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首页> 外文会议>International conference of the System Dynamics Society >A Dynamic Theory of Antibiotic Resistance: Work in Progress1
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A Dynamic Theory of Antibiotic Resistance: Work in Progress1

机译：动态的抗生素耐药性理论：正在进行中1

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Many common bacterial pathogens have become increasingly resistant to the antibiotics used totreat them. Experts agree that the essential cause of the problem is the extensive and oftenunnecessary use of antibiotics, a practice that encourages the proliferation of resistant mutantstrains of bacteria while suppressing the susceptible strains. However, it is not clear to whatextent antibiotic use must be reduced to avoid or reverse an epidemic of antibiotic resistance, andhow early the interventions must be made to be effective. To investigate these questions, wehave developed a relatively simple system dynamics model that portrays changes over a periodof years to three subsets of a bacterial population – antibiotic-susceptible, intermediatelyresistant, and highly resistant. The details and continuing refinement of this model largely reflectour growing knowledge of Streptococcus pneumoniae, a leading cause of illness and deathworldwide. The paper presents the model’s structure and behavior, including its ability toreproduce time series from four different countries, and explores possible directions for furthermodel development.Over the past few decades and around the world, a wide variety of common bacterialpathogens have become increasingly resistant to the antibiotics used to treat them. As aconsequence, the illness and death rates for some formerly well-controlled diseases, such astuberculosis, are now climbing in worrisome fashion. In the United States, it is estimated thatdrug-resistant bacteria are now responsible for some 70% of the 90 thousand fatal hospitalinfections that occur annually (Bright 1999). Antibiotic resistance was estimated in 1993 to add$200 million a year to U.S. medical bills in the form of more expensive antibiotics, and over $30billion a year when the costs of extended hospital care are included (Garrett 1994).
机译：许多常见的细菌病原体已越来越对用于以下用途的抗生素产生抗药性： 对待他们。专家们认为，问题的根本原因在于广泛且经常 不必要使用抗生素，这种做法可鼓励耐药性突变体的繁殖 菌株，同时抑制易感菌株。但是，目前尚不清楚 必须减少使用抗生素的程度，以避免或逆转抗生素耐药性的流行，并且 必须多早采取干预措施才能有效。为了调查这些问题，我们 已经开发了一个相对简单的系统动力学模型，该模型描述了一段时间内的变化 年至细菌种群的三个子集–对抗生素敏感，中等 抵抗力和高度抵抗力。该模型的细节和持续完善在很大程度上反映了 我们对肺炎链球菌（疾病和死亡的主要原因）的知识日益增长 全世界。本文介绍了该模型的结构和行为，包括其 再现来自四个不同国家的时间序列，并探索进一步的可能方向 模型开发。 在过去的几十年中，在世界范围内，各种各样的常见细菌 病原体已变得越来越对用于治疗它们的抗生素具有抗性。作为一个 因此，某些以前得到良好控制的疾病的疾病和死亡率，例如 结核病，现在正以令人担忧的方式攀升。在美国，据估计 现在，在9万例致命医院中，约有70％由耐药菌引起 每年发生的感染（Bright 1999）。 1993年估计增加了抗生素耐药性 每年以更昂贵的抗生素形式向美国支付2亿美元的医疗费用，超过30美元 如果将扩展的医院护理费用包括在内，则每年需要支付10亿美元（Garrett 1994）。

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