Representatives from academic research, industry, funding bodies and government from Scotland and beyond met in Glasgow last month to share their expertise on antimicrobial resistance (AMR). The conference, organised by the Scottish Universities Life Sciences Alliance (SULSA），旨在促进合作和共同方法，以应对国际公认的对全球健康的根本威胁。
苏格兰凭借其公认和备受尊敬的抗菌研究和产品开发格局，已经开始努力应对AMR的问题，现在正试图进一步促进该领域的研究和创新。会议使代表们有机会讨论与AMR有关的问题（从临床和研究的角度来看），并概述所取得的进展。
The search for new antimicrobials
Since the discovery of penicillin by the Scottish-born Alexander Fleming in 1928 we have taken antibiotics for granted. However, things are now changing. A worrying rise in drug resistant bugs means we risk losing these “wonder drugs” which protect us from potentially life-threatening infections.
这种状况要求在追求新颖的抗菌剂时做出重振的努力，这是一个自1980年代后期以来制药“发现无效”的研究领域。需要新武器来抵抗抵抗力致病细菌but also other nasty microorganisms such as fungi like念珠菌，“真菌学的MRSA”。不幸的是，正如阿伯丁大学尼尔·高教授指出的那样，真菌感染attract little attention or funding, despite affecting over a billion people globally and causing twice as many deaths as malaria.
抗菌药物发现同样具有挑战性。正如邓迪大学伊恩·吉尔伯特（Ian Gilbert）教授所解释的那样，研究人员必须考虑到虫子已经发展为逃脱的多种机制。这些防御机制包括外排泵和生物膜的形成，这些机制支持持久：代谢不活跃的细菌抗药性或耐受性。
Despite the difficulties, some innovative tools are being developed. ProfessorColin Suckling（Strathclyde University）介绍了他的新一类抗感染的小凹槽粘合剂化合物，这些化合物与虫子的DNA结合，目前正在反对反对Clostridium difficilebyMGB-Biopharma。Deborah O’Neil博士说明了一种完全不同的方法（novabiotics) who is targeting infection by boosting the host side. Two of her re-engineered human immune defence molecules are already in trials and more are in preclinical development.
In the near future novel medicines might be discovered among the unknown metabolites ofactinomycetes, the same bacteria that produce most of the antibiotics we currently use, as shown by the work of Dr凯瑟琳·邓肯（Katherine Duncan）（Strathclyde University）。
一个未解决动态的健康问题
The introduction of novel antimicrobials is only one part of the solution to combat AMR. History tells us that for every new antibiotic introduced,resistanceis soon to be found. AMR is found everywhere in our environment as bugs evolve these defences to compete with other microbes.
人类，农场动物和环境相互互动及其各自的细菌伴侣。细菌，它们的移动遗传元素和药物残留物可以以我们才开始解散的方式在这三个相互联系的玩家之间移动。AMR是典型的一个健康问题。只有在所有这三个领域中采用干预措施的综合方法，才会产生影响，因为教授马克羊毛屋（爱丁堡大学）强调。
The diagnostic problem
When it comes to the clinic the first hurdle is the correct and prompt identification of the infectious agent and its potential drug resistance spectrum. This information is needed to allow the selection of the appropriate treatment, avoiding the misuse of antibiotics which is associated with resistance development.
However, as Dr Till Bachman, from the University of Edinburgh, pointed out,快速诊断is still an unmet need in clinical microbiology. He and his team are working on几个项目aimed at shortening the time required for a diagnosis that currently can take up to 72 hours. Professor Stephen Gilliespie from the University of St Andrews reiterated the clinical need stressing how in GP surgeries and clinics most diagnostics fail to make an impact because they take more than the ideal 30 minutes for a result.
So far, most of our data on AMR is based on reported clinical cases with little known on the extent of resistant bacteria in the general population.
Despite the global recognition of AMR as a problem and the launch of initiatives such asGLASS和全球ppswe have no clear picture of AMR spread. As Professor Dilip Nathwani (University of Dundee) emphasised, better surveillance data are required.
公平的行动和教育
解决AMR时，公平和社会问题也必须是方程式的一部分。MRC的乔纳森·皮尔斯（Jonathan Pierce）说，“ AMR是'Glocal'：与不同的本地司机共同的问题。在计划干预措施（例如使用抗生素的限制）时，将需要考虑每个驾驶员。另一方面，对于那些负担不起的人来说，获得抗生素应该是国际优先事项。
Finally, education of not just medical staff and veterinarians, but also of the general public on the topic of AMR and the responsible use of antibiotics is essential as part of the effort to prolong the life span of these life-saving drugs.
注释