Antibiotic Resistance: A Lesson for Healthcare Interpreters
抗生素耐药性:医疗口译员的“关键一课”
(图片来源:Multilingual官网)
Antibiotics are among the most powerful tools modern medicine has ever developed. From routine surgeries to cancer chemotherapy, much of contemporary healthcare depends on the ability to prevent and treat bacterial infections effectively. Antibiotic resistance — the ability of bacteria to survive drugs designed to kill them — is now recognized as one of the most serious global public health threats of the 21st century. This is due in part due to lack of funding and research into the development of novel types of antibiotics.
抗生素堪称现代医学最强有力的武器之一。无论是常规手术还是癌症化疗,当代医疗的方方面面都离不开有效预防和治疗细菌感染。所谓抗生素耐药性,就是细菌能在本该杀死它们的药物面前存活下来。这如今已被视为21世纪最严重的全球公共卫生威胁之一。而推动这一危机加剧的部分原因,正是研发新型抗生素的资金和研究投入不足。
According to the World Health Organization, antibiotic resistance contributes to millions of infections and deaths worldwide each year. Hospital-acquired infections play a major role. Each year, an estimated 7.7 million deaths globally are caused by bacterial infections, making bacterial infections the second largest cause of death worldwide. Of those, almost 5 million are associated with bacteria that have developed antibiotic resistance. In settings where many patients with compromised or lower immunity gather, bacteria have it easier to share their own antibiotic resistance genes with other strains and even other bacterial species or to develop new resistance mechanisms due to selective pressure caused by the many types of antibiotics already in use in the clinical settings.
世卫组织的数据显示,抗生素耐药性每年在全球造成数百万人感染,并夺走无数生命,医院获得性感染在其中扮演了重要角色。全球每年约有770万人死于细菌感染,令其成为全球第二大死因。其中,近500万人的死亡与耐药菌有关。在许多聚集了大量免疫力低下患者的场所,细菌不仅更容易将耐药基因传递给其他菌株甚至其他菌种,还会因临床使用的多种抗生素带来的选择压力,演化出新的耐药机制。
Physicians, microbiologists, epidemiologists, and policymakers are at the forefront of combating this crisis, calling for a greater investment in research by public and private institutions.
医生、微生物学家、流行病学家和政策制定者是抗击这场危机的主力军,他们正呼吁政府与药企等机构增加研发投入。
Healthcare interpreters who, in the course of their work, constantly enter and exit hospitals, clinics, and doctors’ offices are inevitably exposed to an environment full of pathogens and infectious opportunistic bacteria. For interpreters, antibiotic resistance should not be an abstract scientific concept, but an important part of their medical knowledge and terminology. Infectious diseases and antibiotic resistance shape the conversations about diagnosis, treatment decisions, infection control, patient compliance, and even hospice care.
医疗口译员的工作需要不断穿梭于医院、诊所等场所,这让他们无可避免地暴露在充满病原体和机会性致病菌的环境里。对译员来说,抗生素耐药性不该只是一个抽象的科学名词,而应是他们必须掌握的医学知识和术语。无论是诊断、治疗决策、感染控制,还是患者依从性乃至临终关怀,每一次沟通都离不开传染病和抗生素耐药性的话题。
Here, we explore and raise awareness of the growing problem of antibiotic resistance, especially in healthcare settings, and outline what healthcare interpreters can learn from it, as well as how they can improve their professional competency in this important field of healthcare.
本文探讨并提高人们对抗生素耐药性日益严重问题的认识,尤其是在医疗环境中,并概述医疗口译员可以从中学到什么,以及他们如何提升在这一重要医疗领域的专业能力。
What Is Antibiotic Resistance?
什么是抗生素耐药性?
Antibiotic resistance occurs when bacteria change in ways that reduce or eliminate the effectiveness of antibiotics. These changes can arise through genetic mutations or by acquiring resistance genes from other bacteria. Once resistant, bacteria can continue to grow and spread even in the presence of antibiotics that once were effective.
当细菌发生变异,使得抗生素的效果减弱或被消除,这时就会产生抗生素耐药性。这种变异有两种方式:一是细菌自身发生了基因突变,二是从别的细菌那里获得了耐药基因。一旦细菌有了耐药性,就算用上以前管用的抗生素,它们也照样能活下来,继续繁殖和传播。
Resistance is a natural evolutionary process, but human activity has dramatically accelerated it. Overprescription of antibiotics (doctors preemptively prescribing antibiotics without first clarifying whether the underlying cause of infection is bacterial or viral), incomplete treatment courses (lack of patient compliance), inappropriate use for viral infections (many people use antibiotics against viral infections without knowledge that antibiotics do not eliminate viruses), and easy and prescription-free access to antibiotics in many countries have all contributed to the problem.
耐药性本身是自然的进化现象,但人类活动让它大大加速。比如:医生可能在没搞清楚是细菌还是病毒感染的情况下就开抗生素(这叫过度处方);患者吃几天药觉得好了就停药,没完成整个疗程;还有人用抗生素治疗病毒感染——他们根本不知道抗生素杀不死病毒。再加上很多国家买抗生素根本不需要处方,所有这些都让问题变得更糟。
Another very important cause of spread of resistance is the widespread use of antibiotics in agriculture. Antibiotics are added to feedstock as a preventive measure for animals kept in the overcrowded conditions of industrial-scale farms. This is the ideal environment for the development of antibiotic resistance genes, which easily transfer from one bacterial species to the next, then enter into the natural environment and spread further from there.
耐药性传播的另一个重要推手,是抗生素在农业中的广泛使用。在工业化农场拥挤的饲养环境中,抗生素常被作为预防措施添加到饲料中。这种环境为抗生素耐药基因的产生提供了理想温床,这些基因极易从一种细菌转移至另一种细菌,进而进入自然环境并持续扩散。
Why Are Hospitals High-Risk Environments?
为什么医院是高风险环境?
Hospitals are prime locations for antibiotic resistance for many reasons, the first being high antibiotic use. Broad-spectrum antibiotics are frequently administered, sometimes preemptively. Patients are more vulnerable; those with weakened immune systems are more susceptible to infection. Invasive procedures utilizing catheters and ventilators and surgical wounds create entry points for bacteria. Patients may suffer from recurrent types of infections; some infections such as abscesses lay dormant in between cyclical treatments of antibiotics. Dormant bacteria have a greater potential of developing resistance. Renewed breakouts of infections can quickly turn deadly due to sepsis. Because of the proximity of patients and staff in hospital settings, pathogens spread easily among patients, staff, and surfaces (walls, door handles, light switches, etc.).
医院是抗生素耐药性的重灾区,原因复杂多样,首要因素便是抗生素用量巨大。广谱抗生素被广泛使用,有时甚至用于预防。患者免疫力普遍较低,尤其是免疫系统受损者,极易受到感染。导管、呼吸机等侵入性操作及手术伤口为细菌入侵打开了方便之门。患者还可能遭遇复发性感染;某些感染(如脓肿)在间歇性抗生素治疗间隙会转入休眠,而休眠的细菌更易产生耐药性。一旦感染复发并引发败血症,病情可能迅速恶化并致命。加之医院内患者、工作人员及物体表面(墙壁、门把手、电灯开关等)的密切接触,病原体极易在人际间及环境中传播。
These factors have led to the rise of hospital-acquired infections caused by resistant organisms such as MRSA (methicillin-resistant Staphylococcus aureus) and CRE (carbapenem-resistant Enterobacter). In the United States alone, the Centers for Disease Control and Prevention estimates that tens of thousands of deaths annually are linked to antibiotic-resistant infections, many originating in healthcare facilities.
正是这些因素,推高了耐药菌引起的医院获得性感染比例,比如 MRSA(耐甲氧西林金黄色葡萄球菌)和 CRE(耐碳青霉烯类肠杆菌)感染。以美国为例,疾病控制与预防中心估计,每年有数万人死于抗生素耐药性感染,其中不少就发生在医院等医疗机构内。
Communication Is a Pillar of Healthcare
沟通是医疗保健的支柱
Antibiotic resistance is not just a microbiological issue — it is a communication challenge. Interpreters who help non-English speaking patients in medical facilities may have to interpret information such as: The infection is resistant; the usual antibiotics won’t work; isolation precautions may be necessary; treatment options are limited or will come with stronger side effects due to the toxicity level of certain antibiotics; and strict adherence to the medication schedule is critical.
抗生素耐药性不仅是一个微生物学难题,更是一个沟通层面的挑战。在医疗机构中,为英语水平有限的患者提供服务的口译员,可能需要口译以下信息:感染已产生耐药性;常规抗生素已无效;可能需要采取隔离防护措施;治疗方案十分有限,且部分抗生素因毒性较强,可能引发更严重的副作用;严格遵守用药时间表至关重要。
For patients with limited English proficiency, these conversations can be confusing, frightening, or misunderstood. Healthcare interpreters are often the bridge between complex medical science and patient comprehension.
对于英语水平有限的患者来说,这些对话不仅让人摸不着头脑、感到害怕,甚至还容易被误解。这时候,医疗口译员就是那座桥,把难懂的医学知识和患者的理解连在一起。
Misinterpretation can have serious consequences because patients may stop antibiotics early, believing they are no longer needed. Family members may resist isolation measures, interpreting them as unkind treatment or neglect of the patient. Patients may demand antibiotics even when clinicians explain they are ineffective.
误译可能带来严重后果,比如,患者可能觉得病好了就不用再吃药,自己把抗生素停了;家属可能不理解为什么要隔离,觉得这是在虐待或忽视病人。哪怕医生解释了抗生素已经没用,患者可能还是会闹着要用。
Understanding antibiotic resistance as a real danger to human health enables interpreters to convey not just words but intent, nuance, and urgency. Along with increasing complexity of terminology, medical language becomes more specialized. Interpreters encounter names of resistant organisms, classes of antibiotics, diagnostic tests and lab markers, infection-control terminology, and so much more. Without preparation, even experienced interpreters may struggle with accuracy and consistency.
如果口译员能真正认识到抗生素耐药性是威胁人类健康的“大敌”,他们在翻译时就不仅能翻出字面意思,还能把其中的意图、分寸感和紧迫感都传达出来。现在的医学术语越来越复杂,专业门槛越来越高,口译员常常会碰到各种耐药菌名称、抗生素种类、诊断检查和实验室指标,还有感染控制的术语等等。要是没做足功课,就算是有经验的“老翻译”,也可能在准确性和前后一致上卡壳。
During their work with patients from different origins, interpreters encounter different cultural beliefs about medicines and antibiotics. For instance, antibiotics are available over the counter in many countries, often seen as a cure-all, and are associated with “strong” or “real” medicine. Patients may arrive with expectations shaped by prior healthcare systems. Interpreters often find themselves navigating cultural beliefs while trying to remain neutral and accurate, which is a delicate balance. There is even an ethical and emotional weight involved in discussions about antibiotic-resistant infections as a cause of poor outcome prognoses, prolonged hospital stays, and limited treatment options.
在为来自不同文化背景的患者服务时,口译员常常会遇到关于药物和抗生素的不同文化观念。例如,在许多国家,抗生素可作为非处方药随意购买,常被奉为包治百病的“万能药”,并与“强效”或“真正有效”的药物划等号。患者带着这些由既往就医经历塑造的期望前来就诊。口译员往往需要在保持中立和准确传达信息的同时,应对不同文化对药物的看法,而这种平衡往往十分微妙。当医患讨论涉及因抗生素耐药性感染导致的预后不良、住院时间延长以及治疗手段有限时,对话里就更带着一种道德和情感上的沉重感。
What Is Important for Healthcare Interpreters?
医疗口译员需要关注什么?
Interpreters benefit from understanding why resistance happens, not just how terms are translated. In the simplest example, knowing the difference between bacterial and viral infections helps clarify why antibiotics are useless in treating viral infections. Small differences in wording such as “resistant to,” “not responding to,” “ineffective” carry major clinical implications, and interpreters must resist the urge to oversimplify.
口译员不仅要知道术语如何翻译,还需理解耐药性产生的机制,这将对其专业素养大有裨益。以浅显的例子来说,了解细菌感染与病毒感染的区别,有助于阐明为何抗生素对病毒感染无效。“耐药”“无反应”“无效”等措辞上的细微差异,往往承载着重大的临床意义,口译员在传达时切忌简单化处理。
Antibiotic resistance is both an individual and collective issue. Interpreters may be involved in conversations about preventive measures including infection prevention, hand hygiene and sanitation, and antibiotic stewardship programs. In this context, accurate interpreting supports public-health goals and patient safety. Interpreters must also be concerned about their own safety, paying attention to the above-mentioned steps to ensure proper hygiene.
抗生素耐药性既是个人的健康挑战,更是集体的公共卫生课题。口译员常会参与到涉及预防措施的对话中,内容涵盖感染预防、手卫生、环境卫生以及抗生素管理项目。此时,精准的口译工作直接服务于公共卫生目标和患者安全。同时,口译员也必须关注自身防护,严格遵守上述卫生规范以确保安全。
Looking Ahead
展望未来
As antibiotic resistance continues to rise, healthcare interpreters are becoming increasingly important contributors to patient safety and quality of care. Their role extends beyond language transfer to ensuring understanding, adherence, and trust. Professional development in areas like infectious diseases, antimicrobial resistance, and public-health terminology should be viewed not as optional specialization, but as a core competency for interpreters working in medical settings.
随着抗生素耐药性的持续上升,医疗口译员在患者安全和护理质量方面正变得越来越重要。他们的角色从语言转换延伸到确保理解、依从和信任。在传染病、抗微生物药物耐药性和公共卫生术语等领域的专业发展,不应被视为可选的专长,而应被视为在医疗环境中工作的口译员的核心能力。
By deepening their understanding of antibiotic resistance, interpreters strengthen their ability to support clinicians, empower patients, and participate meaningfully in one of the most urgent healthcare challenges of our time. Antibiotic resistance may be driven by microbes, but its outcomes are shaped by human behavior and human communication. Healthcare interpreters stand at that intersection.
吃透了抗生素耐药性,口译员才能更好地帮医生、帮患者,真正投身到解决这个时代大难题的行动中。耐药性虽然是细菌搞出来的,但最后结果好不好,全看人怎么行动、怎么沟通。而医疗口译员,正好就站在这个十字路口。
We have included a glossary to aid interpreters in communicating the nuances of medical terminology related to antibiotic resistance.
以下附上一份术语表,以帮助口译员沟通与抗生素耐药性相关的医学术语的细微差别。
Glossary of Key Antibiotic Resistance Terms for Healthcare Interpreters
医疗口译员抗生素耐药性关键术语表
Antimicrobial Resistance (AMR): An umbrella term including antibiotic resistance.
抗微生物药物耐药性(AMR):包含抗生素耐药性的总称术语。
Antibiotic: A drug used to treat bacterial infections. Not effective against viruses.
抗生素:用于治疗细菌感染的药物,对病毒无效。
Antibiotic Resistance (AR): The ability of bacteria to survive or grow despite exposure to antibiotics.
抗生素耐药性(AR):细菌在接触抗生素后仍能存活或生长的能力。
Antibiotic Stewardship: Coordinated efforts to use antibiotics appropriately to reduce resistance.
抗生素管理:为适当使用抗生素以减少耐药性而进行的协调管理。
Broad-Spectrum Antibiotic: An antibiotic effective against a wide range of bacteria.
广谱抗生素:对多种细菌有效的抗生素。
Carbapenem-resistant Enterobacter (CRE): Enterobacter is a common cause of nosocomial infections (bloodstream, urinary, respiratory).
耐碳青霉烯类肠杆菌(CRE):肠杆菌是医院内感染(血流、泌尿、呼吸道)的常见原因。
Culture and Sensitivity Test: A laboratory test that identifies bacteria and determines which antibiotics are effective.
培养和药敏试验:一种识别细菌并确定哪些抗生素有效的实验室测试。
Drug-Resistant Organism (DRO): A bacterium that is resistant to one or more antibiotics.
耐药菌(DRO):对一种或多种抗生素具有耐药性的细菌。
Empiric Therapy: Treatment started before lab results are available, based on clinical judgment.
经验疗法:在实验室结果出来之前,根据临床判断开始的治疗。
Extended-Spectrum Beta-Lactamase (ESBL): An enzyme produced by some bacteria that makes them resistant to many antibiotics.
超广谱β-内酰胺酶(ESBL):某些细菌产生的一种酶,使它们对许多抗生素具有耐药性。
Hospital-Acquired Infection (HAI): An infection contracted during a hospital stay.
医院获得性感染(HAI):住院期间获得的感染。
Isolation Precautions: Measures taken to prevent the spread of infectious organisms.
隔离防护:为防止传染性生物传播而采取的措施。
MDR Tuberculosis: Tuberculosis is already difficult to treat with effective antibiotics. MDR Tuberculosis becomes untreatable.
多重耐药结核病:结核病本来就难以用有效抗生素治疗。多重耐药结核病变得无法治疗。
Methicillin-Resistant Staphylococcus aureus (MRSA): A common resistant bacterium causing skin and systemic infections.
耐甲氧西林金黄色葡萄球菌(MRSA):一种常见的耐药菌,引起皮肤和全身性感染。
Multidrug-Resistant (MDR): Resistant to multiple classes of antibiotics.
多重耐药(MDR):对多种抗生素类别具有耐药性
Nosocomial Infection: Hospital-acquired infection.
医院内感染:医院获得性感染。
Superbug: A non-technical term for highly resistant bacteria.
超级细菌:对高度耐药细菌的非专业术语称呼。
特别说明:本文内容选自Multilingual官网,仅供学习交流使用,如有侵权请后台联系小编删除。
摘译&推文编辑:韦才月
指导老师:刘婷婷
项目统筹:菅晓硕
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