在对抗耐药性细菌的战斗中，美国政府出台了一个新激励措施：设置2000万美元奖金，用于奖励能识别高耐药性感染的快速诊断试验。该奖金只是白宫近日宣布的大量行动中的一个，这些行动标志着其对耐抗生素细菌威胁的更大关注。
除了相关奖金，美国政府还宣布了一项国家策略，设定了2020年需要达成的目标，包括更好地监督高耐药性感染、更快地发展新抗生素以及更好地使用现存药物。总统巴拉克·奥巴马还签署了一项行政命令，要求成立非政府专家组成的咨询小组委员会以及一个跨部门的特别小组，由健康和人类服务部（HHS）、国防部和农业部部长联合担任组长。
“这代表了该议题的一个重要高度，行政职能的主要累加作用将帮助解决该问题。”白宫科学和政策办公室主任John Holdren在新闻发布会上表示。
该奖金由国立卫生研究院以及生物医学高级研究和发展局联合赞助，它还将是一个即将召开的公共会议的主题，会上HHS将要求对最有用的检测方法进行反馈。
同时，总统科学和技术咨询委员会（PCAST）发布其观点以迎合一些广泛的目标。例如，他们就阻止抗生素耐药性工作的报告表明，一个实验室国家网络追踪高耐药性案例以及广泛使用基因分析调查耐药菌株，将会是一个突破点。他们还督促食品药品监督管理局制定新的批准路径，处理抗菌剂的迫切需求。更具体的建议是：在未来7年中，政府每年提供1.5亿美元用于可能带来新抗生素或对抗感染的“非常规”疗法的基础研究。
当然，政府部门并非必须做这些事情。Holdren表示，新成立的特别小组将会处理PCAST报告提出的建议，但并不一定接纳它们。另外，特别小组将于明年2月15日后提出自己的行动计划。
PCAST Releases New Report on Combating Antibiotic Resistance
（by Eric Lander & Christopher Chyba）
The President’s Council of Advisors on Science and Technology（PCAST）released a report to the President, Combating Antibiotic Resistance. The report was released simultaneously with a National Strategy on Combating Antibiotic Resistant Bacteria as well as with a Presidential Executive Order, emphasizing to the Nation the importance of addressing this growing challenge.
The evolution of antibiotic resistance in bacteria is occurring at an alarming rate and is outpacing the development of new countermeasures. According to the Centers for Disease Control and Prevention（CDC）, the annual domestic impact of antibiotic-resistant infections to the U.S. economy has been estimated at $20 billion in excess direct health care costs, with additional costs to society for lost productivity as high as $35 billion per year and 8 million additional days in hospitals. The safety of many modern medical procedures – including cancer chemotherapy, complex surgery, dialysis for renal disease, and organ transplantation – relies on effective antibiotics. These interventions become significantly more dangerous as bacterial resistance rises. Indeed, the World Health Organization recently warned that we risk entering a “post-antibiotic” era unless we act now.
Bacteria and other microbes evolve in response to their environment and inevitably develop mechanisms to resist antibiotics. In his 1945 Nobel Prize address, Alexander Fleming（recipient of the Nobel Prize for his discovery of penicillin）warned that the inappropriate use of antibiotics would cause human infections to become resistant to these drugs. As bacteria evolve resistance to widely used antibiotics, it is crucial to stay one step ahead of the problem. PCAST recommends measures to strengthen antibiotic stewardship, boost surveillance, and facilitate the development of new drugs, diagnostics, and vaccines to combat this growing crisis.
Responsible stewardship of antibiotics requires identifying the microbe responsible for disease（ideally with rapid and inexpensive diagnostics）; administering the most effective antibiotic at the appropriate dose, route, and time; and discontinuing antibiotic therapy when it is no longer needed. Optimizing the use of our current antibiotics in human healthcare and animal agriculture will extend the longevity of these life-saving medicines and maximize their benefits.
Increased surveillance for antibiotic-resistant bacteria will enable more effective responses to resistant strains, support earlier identification of outbreaks, and limit the spread of resistant organisms. Improved surveillance will help address fundamental questions of where resistant infections originate, practices that contribute to emergence, and how resistant microbes are being transmitted.
Even with improved stewardship and surveillance, it is critical to develop new antibiotics, diagnostics, vaccines, and other interventions at a rate that outpaces the emergence of resistant microbes. A robust antibiotic pipeline is essential for creating new antibiotics to replace those being steadily lost to antibiotic resistance. Establishing this pipeline and successfully addressing the rise in antibiotic resistant bacteria will require coordination across governmental, academic, health-related, agricultural, and private sectors.
In the fight against microbes, no permanent victory is possible：as new treatments are developed, organisms will evolve new ways to become resistant. This reality underscores how essential it is to embark on a course of action that will ensure an effective and enduring arsenal of antibiotics. Committing to combating antibiotic-resistant microbes will support patient care, economic growth, agriculture, and economic and national security. By taking the recommended steps, the United States and global community will continue to reap the benefits of these essential medicines.
（See the detail：http://www.whitehouse.gov/sites/default/files/microsites/ostp/PCAST/pcast_carb_report_sept2014.pdf）
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