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'Some antibiotic resistance was first detected in India. One of the reasons for this is that many antibiotics are used in India, and often these have been bought by patients and not used under prescription. This means that antibiotics are used very widely, not always to treat bacterial infections and not always at the correct dose.'
某些抗生素抗药性在印度是首次发现，原因之一是印度滥用抗生素的现象十分普遍，许多病人未经医嘱随意购买抗生素。这意味着抗生素既没有按照正确的计量使用，也并不总用来治疗细菌感染。
'This provides a 'breeding ground' for the development of antibiotic resistant bacteria.'
这为抗生素抗药菌提供了发展的‘土壤'。
Laura Piddock, who leads Britain's Antibiotic Action, tells Vaihayasi Pande Daniel/Rediff.com how India can defend itself on a war footing against the scourge of superbugs, or bacteria that have become resistant to antiobiotics.
劳拉﹒皮多克是英国抗生素运动的领导人，她告诉瓦哈亚西﹒潘迪﹒丹尼尔/Rediff.com印度应如何准备与(对大多数抗菌素产生抗药性的)超级细菌做斗争.
A sick child in a hospital in Patna. Hygiene is very crucial to the prevention of the spread of superbugs, says Professor Laura J V Piddock, who heads Antibiotic Action. Photograph: Adnan Abidi/Reuters.
上图为巴特那一家医院中的一位病孩。抗生素运动的发起人劳拉﹒JV﹒皮多克教授表示，卫生对于预防超级细菌的传播至关重要。
What exactly are superbugs?
超级细菌到底是什么？
Do all of us need to be worried about these multidrug-resistant bacteria?
我们应该担心这些抗生素抗药菌吗？
Is India also bleakly facing the approach of a time when antibiotics will be toothless?
印度是否正消极面对抗生素失效的那一天？
How can we protect ourselves from superbugs?
我们应该如何抵御超级细菌？
Laura J V Piddock, professor of microbiology at the University of Birmingham, the United Kingdom, also heads up Antibiotic Action, an independent UK-led global initiative working to push home the gravity of this problem facing people the world over.
劳拉﹒JV﹒皮多克是伯明翰大学的微生物学教授，也是抗生素运动的发起人。抗生素运动是一项英国主导的独立运动，致力于向全球传播抗生素抗药菌问题的严重性。
"It is vital to the health of all nations that antibiotics remain the mainstay of modern medicine and are available to all on an equitable basis," she tells Vaihayasi Pande Daniel/Rediff.com in an e-mail interview.
皮多克教授在一封电子邮件中，向Rediff.com网站的哈亚西﹒潘迪﹒丹尼尔：“抗生素仍是现代医学中最重要的发现之一，向所有人一视同仁的提供抗生素对于人类健康至关重要。”
About Antibiotic Action, Piddock says, contributes to "national and international activities and acts as a conduit through which all stakeholders -- from the general public to healthcare professionals to politicians -- are educated on the importance of new ways to treat bacterial infections".
皮多克教授表示，抗生素运动为“普罗大众、医疗从业者和政治家 – 所有利益攸关者了解治疗细菌感染的新途径”做出贡献。
How did the phenomenon of superbugs becoming drug-resistant come about? What were the factors that led to the misuse and overuse of antibiotics?
超级细菌是如何变得具有耐药性的？是什么因素导致乱用和滥用抗生素？
Bacteria evolve to survive in hostile environments.
细菌通过进化适应恶劣的环境。
Antibiotics can be viewed as making a hostile environment and so put evolutionary pressure on bacteria so this drives the evolution of strains resistant to antibiotics. Whilst many bacterial strains remain susceptible within a population, mutations occur very rarely to give resistance.
我们可以把抗生素看作为细菌创建了一个不利的环境，从而促使细菌菌株进化出抗药性。然而在一定数量内，许多细菌菌株对抗生素仍十分敏感，发展出抗性的突变是非常罕见的。
However, because antibiotics kill all of the susceptible bacteria in that population, the resistant bacteria remain and are able to grow up.
因为抗生素杀死了那些对抗生素敏感的细菌，而具有抗性的细菌活了下来，继续成长。
Bacteria grow very quickly and their generation time, such as for E.Coli, is 20 to 30 minutes. This means that many rare mutant bacteria that are antibiotic resistant can grow up and become millions and millions of cells within 24 hours.
细菌生长的速度非常快，更新换代的速度，如大肠杆菌，是20至30分钟。这意味着许多发展出抗药性的罕见变异细菌能在24小时内繁殖出数以百万计的细胞。
Even for the bacteria that cause tuberculosis, which grow extremely slowly, resistant bacteria can emerge and proliferate within several weeks.
即使是导致肺结核的细菌，其生长速度非常缓慢，但抗药菌仍可在数周内出现并扩散。
Bacteria are also able to share genes, some of these confer the ability for bacteria to infect their host and other confer antibiotic resistance.
细菌能够分享基因，其中一些传播传染宿主的能力，另一些则传播抗生素抗药性。
Again, acquiring resistance gives an evolutionary advantage to those bacteria with the resistance genes over the antibiotic susceptible population. Again, these bacteria survive and grow up very quickly. Any use of antibiotics will select antibiotic resistant bacteria and the more that antibiotics are used (and if there is insufficient dosing to kill any bacteria), then the environment is made to drive and select antibiotic resistant bacteria.
再一次，获得抗药性使这些具有抗性基因的细菌保有进化优势。那些对抗生素敏感的细菌被杀死，而这些细菌活了下来，成长的非常快。每一次抗生素的使用是对抗生素抗药菌的筛选，抗生素使用的越多（且如果剂量不足以杀死任何细菌），那么抗生素创造的环境将筛选和保留抗生素抗药菌。
In which areas of the world is the risk highest? Why are certain areas at higher risk?
世界上哪些地区风险最大？为什么？
Selecting antibiotic resistant bacteria can occur anywhere at any time an antibiotic is used, whether it be in people, animals or the environment. Therefore, areas with the highest use of antibiotics, and where dosing is not carefully adhered to, or where antibiotics are freely available, without prescription, means that the risk of selecting antibiotic resistant bacteria is greatest.
当使用抗生素时，无论什么时间、什么地点、使用对象是人类、动物还是环境都有可能导致产生抗生素抗药菌。因此，那些频繁使用抗生素，没有掌握正确的使用剂量，或抗生素随处可得，没有按处方使用的地区最有可能产生抗生素抗药菌。
Why is this phenomenon so frightening? As this tragedy spreads, without being alarmist, what is the worst case scenario we could be looking at globally?
为什么这种现象这么可怕？如果抗生素抗药菌四处蔓延，这不是危言耸听，我们所面临的最糟糕情况是怎样的？
The phenomenon is frightening because these bacteria cause infections that are so difficult to treat. With so few drugs active against resistant bacteria, patients will now suffer from untreatable infections.
这种现象的可怕之处在于抗生素抗药菌造成的感染很难医治。有效治疗抗药菌的药物非常稀少，病人将会饱受无法治愈的感染折磨。
This will occur more and more often until we have new ways to prevent and treat bacterial infections.
这种现象将变得愈加频繁，直至我们找到预防和治疗细菌感染的新方法。
The worst case scenario is that many common place treatments no longer work and people start to die from infections that until recently were fully treatable.
最坏的情况是许多常见的治疗方式不起作用，某些直至最近才能彻底治疗的细菌感染将致人死地。
What are the key issues that need to be addressed to solve this calamity?
解决这个灾难的关键是？
The key issues are that we must minimise and prevent the opportunities for bacteria to infect people (and animals) and minimise the use of antibiotics so that they are only used when needed to treat a bacterial infection.
解决问题的关键在于我们应该尽可能减少和预防细菌感染人类（和动物）的机会；尽量减少使用抗生素，仅在治疗细菌感染时使用。
We need new ways to diagnose bacterial infections quickly so the correct treatment is used, and we need new treatments, including new antibiotics that are active against antibiotic resistant bacteria.
我们必须找到快速确诊细菌感染的新方法，对症下药；我们需要新的治疗方式，包括新的抗生素，能有效对抗抗生素抗药菌。
To do all of this, new research is required, not least to find the best doses and strategies to minimise the selection of resistant bacteria.
为了达到这一目的，我们必须展开新的研究，而不仅仅是找寻最合适的剂量和方案以减少抗生素抗药菌的产生。
Why is it that these superbugs evade even the hardest-hitting or last resort antibiotics, like carbapenems (antibiotics which are resistant to most bacteria)? Why are these bugs so super strong?
为什么这些超级细菌能够侵入最强力，最顽强的抗生素？比如碳青霉烯（对大部分细菌都有效的抗生素）？为什么这些细菌这么厉害？
These bacteria are not super strong. They have just been exposed to many different antibiotics over decades, allowing them to add antibiotic resistances in the same way as trains add carriages.
这些细菌并不厉害。他们只是在数十年间历经多种不同的抗生素，使他们能够像火车加车厢一样具备抗生素抗药性。
Where does India connect in all this? How much of a problem is this in India? Are there any diseases in particular that India needs to be worried about?
印度和这些有什么关系？这些问题在印度常见吗？哪些疾病是印度需要特别关注的？
Some antibiotic resistances were first detected in India.
一些抗生素抗药性在印度是首次发现。
One of the reasons for this is that many antibiotics are used in India, and often these have been bought by patients and not used under prescription. This means that antibiotics are used very widely, not always to treat bacterial infections and not always at the correct dose.
原因之一是印度滥用抗生素的现象十分普遍，许多病人未经医嘱随意购买抗生素。这意味着抗生素既没有按照正确的计量使用，也并不总用来治疗细菌感染。
This therefore provides a 'breeding ground' for the development of antibiotic resistant bacteria.
这为抗生素抗药菌提供了发展的‘土壤'。
In what manner does India need to join the fight?
印度该如何对抗抗生素抗药菌？
India, via the Chennai Declaration (external link,) is already starting to address the issues of over-prescription of antibiotics by hospital doctors. In addition, with increased awareness it is hoped that use of antibiotics in all sectors will be reduced.
金奈宣言（印度医疗界解决抗生素抗药性问题的宣言）说明印度已经开始解决医院医生滥开抗生素的问题，除此之外，随着认识的提高，使用抗生素治疗所有疾病的现象将有所缓和。
What is the most basic advice and precautions you can offer the Indian public, including those who may be illiterate? And what is the most important advice you can offer Indian doctors?
皮多克教授，您能向印度大众，特别是那些不识字的人给予一些基本的建议和提醒吗？至于印度医生，您觉得最重要的意见是？
The best advice is to have as good hygiene as possible and so prevent infection.
最好的建议是尽可能保持卫生，预防感染。
Secondly, if an individual gets an infection, to do their best not to pass on the infection to other members of their household, school or workplace.
第二，如果有人被感染，尽可能不要传染给家人、学校师生或同事。
To also help this, people should not share washcloths, towels or clothes until they have been washed and any bacteria removed. The same goes for preventing transmission of viral infections.
还有一点可能有所帮助的是，除非经过清洗和消毒，人们不应该共用面巾、毛巾或衣物。这一点对于预防病毒传播也非常有效。
For Indian doctors, they should only use antibiotics to treat infections that are likely to be caused by bacteria. They should be aware of local antibiotic resistance patterns so that they can make the best choice of effective antibiotics.
至于印度医生，他们应该对疑似细菌引起的感染使用抗生素。印度医生应该了解当地抗生素的抗药模式，这样他们能选择最有效果的抗生素用于治疗。
They need to make sure that they use the correct dose and for the appropriate duration and encourage their patients to take the antibiotics properly.
印度医生应该确保使用正确的剂量，适当的用药时限并鼓励病人按需使用抗生素。
What does the Indian government need to do on a war footing?
在与抗生素抗药性作斗争时，印度政府需要做哪些工作？
The Indian government should sign up to the WHO Global Action Plan and do their best to implement it to meet the needs of India and address the current resistance concerns specific to India.
印度政府应该签署世界卫生组织全球行动计划，尽全力实施这项计划以满足印度的需要。解决印度特有的抗生素抗药性问题。
Is it a race to find better antibiotics? Or a matter of looking at other creative options too and what could they be?
我们应该就寻找更好的抗生素展开竞赛吗？还是应该寻找其他更有创造力的解决方案？
What are the key issues hampering the bringing of new antibiotics to the global markets quickly and in more variety?
是什么在阻碍新抗生素以各种形式快速出现在全球市场上？
There are numerous key issues hampering bringing new antibiotics to market, not least regulatory hurdles and that the business model for antibiotics needs to be different to that for drugs for other therapeutic areas.
阻碍新抗生素上市的原因太多了，不仅仅是监督障碍，还有抗生素的商业模式必须与其他领域的药物有所区别。
All options, including new antibiotics, should be explored.
我们应探索所有的解决方案，包括发明新抗生素。
How are superbugs different from regular bugs apart from their ability to resist bacteria?
除了抗药能力之外，超级细菌与普通细菌还有什么区别吗？
Superbugs only differ from 'regular' bugs in that they are antibiotic resistant. Very few antibiotic resistance mechanisms make bacteria fitter.
超级细菌和‘普通'细菌的区别只是抗生素抗药性。很少有抗生素抗药机制能把细菌变得更强。
When AIDS came on the scene people quickly got to know about the disease and its causes although prevention took longer. Why has awareness about superbugs, which is as scary, taken longer?
当AIDS出现时，人们很快就了解了这种疾病及其病因，虽然理解AIDS预防措施的时间长了些。为什么超级细菌这么可怕，人们却并不很了解它？
People become very frightened of AIDS because it was a terminal disease for which there is no cure.
人们非常害怕AIDS，因为这是一种不治之症。
For antibiotic-resistant bacteria, we still have some cures although these are diminishing in number day by day.
尽管治疗抗生素抗药菌的方法日渐稀少，但仍是可以治愈的。
AIDS also affected particular demographic groups, who were extremely vocal in bringing this to public awareness. Unfortunately, people are used to getting infections and used to being able to treat them with antibiotics.
AIDS还对特定人群产生影响，这对唤醒大众的认知非常有说服力。不幸的是，印度人已经习惯了被感染和依赖抗生素进行治疗.
