绘荤锛涓浣瀛缁缂濮浼涓璧凤涓卞姹绱浜娆¤浆杞芥浣璇疯绯fanpu2019@outlook.com