A study has found that some bacteria are becoming "more tolerant" of the alcohol-based hand sanitizers used in hospitals.
一項研究發現，一些細菌對醫院使用的含酒精的洗手液越來越「耐受」。
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In the early 2000s, hospitals across Australia began installing more hand-sanitizer dispensers in their rooms and hallways for staff, visitors and patients to use. Research showed these alcohol-based disinfectants helped battle staph infections in patients and certain kinds of drug-resistant bacteria. And rates of these infections went down.
在21世紀初期，澳大利亞各地的醫院開始在他們的房間和走廊安裝更多的洗手液分配器，供員工，訪客和患者使用。研究表明，這些以酒精為基礎的消毒劑有助於對抗葡萄球菌感染和某些種類的抗藥性細菌。這些感染的比率下降了。But other infections didn't drop when people started using the sanitizer stations. In fact, certain infections went up.
但是當人們開始使用消毒劑站時，其他感染並沒有下降。事實上，某些感染率上升了。In particular, enterococcal infections — caused by bacteria that affect the digestive tract, bladder, heart and other parts of the body — started increasing.
特別是腸球菌感染 - 由影響消化道，膀胱，心臟和身體其他部位的細菌引起 - 開始增加。This wasn't only happening in Australia. Countries around the world saw rises in this type of infection even as hand sanitizer became more popular. Globally, enterococci make up ten percent of bacterial infections acquired in the hospital. In North America and Europe, they are a leading cause of sepsis, a deadly blood infection.
這不僅僅發生在澳大利亞。儘管洗手液越來越受歡迎，但世界各國的這類感染都有所增加。在全球範圍內，腸球菌佔醫院獲得的細菌感染的百分之十。在北美和歐洲，它們是導致敗血症的主要原因，一種致命的血液感染。Now, researchers say, they may have found the cause. Blame it on the alcohol.
現在，研究人員說，他們可能找到了原因。把它歸咎於酒精。New research published by Science Translational Medicine on Wednesday shows that several strains of these bacteria have begun adjusting to alcohol-based hand sanitizers. They're not resistant to the alcohol — at least, not yet — but they're becoming "more tolerant" of it, the authors write. That means the bacteria were able to survive for longer periods of time after being doused with alcohol.
《科學轉化醫學》周三發表的一項新研究顯示，這些細菌中的幾種菌株已經開始適應基於酒精的洗手液。作者寫道，它們對酒精沒有抵抗力 - 至少，現在還沒有 - 但它們正變得「更加寬容」。這意味著細菌在被酒精浸泡後能夠存活更長時間。The researchers used different strengths of alcohol concentrations to combat the bacteria, starting with 23 percent. Eventually, at a 70-percent alcohol mixture, the bacteria were conquered. Typically, hand sanitizers are 60 percent alcohol.
研究人員使用不同濃度的酒精來對抗細菌，從23％開始。最終，在70％的酒精混合物中，細菌被攻克。通常，洗手液中含有60％的酒精。To make matters worse, many of these alcohol-tolerant bacteria are resistant to multiple drugs as well. Half of the strains the researchers studied cannot be treated with vancomycin, a last-line antibiotic. That means the bacteria are spreading more easily within hospitals, and there aren't many options for treatment.
更糟糕的是，這些耐酒精的細菌中有許多對多種藥物也有抗藥性。研究人員研究的半數菌株不能用萬古黴素治療，萬古黴素是最後一種抗生素。這意味著細菌在醫院裡更容易傳播，治療方案也不多。The researchers were surprised by their findings.
"To our knowledge this was the first time anyone had shown hospital bacteria becoming tolerant to alcohols," says Timothy Stinear, a coauthor of the study and a researcher at the University of Melbourne's Doherty Institute for Infection and Immunity.
「據我們所知，這是有史以來第一次有人證明醫院細菌對酒精的耐受性，」該研究的合著者，墨爾本大學多赫蒂感染和免疫研究所的研究員Timothy Stinear說。First the researchers compared 139 types of bacteria, looking at the same strains over a 19-year stretch — from 1997 to 2015. As time passed, the bacteria evolved to tolerate alcohol better. To be exact, bacteria collected after 2009 were 10 times more tolerant than pre-2004 bacteria — which corresponds to the national push to use more hand sanitizers.
首先，研究人員對139種細菌進行了比較，觀察了從1997年到2015年這19年時間裡的相同的菌株。隨著時間的推移，細菌進化出了更好地耐受酒精的能力。確切地說，2009年之後收集的細菌耐受性比2004年之前的細菌高10倍 -這與國家推動使用更多的洗手液是一致的。But bacteria don't always operate in your body the way they do in a lab. It's risky to test these drug-resistant bacteria on people, so researchers turned to tests on mice — a common way to model how humans might also react. The results were the same — the guts of mice quickly showed signs of alcohol-tolerant bacteria, even when their cages were cleaned with an alcohol solution.
但細菌並不總是像在實驗室中那樣在你體內活動。在人體上測試這些耐藥細菌是有風險的，因此研究人員轉向在老鼠身上進行測試 -這是一種常見的模擬人類反應的方法。結果是相同的 - 即使用酒精溶液清洗籠子，老鼠的內臟很快就會出現酒精耐受細菌的跡象。Health-care institutions trying to control the spread of these infections will need to "adhere rigorously to hand-hygiene protocols," Stinear says — and probably institute additional measures to stop the spread, such as increased hand-washing with soap after coming into contact with the bacteria.
試圖控制這些感染傳播的醫療機構將需要「嚴格遵守手部衛生規程」，Stinear說 - 並且可能會採取額外的措施來阻止傳播，例如在接觸細菌後增加用肥皂洗手。Lance Price, a professor at the George Washington University's Milken Institute School of Public Health and the founding director of GW's Antibiotic Resistance Action Center, was also surprised by the findings.
喬治華盛頓大學米爾肯研究院公共衛生學院教授，GW抗生素耐藥性行動中心的創始主任Lance Price也對這一發現感到意外。"I always thought of alcohol as being like a sledgehammer," says Price, who was not affiliated with the study. "But clearly, these are innovative organisms. And evolution happens pretty fast."
「我一直認為酒精就像一把大錘，」 Price說，他沒有參與這項研究。「但很明顯，這些都是創新生物體。而且進化發生的非常快。」The particular type of bacteria, enterococci, is most often found in hospitals. But this research has implications for any bacteria that may begin tolerating alcohol. For instance, organisms like C. diff, another rapidly rising infection that is difficult to treat, have hard shells that make it difficult for alcohol to kill them; the best way to get rid of them is to wash them down the drain.
特定類型的細菌腸球菌最常見於醫院。但這項研究對任何可能開始耐受酒精的細菌都有影響。例如，像C. diff這樣的生物，另一種快速上升的難以治療的感染，有堅硬的外殼，使酒精很難殺死它們；擺脫它們的最好方法是將它們衝洗乾淨。"If you're washing your hands less because that alcohol-based hand sanitizer makes you feel confident that your hands are clean," Price says, "all of a sudden you can become a vehicle for alcohol-resistant organisms."
「如果你不怎麼洗手，因為使用含酒精的洗手液會讓你覺得雙手都很乾淨，」 Price說，「突然間，你就可能成為耐酒精生物的載體。」The research is still clear that alcohol-based hand sanitizers are more effective at battling some bacteria, like those causing staph infections. However, this study indicates that other bacteria are best cleaned off with simple soap and water.
研究仍清楚地表明，含酒精的洗手液在對抗某些細菌方面更有效，例如那些引起葡萄球菌感染的細菌。然而，這項研究表明，其他細菌最好用簡單的肥皂和水來清除。"It's the physical action of lifting and moving them off your skin, and letting them run down the drain," Price says.
Price說：「這是一種身體動作，把它們從你的皮膚上去除，然後讓它們流進下水道。」"We have to be careful about this new trend towards heavy reliance on alcohol-based hand sanitizers," Price continues. "Soap and water should be our number-one protection" — both in hospitals and for personal use.
「我們必須謹慎對待這種嚴重依賴酒精洗手液的新趨勢，」Price繼續說道。「肥皂和水應該是我們的首要保障」 - 無論是在醫院還是個人使用。The next question, Price says, is whether the bacteria will continue to evolve and tolerate higher and higher doses of alcohol — or even stop responding entirely.
Price說，下一個問題是，細菌是否會繼續進化並耐受越來越大劑量的酒精，甚至完全停止反應。"Is it possible for these organisms to develop complete resistance to alcohol?" he asks.
「這些生物體是否有可能對酒精產生完全抵抗力？」他問。Melody Schreiber (@m_scribe on Twitter) is a freelance journalist in Washington, D.C.
Melody Schreiber（Twitter @m_scribe）是華盛頓特區的自由撰稿人。
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