ImmuCell, a biotech company in Portland, Maine, has developed a bacteriocin that treats dairy cows for mastitis, a disease that costs the dairy industry $2 billion a year. Riley says labs like hers can adapt phages and bacteriocins to target virtually any sort of human microbial infection too, with little risk of nurturing new resistance. “These are stable, hardy killing mechanisms that evolved 2 billion years ago,” she says.
缅因州波特兰市的生物技术公司ImmuCell开发了一种细菌素，用于治疗乳腺炎，乳腺炎每年给乳制品行业带来20亿美元的损失。莱利表示，像她这样的实验室可以让噬菌体和细菌素适应几乎任何一种人类微生物感染，几乎没有培育新的耐药性的风险。“这些是20亿年前进化而来的稳定、顽强的杀戮机制，”她说。
Several clinical trials of phage therapy have already been successfully conducted in Poland, the nation of Georgia and Bangladesh. In the West, there have been successful phage trials for foot ulcers. No trials are underway for more serious infections, but a successful phage treatment of a critically multiresistant-infected patient in California in 2017 under Food and Drug Administration emergency rules has more researchers in the U.S. looking to develop phage treatments. One or more of these could move toward trials in the next few years, says Riley, including one for multi-resistant tuberculosis and another for pulmonary infections in cystic fibrosis patients. Bacteriocins are further behind. The U.S. government has promised to provide $2 billion for the effort to develop these alternatives, “but that's not nearly enough,” she says.
波兰、格鲁吉亚和孟加拉国已经成功地进行了若干噬菌体治疗的临床试验。在西方，已经有成功的噬菌体试验治疗足溃疡。目前还没有针对更严重感染的试验，但根据美国食品和药物管理局的紧急规定，2017年加州一名多重耐药性感染患者的噬菌体治疗取得成功，这让美国有更多研究人员希望开发噬菌体治疗方法。赖利说，其中一种或多种药物有望在未来几年进入临床试验阶段，其中一种用于治疗耐多药结核病，另一种用于治疗囊性纤维化患者的肺部感染。细菌素远远落后。美国政府承诺提供20亿美元用于开发替代能源，“但这还远远不够，”她说。
Cancer researchers are widely investigating drugs that can boost immune systems, and these immunotherapies could be promising in helping weakened patients fight off resistant bugs that try to take hold. Researchers have produced human antibodies in cows and other animals that can be injected into patients. Boston's Harvard-affiliated Brigham and Women's Hospital, in an emergency effort, reported injecting a combination of antibodies and antibiotics to save a patient with a drug-resistant infection, but the results weren't disclosed. Otherwise, little has been done to bring the approach to trials in infected patients. Researchers are also working on vaccines against resistant staph infections and other resistant bacteria, but these too are just research efforts. “These non-antibiotic treatments are still in the early stages of investigation,” says David Banach, who heads infection prevention at the UConn Health medical center in Farmington, Connecticut. “But we have to keep thinking of new approaches.”
癌症研究人员正在广泛研究能够增强免疫系统的药物，这些免疫疗法有望帮助身体虚弱的病人击退那些试图占据优势的抗药性细菌。研究人员已经在牛和其他动物身上制造出了人类抗体，可以注射到病人体内。波士顿哈佛大学附属的布里格姆女子医院在紧急情况下报告说，他们注射了抗体和抗生素的混合物，以挽救一名耐药感染患者，但没有告知调查结果。除此之外，几乎没有人将这种方法应用于感染患者的试验。研究人员还在研究针对耐药葡萄球菌感染和其他耐药细菌的疫苗，但这些也只是研究工作。“这些非抗生素治疗仍处于研究的早期阶段，” 康涅狄格州法明顿市康州大学健康医疗中心感染预防部门的负责人大卫·巴纳奇说。“但我们必须不断思考新的方法。”
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