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首页> 外文期刊>Frontiers in Public Health >The Antimicrobial Resistance Crisis: Causes, Consequences, and Management
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The Antimicrobial Resistance Crisis: Causes, Consequences, and Management

机译：抗菌素耐药性危机：原因，后果和管理

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The antimicrobial resistance (AMR) crisis is the increasing global incidence of infectious diseases affecting the human population, which are untreatable with any known antimicrobial agent. This crisis will have a devastating cost on human society as both debilitating and lethal diseases increase in frequency and scope. Three major factors determine this crisis: (1) the increasing frequency of AMR phenotypes among microbes is an evolutionary response to the widespread use of antimicrobials; (2) the large and globally connected human population allows pathogens in any environment access to all of humanity; and (3) the extensive and often unnecessary use of antimicrobials by humanity provides the strong selective pressure that is driving the evolutionary response in the microbial world. Of these factors, the size of the human population is least amenable to rapid change. In contrast, the remaining two factors may be affected, so offering a means of managing the crisis: the rate at which AMR, as well as virulence factors evolve in microbial world may be slowed by reducing the applied selective pressure. This may be accomplished by radically reducing the global use of current and prospective antimicrobials. Current management measures to legislate the use of antimicrobials and to educate the healthcare world in the issues, while useful, have not comprehensively addressed the problem of achieving an overall reduction in the human use of antimicrobials. We propose that in addition to current measures and increased research into new antimicrobials and diagnostics, a comprehensive education program will be required to change the public paradigm of antimicrobial usage from that of a first line treatment to that of a last resort when all other therapeutic options have failed.
机译：抗菌素耐药性（AMR）危机是影响人类的全球传染病发病率的上升，而任何已知的抗菌剂都无法治愈。由于使衰弱和致死性疾病的频率和范围都在增加，这一危机将给人类社会带来毁灭性的代价。三个主要因素决定了这一危机：（1）微生物中AMR表型频率的增加是对抗菌剂广泛使用的进化反应; （2）庞大且全球相连的人口使病原体可以在任何环境中进入全人类; （3）人类对抗菌剂的广泛使用（通常是不必要的使用）提供了强大的选择压力，正驱动微生物世界的进化反应。在这些因素中，人口的数量最不适合快速变化。相反，其余两个因素可能会受到影响，因此提供了一种管理危机的方法：通过降低施加的选择压力，可以减慢微生物世界中AMR以及致病因子的发展速度。这可以通过从根本上减少当前和未来抗菌剂的全球使用来实现。目前的立法中使用抗菌剂的立法和医疗保健领域的管理措施虽然有用，但并未全面解决实现全面减少人类使用抗菌剂的问题。我们建议，除了当前的措施以及对新的抗菌剂和诊断方法的更多研究之外，还需要一项全面的教育计划，以将公共抗菌剂使用范式从一线治疗改为最终手段，而其他所有治疗方案失败了。

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