The accident that changed the world - Allison Ramsey and Mary Staicu

譯者: Clement Fu 審譯者: Bruce Sung

London, 1928: a group of mold spores surf a breeze through a lab.

1928 年，倫敦

一群黴菌孢子隨風飄進一個實驗室

They drift onto a petri dish, and when they land,

飄落在一個細菌培養皿上

they germinate a medical revolution.

著陸的一刻，萌生一場醫學革命

This lab belongs to Alexander Fleming, a Scottish scientist

這個實驗室屬於一位蘇格蘭科學家

亞歷山大·弗萊明 (Alexander Fleming)

investigating the properties of infectious bacteria.

他在研究感染性細菌的特性

At this time, Fleming is away on vacation.

那時候正遠遊渡假，回來時卻發現

When he returns, he finds a colony of mold growing on a petri dish

培養皿上孳生一個黴菌菌落

he’d forgotten to place in his incubator.

原來這個培養皿忘了放進培養器內

And around this colony of mold is a zone

而在黴菌菌落的周圍一帶

completely and unexpectedly clear of bacteria.

出乎意料、乾淨澈底的無菌

In studying this mysterious phenomenon,

弗萊明考究這個神奇現象的背後

Fleming came to realize that the mold was secreting some kind of compound

發現黴菌釋出一種化合物

that was killing the bacteria.

足以把細菌殺死

The mold was a species in the Penicillium genus,

那是青黴屬 (Penicillium genus) 之下其中一種黴菌

so Fleming dubbed the antibacterial compound “penicillin.”

於是這抗菌化合物就被他命名為 「青黴素」(Penicillin，即盤尼西林)

What Fleming stumbled upon was a microbial defense system.

弗萊明巧遇的是一種微生物防禦機制

The penicillium mold constantly produces penicillin

青黴屬黴菌會不斷地產生青黴素

in order to defend itself from threats,

以防禦威脅

such as nearby bacterial colonies that might consume its resources.

例如鄰近會耗用資源的細菌菌落

Penicillin destroys many types of bacteria

青黴素能破壞許多類型的細菌

by disrupting synthesis of their cell walls.

全靠阻斷細菌細胞壁的合成

These walls get their strength from a thick, protective mesh of sugars

細胞壁的強度來自一層保護厚網

是由糖和胺基酸組成網狀

and amino acids,

that are constantly being broken down and rebuilt.

而且會不斷地分解和重建

Penicillin binds to one of the compounds that weaves this mesh together

青黴素與一種組織成網的化合物結合

and prevents the wall from being reconstructed at a critical phase.

在關鍵階段阻止細胞壁重構

Meanwhile, penicillin stimulates the release of highly reactive molecules

青黴素同時刺激高活性分子的釋放

that cause additional damage.

進一步帶來損害

Eventually, the cell’s structure breaks down completely.

最終，細胞的結構完全瓦解

This two-pronged attack is lethal to a wide range of bacteria,

雙管齊下的攻擊，致多種細菌於死地

whether in petri-dishes, our bodies, or elsewhere.

不論在培養皿、人體還是他處亦然

It’s not, however, harmful to our own cells,

對人體細胞則無害

because those don’t have cell walls.

因為人類細胞並沒有細胞壁

For a decade or so after Fleming’s discovery,

繼弗萊明的發現之後，有十年左右

penicillin remained a laboratory curiosity.

青黴素只是實驗室裡的不尋常之物

But during World War II,

直到第二次世界大戰的時候

researchers figured out how to isolate the active compound

研究員找到分離活性化合物的方法

and grow the mold in larger quantities.

大量培養黴菌

They then went on to win the Nobel Prize for their work.

他們研究有成，更獲諾貝爾獎表彰

Teams at Oxford and several American drug companies continued development,

牛津大學及數家美國藥廠繼續研發

and within a few years it was commercially available.

數年後，青黴素以商品面世

Penicillin and similar compounds quickly transformed the treatment of infections.

青黴素之類化合物迅速扭轉感染治療

For the time being,

迄今為止

they remain some of the most important, life-saving antibiotics used in medicine.

仍屬醫學中重要的救命抗生素

However, the more we use any antibiotic, the more bacteria evolve resistance to it.

不過，當一種抗生素用得愈多

細菌愈對那種抗生素演化出抗藥性

In the case of penicillin,

以青黴素為例

some bacteria produce compounds that can break down the key structure

一些細菌產生出化合物

專門分解阻斷細胞壁合成的關鍵結構

that interferes with cell wall synthesis.

As antibiotic use has increased,

隨著抗生素日益廣泛使用

more and more bacteria have evolved this defense,

越來越多細菌演化出這種防禦

making these antibiotics ineffective

讓這些抗生素頓失用武之地

against a growing number of bacterial infections.

愛莫能助的細菌感染與日俱增

This means it’s essential that doctors not overprescribe the drug.

所以醫生萬萬不可過度處方這藥物

Meanwhile, 5 to 15% of patients in developed countries

與此同時，已開發國家中的病人

百分之 5 至 15 自訴對青黴素過敏

self-identify as allergic to penicillin,

making it the most commonly reported drug allergy.

成為最普遍的呈報藥物過敏

However, the vast majority— over 90%— of people

然而當中絕大多數 (即超過九成) 人

who think they’re allergic to penicillin actually are not.

自以為對青黴素過敏，其實不然

Why the misperception?

哪兒來的誤解？

Many patients acquire the allergy label as children,

許多病人在兒時被標記為過敏

when a rash appears after they’re treated for an infection with penicillin

小時候，有一次治療感染的時候

接受青黴素或密切相關的藥物

or closely related drugs.

The rash is often blamed on penicillin,

之後出現皮疹，就歸咎於青黴素

while the more likely culprit is the original infection,

但實際成因更大可能是原本的感染

or a reaction between the infection and the antibiotic.

或是感染與抗生素之間產生的反應

However, genuine penicillin allergies,

不過，真正的青黴素過敏也有所聞

where our immune systems mistake penicillin for an attacker,

人體免疫系統誤認青黴素為攻擊者

do occur rarely and can be very dangerous.

雖則罕見，卻可以非常危險

So if you think you’re allergic but don’t know for sure,

因此若你認為自己有過敏但不肯定

your best bet is to visit an allergist.

諮詢一下過敏症專家就再好不過了

They’ll complete an evaluation that’ll confirm

專家為你完成一個評估後

whether or not you have the allergy.

就會確認你有沒有過敏

Even if you do have a penicillin allergy,

又即使你對青黴素過敏，隨著年月

your immune cells that react to the drug may lose their ability to recognize it.

產生反應的免疫細胞 或許會失去辨識能力

In fact, about 80% of people who are allergic to penicillin

事實上，約八成青黴素過敏者

outgrow their allergy within ten years.

十年後不再過敏了

This is great news for people who currently identify

對目前識別為青黴素過敏的人來說

as allergic to penicillin;

這是個喜訊：

the drug may one day save their lives, as it has done for so many others.

救人無數的藥物

哪一天也許也能救他們一命