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1、Are Antibiotics Killing Us? 抗生素会杀死我们吗？For every cell in your body , you support 10 bacterial cells that make vitamins , trigger hormones , and may even influence how fat you are .Guess what happens to them when you pop penicillin ?我们身体里的每一个细胞来说，10个菌细胞就可以形成维生素，引发荷尔蒙，甚至可能影响你的体形。当你身体里有流行青霉素时这些细胞会有什么变化呢

2、？ By Jessica Snyder Sachs杰西卡斯奈德扎克斯著Alan Hudson , who has a microbiology laboratory at Wayne State Medical School in Detroit , likes to tell a story about a soldier and his high school sweetheart.哈德森在底特律的韦恩州立大学医学院有自己的微生物实验室，他总是很乐意讲关于一个士兵和他高中的情人的故事。The young man returns from an overseas assignment for

3、 their wedding with a clean bill of health , having dutifully cleared up an infection of sexually transmitted Chlamydia .一个年轻的男人全心全意地清除掉了体内的性传播感染衣原体，带着一份无疫证明书从他的外派工作中回来去参加他们的婚礼“Three weeks later , the wife has a screaming genital infection ,” Hudson recounts , “and I get a call from the small-town d

4、octor whos trying to save their marriage.” The soldier , it seems , has decided his wife must have been seeing other men , which she denies .“三周后，这个妻子得上了惊人的生殖器感染”哈德森叙述到。“并且我接到了一个来自一个小乡镇医生的电话，他正在极力抢救他们的婚姻”这个士兵似乎怀疑他的妻子见了其他的男人，但是他的妻子坚决否认。Hudson pauses for effect , “the doctor is convinced shes telling

5、the truth,” he continues, folding his hands behind a sweep of white , collar-length hair . “This is done after the couple has completed a full course of antibiotic treatment and tested free of infection .哈德森为了效果稍作停顿，“这个医生坚信她说的是真的”他继续说道，这时他的手在他的白花花的头发后面合拢了起来。“这发生在这对夫妇完成了全套抗生素治疗和免费测试之后。”“I PCRem both,

6、” Hudson says , “and he is red hot.”“我考虑了他们双方聚合酶链反应的可能性，并且他是很猛烈的”哈德森说PCR stands for polymerase chain reaction- a technique developed about 20 years ago that allows many copies of a DNA may be available . Hudsons use of the technique allowed him to find traces of Chlamydia DNA in the soldier and his

7、wife that traditional tests miss because the amount left after antibiotic treatment is small and asymptomatic . Nonetheless , if a small number of inactive Chlamydia cells from groom to bride , the infection could have become active in its new host .PCR表示的是发展于20年前能无限复制可用DNA的聚合酶链反应技术。哈梅森对这一技术的使用使他找到了

8、这个士兵和他妻子体内的披衣菌的源头，这种披衣菌很容易被传统的检测方式遗漏，因为抗生素检查后遗留的大量菌体很微小，并且没有任何症状。尽管如此，如果少量的不活跃的衣原体感染细胞从新郎到新娘，那么在新主人体内传染会变得活跃。Hudson tells the tale to illustrate how microbes that scientists once thought were easily eliminated by antibiotics can still thrive in the body . His findings and those of other researchers

9、raise disturbing questions about the behavior of microbes in the human body and how they should be treated.哈德森讲述这个故事是为了说明曾被科学家认为很容易通过抗生素消除微生物仍然可以在体内繁荣兴旺。他的发现和其他的这方面的研究人员掀起了一个关于人体内微生物的行为和他们应该怎样被治愈的令人们不安的问题。For example , Hudson has found that quiescent varieties of Chlamydia may play a role in chronic

10、 ailments not traditionally thought to be related to this infectious agent . In the early 1990s , he found two types of Chlamydia-Chlamydia trachomatis and Chlamydia pneumonia-I the joint tissue of patients with inflammatory arthritis . More famously , in 1996 , he began fishing C.pneumonia out of t

11、he brain cells of Alzheimers victims . Hidden infectious are now thought to be the basis of still other stubbornly elusive ills like chronic fatigue syndrome , Gulf War syndrome , multiple sclerosis , Parkinsons disease .例如，哈梅森发现那个静品种的衣原体可能在慢性疾病中发挥作用而不是传统上被认为是与此相关的传染病。在二十世纪早期，他发现了两种类型的衣原体抗体和衣原体肺炎类风湿

12、性关节炎。更引人注目的是，在1996年他开始挑出肺炎的老年痴呆症患者的大脑细胞。目前隐藏的传染性被认为是那些顽固难以捉摸的问题的基础如慢性疲劳综合症，海湾战争综合症、多发性硬化症、帕金森氏症等疾病。To counteract these killers , some physicians have turned to lengthy or lifelong courses of antibiotics . At the same time , other researchers are finding that bacteria we think are bad for us also war

13、d off other disease and keep us healthy . Using antibiotics to tamper with this complicated and little-understood population could irrevocably alter the microbial ecology in an individual and accelerate the spread of drug-resistant genes to the public at large .为了消除这些杀手，一些物理学家转而研究抗生素的长期或者终生的课程。同时，其他

14、的研究者也在寻找那些我们认为对我们健康有害但是也能防治其他疾病保持我们健康的细菌。用抗生素来干涉这个复杂并且鲜为人知的人口会不可逆转地改变个体的微生物生态学和尽最大可能加速耐药基因向公众的传播。Today we know that trillions of bacteria carpet not only our intestines but also our skin and much of our respiratory and urinary tracts . The vast majority of them seem to be innocuous , if not benefici

15、al . And bacteria are everywhere , in abundance-they outnumber other cells in the human body by 10 to 1 .今天我们数以万亿计的细菌覆盖了不仅我们的肠道,而且我们的皮肤和大部分的呼吸道、泌尿系统。他们绝大多数即使没有益处也是无害的。细菌无处不在，在数量上，他们以占人体十分之一的比率远远超过其他细胞。Meanwhile , the behavior of even well-known bacterial inhabitants is challenging the old , straight

16、forward view of infectious disease . In the 19th century , Robert Koch laid the foundation for medical microbiology , postulating: Any microorganism that causes a disease should be found in every case of the disease and always cause the disease when introduced into a new host . That view prevailed u

17、ntil the middle of this past century . Now we are more confused than ever . Take Helicobacter pylori . In the 1980s infection by the bacterium , not stress , was found to be the cause of most ulcers . Overnight , antibiotics became the standard treatment . Y et in the undeveloped world ulcers are ra

18、re , and H. pylori is pervasive .同时，甚至著名的细菌附着体的行为正在挑战着对于传染病旧的，简单的观点。在十九世纪，罗伯特·科赫奠定了医学微生物学的基础，假设：任何能引起疾病的微生物应该在每个这种疾病的案例中被发现并且当被引入到一个新的主人时总是会导致疾病。这一观点一直盛行到过去那个世纪的中叶。现在我们比以前更加迷惑了。例如，幽门螺杆菌。在二十世纪八十年代由细菌感染，而不是压力被认为是大多数溃疡的原因，一夜之间，.抗生素成为治疗的标准，然而在不发达地区溃疡很罕见，幽门螺杆菌无处不在。“This stuff drives the old-time mic

19、robiologists mad ,” says Hudson , “because Kochs postulates simply dont apply.” With new technologies like PCR , researchers are turning up stealth infectious everywhere , yet they cause problems only in some people sometimes , often many years after the infection .“这个东西把老牌微生物学家逼疯了”哈德森说道，“因为科赫年代的假设根

20、本不适用”随着新技术的发展例如聚合酶链反应，研究者们转而研究到处出现的隐形传染病，然而他们也只是不时地在一些人身上引发问题,通常是感染后的很多年。These mysteries have nonetheless not stopped a free flow of prescriptions. Many rheumatologists , for example , now prescribe long-term -even lifelong-courses of antibiotics for inflammatory arthritis , even though it isnt know

21、n if the antibiotics actually clear away bacteria or reduce inflammatory arthritis in some other unknown manner.这些谜团仍然不能阻止一个自由流动的处方。,例如许多风湿病学家尽管还不清楚是否真正清除细菌的抗生素或减少炎性关节炎在其他一些未知的方式,现在仍然为抗生素类风湿性关节炎开展长期的甚至是终身的课程。Even more far-reaching is the use of antibiotics to treat heart disease . In April two large

22、-scale studies reported that use of antibiotics does not reduce the incidence of heart attacks or eliminate C.pneumonia . But researchers left antibiotic-dosing cardiologists a strange option by admitting they do not know if stronger , longer courses of antibiotics or combined therapies would succee

23、d .甚至更深远的是使用抗生素来治疗心脏病。在4月两项大型研究报道称,使用抗生素并不能减少心脏病的发病率或消除肺炎披衣菌。但研究者们通过承认他们不知道更强并且更长期的抗生素或联合治疗疗程是否会成功给使用抗生素心脏病专家留下了一个奇怪的选择, Meanwhile , many researchers are alarmed . Infectious-disease specialist Curtis Donskey , of Case Westren Reserve University in Cleveland , says :”Unfortunately , far too many phy

24、sicians are still thinking of antibiotics as benign And from an ecological point of view , were just starting to understand the medical consequences of using antibiotica.”与此同时,许多研究人员感到恐慌。凯斯西储大学传染病专家柯蒂斯德斯科说:不幸的是,太多的医生仍认为抗生素是良性的,从生态的角度来看,我们是刚刚开始理解使用抗生素的医疗后果。Donskey has seen the problem fisthand at the

25、 Cleveland VA Medical Center , where he heads infection control.”Hospital patients get the broadest spectrum , most powerful antibiotics , ”he say , but they are also “in an environment where they get exposed to some of the nastiest , most drug-resistant pathogens.”Powerful antibiotics can be danger

26、ous in such a setting because they kill off harmless bacteria that create competition for drug-resistant colonizers , which can then proliferate . The resuli : Hospital-acquired infections have become a leading cause of death in critical-care unit .德斯科已经在弗吉尼亚州克利夫兰医学中心看到问题的直接性,在那里他领头感染控制。“住院病人得到最广泛的光

27、谱,最强大的抗生素,“他说,”但他们也在他们的环境中,接触到的一些最大、最耐药病原体。“强效抗生素在这种环境下可以变得很危险,因为他们杀死了为耐药依附体创造竞争的一些无害的细菌, 这使得这些耐药依附体得到扩散。结果:院内感染已成为主治单位死亡的主要原因“We also see serious problems in the outside community,”Donskey says,because of inappropriate antibiotic use.“我们也看到外面社会的严重问题”德斯科说,因为不适当的使用抗生素。Microbiologist Abigail Salyers a

28、t the University of Illinois at Urbana-Champaign has been exploring a more sinister feature of our bacteria and their role in antibiotic resistance.At the center of her research stands a room-size,walk-in artificial “gut” with the thermostat set at the human intestinal temperature of 100.2 degrees F

29、ahrenheit.Racks of bacteria-laced test tubes line three walls,the sealed vials purged of oxygen to simulate the anaerobic conditions inside a colon.Her study results are alarming.在伊利诺大学香槟分校的微生物学家阿比盖尔塞勒斯一直在探索我们细菌的一个更险恶特性以及他们抗生素耐药性中的角色。她的研究的中心矗立着一个房间大小的步行人工肠道并且设定了一个恒温器，温度设定为人类肠道100.2华氏度的温度。微生物结构试管的温度架

30、周围着树立三面墙,氧气的密封小瓶清除结肠内模拟厌氧条件。她的研究结果令人担忧。Salyers says her research shows that decades of antibiotic use have bred a frightening degree of drug resistance into our intestinal flora.The resistance is harmless as long as the bacteria remain confined to their normal habitat.But it can prove deadly when th

31、ose bacteria contaminate an open wound or cause an infection after surgery.赛勒斯说她的研究表明,几十年的抗生素的使用已经在我们的肠道菌群酝酿了一个可怕的耐药性。只要细菌仍局限于正常的栖息地内，抗性是无害的。但当这些细菌污染伤口或手术后引起感染时，它就会被证明具有致命性,。As drug-resistance genes become common in bacteria in the gut,they are more likely to pass their information to truly dangerou

32、s bugs that only move periodically through our bodies,says Salyers.Even distantly related bacteria can swap genes with one another using a variety of techniques,from direct cell-to-cell transfer,called conjugation,to transformation,in which a bacterium releases snippets of DNA that other bacteria pi

33、ck up and use.随着细菌耐药性基因在肠道的细菌内变成普遍现象,他们更有可能将他们的信息传递到真正危险的只有定期通过我们的身体移动的缺陷, 赛勒斯说。连人类的远亲细菌都可以通过使用各种技术彼此交换基因,从直接的细胞间转移,称为共轭转移, 在转移中其他细菌可以获得和使用的一种细菌释放的DNA片段。Salyers has shown that Bacteroides probably picked up erythromycin-resistant genes from distantly retated species of staphylococcus and streptococc

34、us.Most disturbing is Salyerss discovery that antibiotics like tetracycline actually stimulate Bacteroides to begin swapping its resistance genes.赛勒斯表明,拟杆菌很可能从与葡萄球菌和链球菌关系遥远的物种中获取红霉素耐药基因。最令人不安的是赛勒斯年代发现实际上抗生素例如四环素等能刺激拟杆菌开始交换其抗性基因。Nor is Bacteroides the only intestinal resident with such talents . “In

35、June 2002 , we passed a particularly frightening milestone , Salyers says . That summer , epidemiologists discovered hospital-bred strains of the gut bacterium enterococcus harboring a gene that made them improvious to vancomycin , The bacterium may have since passed the gene to the far more dangero

36、us Staphylococcus aureus , the most common cause of fatal surgical and wound infections .拟杆菌并不是唯一以这样天才的方式常驻在肠道的细菌。“在2002年6月,我们跨过了一项特别可怕的里程碑”赛勒斯说。那年夏天,流行病学家发现医院培育的肠道细菌肠球菌窝藏着一种使他们不受万古霉素的影响的基因,这一细菌可能已经将基因传递到更危险的上, 金黄色葡萄球菌是最致命的外科手术和伤口感染的常见原因。“I am completely mystified by the lack of public concern about

37、 this problem,”she says.“我对这个问题公众关注的缺乏感到很迷惑”她说。With no simple solution insight , Salyers continues to advise government agencies such as the Food and Drug Administration and the Department of Agriculture to reduce the use of antibiotics in livestock feed , a practice banned throughout the European U

38、nion.由于缺乏简单的解决方案,塞勒斯继续建议政府机构如美国食品和药物管理局和农业部在牲畜饲料上减少抗生素的使用,这一活动在整个欧盟内实行。Yet just when the message appears to be getting though-judging by a small but real reduction in antibiotic prescriptionsothers are calling for an unprecedented increase in antibiotic use to clear the body of infections we never k

39、new we had . Among them is Willian Mitchell, a Vanderbilt University chlamydia specialist . If antibiotics ever do prove effective for treating coronary artery disease , he says , the results would be “staggering . Were talking about the majority of the population being on the long-term antibiotics

40、, possibly multiple antibiotics.”然而就当这个建议就要被通过时根据一个小型但实际上是抗生素处方上的真正消减的部门判断其他人却呼吁空前增加抗生素的使用来清除甚至我们都不知道的身体的感染。威廉米切尔是他们其中的一个，他是一个范德比尔特大学的衣原体专家。“如果抗生素从没被证明在治疗冠状动脉疾病上是有效的，”他说，“结果将会是令人惊愕的。我们正在重新讨论使用长期的抗生素，甚至使用多种抗生素的大多数人口 。”Hudson cautions that before we set out to eradicate our bacterial fellow travelers , “ wed damn well better understand what theyre doing in there .” His interest centers on chlamydia ,