来源：《经济学人》
原文见刊日期：2023年5月6日
It was on the golf course that Barry Rud first noticed something was seriously wrong. A trim 60-year-old who played hockey as a young man, he found himself unable to take more than a few steps without gasping for breath. His doctors said he had caught a strain of Pseudomonas aeruginosa, one of the growing number of “superbugs” that have evolved resistance to many common antibiotics.
在高尔夫球场上，巴里·路德第一次注意到健康出了严重问题。60岁的他年轻时打过曲棍球，身材苗条，但他发现自己每走几步就会上气不接下气。他的医生说，他感染了一类铜绿假单胞菌，这是一种越来越常见的“超级细菌”，已经进化出对许多常见抗生素的耐药性。
Mr Rud’s experience illustrates a growing problem—and one possible solution to it. Antibiotics are among medicine’s most spectacular achievements. A class of “silver bullet” drugs that destroy disease-causing bacteria while sparing the patient’s own cells, they have defanged all sorts of once-feared illnesses, from cholera to syphilis. They have drastically reduced the risks of surgery and chemotherapy, which destroys the patient’s immune system.
路德的经历说明了一个日益严重的问题——以及一个可能的解决方案。抗生素是医学上最引人注目的成就之一。这类“银弹”药物既能消灭致病细菌，又能保护病人自身的细胞，从霍乱到梅毒，它们已经消灭了各种曾经令人恐惧的疾病。它们大大降低了手术和化疗的风险，化疗会破坏病人的免疫系统。
But their magic is waning. Repeated exposure to a lethal threat has led bacteria to evolve resistance to many existing antibiotics, blunting their efficacy. At the same time, much of the pharmaceutical industry has lost interest in finding new ones. It has been almost 40 years since a new class of antibiotics has been made available to patients. Some infections, including gonorrhoea and tuberculosis, are once again becoming difficult to treat. One estimate, published in the Lancet in 2022, reckons antibiotic resistance directly caused 1.2m deaths in 2019, and was indirectly implicated in 3.8m more.
但抗生素的魔力正在减弱。反复接触致命威胁导致细菌对许多现有抗生素产生耐药性，削弱了它们的疗效。与此同时，许多制药企业已经对寻找新的抗生素失去了兴趣。自从上一种新型抗生素被提供给病人以来，已经将近40年了。包括淋病和肺结核在内的一些感染再次变得难以治疗。2022年发表在《柳叶刀》上的一项估计认为，2019年抗生素耐药性直接导致120万人死亡，间接导致380万人死亡。
With antibiotics unable to cure his illness, Mr Rud took a chance. He travelled to the Eliava Institute in Tbilisi, Georgia, one of a handful of institutions specialising in the study of bacteriophages. These are viruses that infect and kill bacteria. The Eliava Institute uses them as living antibiotics.
由于抗生素无法治愈他的病，路德先生决定冒险。他前往格鲁吉亚第比利斯的埃利亚瓦研究所，这是少数专门研究噬菌体的机构之一。噬菌体是感染并杀死细菌的病毒。埃利亚瓦研究所使用它们作为活抗生素。
“Phages” are little known outside the former countries of the Soviet Union, which did the most to develop the idea. In Georgia they have been part of the local pharmacopoeia for decades. Little vials containing stale-tasting liquid full of antibacterial viruses can be bought at pharmacies across Tbilisi. Now, as worries about antibiotic resistance build, Western firms are taking a second look.
“噬菌体”在前苏联国家之外鲜为人知，而这些国家对这一想法的发展贡献最大。在格鲁吉亚，几十年来它们一直是当地药典的一部分。在第比利斯的各个药店都可以买到小瓶装着充满抗菌病毒的味道不好的液体。现在，随着对抗生素耐药性的担忧加剧，西方公司正在重新审视。