Recently CNN News on-line reported the following:
Superbug crisis could get worse, killing nearly 40
million people by 2050, study estimates (2/2)
By Jacqueline Howard, CNN
Updated 8:40 PM EDT, Mon September 16, 2024
CNN
—
(continue)
According to the data, the regions of the world most
affected by AMR and attributable deaths are South Asia, Latin America and the
Caribbean, and sub-Saharan Africa – and many of these regions don’t have
equitable access to quality care, Murray said.
“There are still, unfortunately, a lot of places in low-resource settings where people who need antibiotics are just not getting them, and so that’s a big part of it. But it’s not just the antibiotics. It’s when you’re sick, either as a kid or an adult, and you get sent to hospital, and you get a package of care, essentially, that includes things like oxygen,” Murray said.
“In low-resource settings, even basics like oxygen are often not available. And then, if you are very sick and you need an intensive care unit, well, there’s big parts of the low-resource world – most of them, actually – where you wouldn’t get access to that sort of care,” he said. “So there’s a spectrum of supportive care, plus the antibiotics, that really make a difference.”
But in a scenario where the world has better health care, 92 million cumulative deaths could be averted between 2025 and 2050, the researchers forecast. And in a scenario where the world has new, more potent drugs, about 11 million cumulative deaths could be avoided.
‘There is possible hope on the horizon’
The “innovative and collaborative” approach to this study
provides a “comprehensive assessment” of antimicrobial resistance and its
potential burden on the world, Samuel Kariuki, of the Kenya Medical Research
Institute, wrote in a commentary that accompanied the new study in The Lancet.
Yet he warned that the forecast models do not consider the emergence of new superbugs “and might lead to underestimation if new pathogens arise.”
The new paper represents decades of research on the global burden of antimicrobial resistance, said Dr. Steffanie Strathdee, associate dean of global health sciences and distinguished professor at the University of California San Diego School of Medicine, who was not involved in the study.
Strathdee saw firsthand the effects that antimicrobial resistance can have on health when her husband nearly died from a superbug infection.
“I’m somebody who’s lived with antimicrobial resistance affecting my family for the last eight years. My husband nearly died from a superbug infection. It’s actually one of the infections that’s highlighted in this paper,” said Strathdee, who serves as co-director of the Center for Innovative Phage Applications and Therapeutics at UC San Diego.
“That’s one of the urgent priority pathogens, which is one of these gram-negative bacteria,” Strathdee said. “And my husband, when he fell ill from this, he was 69. So he’s exactly at the age that this paper is highlighting, that older people are going to be affected by this more in the future, because our population is aging and people have comorbidities, like diabetes, like my husband has.”
Strathdee’s husband recovered after treatment with phages, viruses that selectively target and kill bacteria and that can be used as a treatment approach for antimicrobial-resistant bacterial infections.
“The most important alternative to antibiotics is phage therapy, or bacteriophage therapy, and that’s what saved my husband’s life,” Strathdee said. “Phage can be used very effectively with antibiotics, to reduce the amount of antibiotics that are needed, and they can even be used potentially in livestock and in farming.”
“There is possible hope on the horizon,” Strathdee said. “If we were to scale up these interventions, we could dramatically reduce the number of deaths in the future.”
Translation
研究估計，超級細菌危機可能會變得更嚴重，到
2050 年將導致近
4,000 萬人死亡
(2/2)
CNN
—
（繼續）
Murray說，根據數據，世界上受抗菌素抗藥性, 和它相關死亡影響的最嚴重地區是南亞、拉丁美洲和加勒比地區以及撒哈拉以南非洲地區，其中許多地區無法公平地獲得優質護理。
Murray說: 「不幸的是，在很多資源匱乏的地方，需要抗生素的人卻得不到抗生素，而這正是其中很大的一部分的地方。但這不僅單是抗生素。當你生病時，無論是作為一個孩子還是一個成年人，你應會被送往醫院，你會得到一籃子護理，基本上包括氧氣等」。
他說:「在資源匱乏的環境中，甚至連氧氣等基本物資也常常無法取得。然而，如果你病得很重，需要重症監護室，那麼，在大部分地區都是資源匱乏的世界裡 - 實際上是絕大部分 - 你無法獲得這種護理」; 「因此，一系列支持性護理，再加上抗生素，確實能帶來改善」。
研究人員預測，如果世界有更好的醫療保健，2025 年至 2050 年間，可避免累計死亡人數達9,200 萬人。如果世界上有新的、更有效的藥物，就可以避免累積死亡人數大約 1,100 萬人。
“有可能會出現希望”
肯亞醫學研究所的Samuel
Kariuki 在附帶於《柳葉刀》新研究的評論中寫道，這項研究的「創新和協作」方法為抗菌素抗藥性及其給世界帶來的潛在負擔提供了「全面評估」。
但他警告說，預測模型沒有考慮新超級細菌的出現，“如果出現新病原體，預測可能會被低估。”
Kariuki寫道，總體而言， “這些數據應該推動投資和有針對性的行動” ，以應對世界所有地區日益嚴峻的抗菌素抗藥性挑戰。
加州大學聖地牙哥分校醫學院全球健康科學副院長、傑出教授Steffanie Strathdee博士（未參與這項研究）表示，這篇新論文代表了數十年來對全球抗菌素抗藥性負擔的研究。
當Strathdee的丈夫差點死於超級細菌感染時，她親眼目睹了抗菌素抗藥性對健康的影響。
加州大學聖地牙哥分校創新噬菌體應用和治療中心聯合主任Strathdee說。「在過去的八年裡，我親身經歷我的家人一直受到抗生素抗藥性的困擾。我先生差點死於超級細菌感染。這實際上是本文強調的感染之一」。
在2015 年感恩節尼羅河遊輪期間，Strathdee的丈夫Tom Patterson 突然出現嚴重的胃痙攣。當埃及的一家診所對他惡化中的症狀未能幫忙時，Patterson被空運往德國，在那裡醫生發現了一個柚子大小的腹部膿腫，裡面充滿了Acinetobacter baumannii (鮑曼不動桿菌)，這是一種對幾乎所有抗生素都有抵抗力的劇毒細菌。
從1990
年到2021 年，每年死於gram-negative
bacteria(革蘭氏陰性菌), 如鮑曼不動桿菌的人數增加了89,200 人，超過了過去10 年中任何抗生素類別的數量, 這些細菌對carbapenem (碳青黴烯類抗生素) 一類用於治療嚴重細菌感染的最後手段的抗生素具有抗藥性。
Strathdee說：「這是當務之急的病原體之一，也是革蘭氏陰性細菌之一」; 「而我的丈夫，當他因此細菌而病倒時，他已經69 歲了。所以他正是本文所強調的年齡，老年人在未來將更多地受到這種情況的影響，因為我們的人口正在老齡化，人們有併發症，例如糖尿病，就像我丈夫一樣」。
Strathdee的丈夫在接受噬菌體治療後康復了，噬菌體是一種選擇性針對向並殺死細菌的病毒，可作為治療抗藥性細菌感染的方法。
Strathdee說: 「抗生素最重要的替代品是噬菌體療法，或者說phage療法，這挽救了我丈夫的生命」; 「噬菌體可以非常有效地與抗生素一起使用，以減少所需的抗生素用量，它們甚至可以用於牲畜和農業」。
這項新研究給了Strathdee希望，即世界可以減少抗菌藥物抗藥性的潛在負擔。她說，這需要改善世界各地獲得抗生素和更新的抗菌藥物、疫苗、清潔水源和優質醫療保健其他方面的機會，同時減少牲畜、糧食生產和環境中抗生素的使用，因為抗生素可能會滋生更多的抗藥性。
Strathdee說: 「有可能會出現希望」; 「如果我們要加強這些干預措施，我們未來可以大幅減少死亡人數」。
So, a new study project shows that
the number of lives lost around the world due to infections that are resistant
to the medications could increase nearly 70% by 2050. One
solution is the use of bacteriophage therapy. Also, in order to check
the increasing death due to infection, we need to improve access to antibiotics and newer
antimicrobial medications, vaccines, clean water, and other aspects of quality
health care.
Note:
1. The Center
for Innovative Phage Applications and Therapeutics (IPATH) was
founded in the UC San Diego School of Medicine in 2018. Its goal is to
pursue new treatments for combating antimicrobial resistant diseases-focusing
on bacteriophage (phage) therapy. It also strives to advance phage therapy into
clinical trials so that it can be rigorously evaluated and if proven
efficacious, become more widely available to combat the global superbug crisis. ( https://idgph.ucsd.edu/research/center-innovative-phage-applications-and-therapeutics/about/index.html)
2. A Bacteriophage
(噬菌體) also known informally as a phage is
a virus that infects bacteria and archaea, and is characterized by targeting
bacteria as its host. Like other viruses, phages are also a ball of genetic
material wrapped in a protein coat. Most phages also have a "tail"
used to inject genetic material into the host. After injecting its genome into
the cytoplasm, the phage replicates within the bacterium. Bacteriophages are
the most common and diverse entities in the biosphere. (Wikipedia)
3. Acinetobacter
baumannii (鮑曼不動桿菌), commonly known as AB bacteria, is a gram-negative
bacterium. It is a strictly aerobic, non-lactose fermenting opportunistic
pathogen. This bacterium is a common type of bacteria in the genus
Acinetobacter in hospital infections and is also a pathogenic bacterium in
aquaculture animals. (Wikipedia)
沒有留言:
張貼留言