编者按：今日闭幕的中华医学会感染病学分会第十五次全国会议也是美国感染病学会和中华医学会感染病学分会首次联合召开的会议。美国感染病学会主席、约翰霍普金斯大学Paul G Auwaerter教授在接受《国际肝病》专访时对两个学会的首次合作表示激动，并非常看好后续的强强联手。Auwaerter教授还与我们分享了他对感染病学当下发展和未来方向的看法。

 

Hepatology Digest:  This is the first joint meeting of the Infectious Diseases Society of America and Chinese Association of Infectious Diseases. What do you think about this cooperation and future cooperation?

 

Dr Auwaerter: I am honored to be here in the great country of China, and very excited to continue discussions with the Chinese Society of Infectious Diseases. We believe we have many common goals in education, research and clinical care, so we are discussing our mutual interests to see where we can help one another to expand what we can do to advance the science, as well as improve the care of our patients.

 

《国际肝病》：这次是中美两国感染病学会首次联合举办论坛，您对这次合作以及未来的合作怎么看？

 

Auwaerter教授：能够到中国这个伟大的国家来参加这次会议我感到非常荣幸，能继续与中华医学会感染病学分会继续讨论也令我非常激动。我们相信，中美两个学会在教育、研究和临床关爱等各个方面都有很多共同的目标。因此，我们就这些共同的利益所在进行了讨论，寻求互助，扩大我们的工作，促进科学的发展，并改善患者的医疗。

 

Hepatology Digest: What is the value of the infectious diseases physician？

 

Dr Auwaerter: The field of infectious diseases is more important than ever. We continue to describe new pathogens. We have problems that arise because of the use of important agents of an antimicrobial nature that demand that we continue to provide surveillance and help physicians decide what the best choices are. I think this is a field that is more important than ever, especially as the world’s population continues to expand and travel is increasingly common. I am certain we will face new challenges which we can’t even dream of at the moment that will require a trained workforce that can help us understand new problems, and rally and deal with them as quickly as possible.

 

《国际肝病》：感染病学医生的价值是什么？

 

Auwaerter教授：传染病领域比以往更重要。现在还有新病原体在不断被发现。同时，由于使用具有抗微生物作用的重要试剂，相应产生了问题，要求我们持续提供监管，帮助医生决定最佳选择。我认为这是一个比以往更重要的领域，特别是随着世界人口继续扩张和旅行越来越普遍。我确信，我们将面临新的挑战，而且是当下我们甚至无法想像的挑战。这将需要训练有素的工作人员，帮助我们了解新的问题，并集合力量尽快处理这些挑战。

 

Hepatology Digest: Infectious diseases used to be the number one killer to human. Although it is no longer the case, infectious diseases are still an important threat. What are the new challenges that we face in the field of infectious diseases?

 

Dr Auwaerter: The field of infectious disease has, of course, had many notorious infections that have created great problems throughout human history – the plague and pandemic influenza, for example, and more pedestrian infections like pneumonia and cellulitis. The miracles of antimicrobial therapies have truly improved our health, as have vaccines and basic strides in public health in terms of sanitation practices, food quality and other important environmental aspects. However, I think the pressures brought about by our growing population and environmental challenges mean that we are right at the cusp of stepping backwards. We could lose the ability to easily treat common problems like streptococcal and staphylococcal and gram-negative infections, such that we will find ourselves in the same situation our great grandparents faced without effective antimicrobial agents. I believe the biggest challenges are as follows. I feel antimicrobial resistance is the most pressing problem for the planet, and that includes drug-resistant tuberculosis which particularly afflicts countries that are less developed, and the global epidemic of HIV. Every country has to deal with antimicrobial resistance. There are a whole other host of issues including fungal pathogens, viruses such as dengue, and parasites such as malaria. There are many challenges, and there will be new ones to come. The emerging infectious diseases are what make the field so exciting and dynamic. So the challenges are manyfold, but that is what keeps many of us working so hard to keep the field as engaged as possible with the medical community, in public health and with governments.

 

《国际肝病》：感染性疾病曾经是威胁人类生命和健康的头号杀手，尽管现在不再是了，但感染性疾病仍然是一个重要的威胁，您觉得当前在感染病学领域，我们面临哪些新的挑战？

 

Auwaerter教授：不错，人类历史上曾有许多臭名昭著的传染病引发了巨大的问题，例如鼠疫和流感暴发，以及更常见感染如肺炎和蜂窝织炎等。抗菌疗法的奇迹确实改善了我们的健康，还有疫苗以及在卫生实践、食品质量和其他重要的环境方面等公共卫生的基本进步也都改善了人类的健康。

 

然而，我认为，我们不断增长的人口和环境挑战带来的压力意味着我们正处于倒退的拐点。我们可能会丧失轻松处理常见疾病如脑膜炎球菌、葡萄球菌、革兰阴性菌感染的能力，这样你会发现，我们和我们缺少有效抗微生物药物的祖辈们处于同样的境地。

 

我认为最大的挑战如下：抗生素耐药会是这个星球上最紧迫的问题，其中包括耐药性结核病——这个问题在那些不发达的国家格外尖锐，以及全球艾滋病毒的流行。每个国家都必须应对抗生素耐药。还有许多其他的问题，包括真菌病原体、病毒（如登革热病毒）和寄生虫（如疟疾）。有许多挑战，而且还会有新的挑战。新发传染病是使这个领域变得如此令人兴奋和充满活力的原因。因此，面临的挑战是多方面的，但也正因如此，我们许多人为之努力，尽可能保持传染病领域与医疗界、公共卫生和各国政府的紧密联系。

 

Hepatology Digest: Infectious diseases are old but change very quickly. How do you view the relationship and interaction between pathogenic microorganisms and humans?

 

Dr Auwaerter: Another exciting aspect of infectious diseases is the interactions between pathogens, as well as with normal bacterial flora and viruses that become part of our own microbiome and flora. I think we are just beginning to learn all of the ramifications of how these microorganisms interact with our immune system and whether they may drive autoimmunity and cancers. We already have some important examples. We have to be extremely circumspect when we use antimicrobial agents because they can have unintended consequences due to shifts in our normal flora which we are only beginning to learn about. This is a whole other aspect that I think is very exciting, and one that I predict we will learn much more about the impact on human health in the next decade.

 

《国际肝病》：感染性疾病既古老又日新月异，您如何看待病原微生物与人类的关系和相互作用？

 

Auwaerter教授：传染病的另一个令人兴奋的方面是病原体之间的相互作用以及成为我们自身微生物组和菌群的一部分的正常细菌菌群和病毒。 我想我们只是刚刚开始了解这些微生物如何与我们的免疫系统相互作用，以及它们是否能驱动免疫细胞和癌症。我们已经得到了一些重要的例子。使用抗生素时，我们必须非常谨慎，由于正常菌群的变化，它们可能会产生意想不到的后果，而我们对正常菌群的认识才刚刚开始。我认为这又是一个非常令人兴奋的课题，我预测未来十年中我们会更多了解它们对人类健康的影响。