1、National Antimicrobial Resistance Monitoring System (NARMS)Antibiotics kill or inhibit the growth of susceptible bacteria. Sometimes one of the bacteria survives because it has the ability to neutralize or evade the effect of the antibiotic; that one bacteria can then multiply and replace all the ba
2、cteria that were killed off. Exposure to antibiotics therefore provides selective pressure, which makes the surviving bacteria more likely to be resistant. In addition, bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by
3、 acquiring pieces of DNA that code for the resistance properties from other bacteria. The DNA that codes for resistance can be grouped in a single easily transferable package. This means that bacteria can become resistant to many antimicrobial agents because of the transfer of one piece of DNA.抗生素杀死
4、或抑制细菌生长的敏感。 有时候生存的细菌之一,因为它有能力以消除或逃避抗生素的作用,这一个细菌可以繁殖并取代所有关闭的细菌被杀死。 因此,提供接触抗生素的选择压力,使得幸存的细菌更容易产生抗药性。此外,抗生素的细菌,是一次容易获得的材料可以通过突变的遗传性的,或通过收购该细菌的 DNA 片段从其他代码特性的阻力。 该软件包中的 DNA 代码阻力可以转让被集中在一个单一的容易。这意味着可以成为抵抗细菌的 DNA片之一,因为许多抗菌药物的转移。This year 2010 marks another significant turn in the war against microbes. An
5、August 11, 2010 report in The Lancet indicates that medicine has lost an important bacterial infectious disease battle and humans are at risk now more than ever. These new antibiotic-resistant enteric bacteria contain NDM 1 Beta Lantanas. This is no false alarm, nor minor claim it is a very real, cl
6、ear and present danger. The background of antibiotic resistance and The Lancet paper are overviewed and summarized here for important facts and details on these superbugs . The CDC also provides antimicrobic and antimicrobial insights. 这标志着 2010 年在对微生物的战争重大转机。 一个 2010年 8 月 11 日 柳叶刀 的报告显示, 该 药物已失去了一个
7、重要的细菌性传染病的斗争和人的风险现在比以往任何时候。这些新的抗生素的抗药性肠道细菌含有新民主运动 1 内酰胺酶。 这不是危言耸听,也不小索赔 - 这是一个非常真实,清晰和现实的危险。 本文背景的抗生素耐药性 与柳叶刀 的综述和总结这些在这里重要的事实和细节上超级 。 疾病控制中心还提供抗微生物和抗菌的见解。Bacteria, Antibiotics and Resistance Facts and Definitions To better understand the issues involved with NAD 1 Beta lactamases here are some impo
8、rtant terms and definitions: Bacteria (bacterium, sing.) Single-celled, primitive cells with a simple nucleus without a membrane. Each bacterium contains about 1,000 genes Gram-positive Bacteria bacteria which appear purple-blue when stained with the Gram stain (eg, Staphylococcus , Streptococcus ,
9、Clostridium ) Gram-negative Bacteria bacteria which stain red when Gram stained (eg, Escherichia , Enterobacter , Klebsiella , Pseudomonas ) Antibiotics biochemicals normally produced naturally by certain microbes to inhibit or kill other microbes. Antibiotics are isolated in the lab, purified and t
10、ested for effectiveness and safety for use in animals and humans Semi-synthetic and Synthetic Antibiotics are chemically-modified or synthesized antibiotics that are produced in special chemical reaction vessels DNA a macromolecule and double helix that contains nucleotides (chemical code sequences)
11、 called genes for the manufacture of specific kinds of proteins Chromosome a double helix of DNA and associated protein Gene a DNA code that specifies the order and kinds of amino acids needed to make proteins. Plasmids segments or circles of DNA that are not part of the bacterial chromosome Resista
12、nce Genes DNA information on chromosomes or plasmids, or both, that code or instruct for factors, products or enzymes that can block, impede, inactivate or destroy antibiotics Beta Lactamases powerful enzymes that can break and destroy the structural beta-lactam ring of some of the most important ty
13、pes antibiotics (penicillins, cephalosporins, carbapenems) Beta Lactamase NDM 1 and Bacterial Resistance The New Delhi, India, Pakistan and UK enterics have a carbapenemase gene carried on plasmids which is a metallo-lactamase 1 or NDM 1. The multi-city, multi-investigator research is reported in Th
14、e Lancet medical journal and the following findings are significant: The NDM-1 resistance gene is on plasmids (extranuclear DNA) that can be exchanged among enterics. These resistance plasmids can be isolated, characterized and identified. Most NDM 1 bacteria contain several plasmids and up to 8 pla
15、smids have been isolated from some cells. Many common enteric bacteria such as Escherichia , Klebsiella , Enterobacter, Proteus, Citrobacter, Providencia, Morganella contain these plasmids. NDM-1 resistant enterics are common both in outside communities and hospitals in India. These mutant and antib
16、iotic-resistant bacteria have been cultivated by excessive and indiscriminate use of many non-prescription antibiotics throughout the Indian population. Patients and travelers to the UK may have acquired these NDM 1 strains of bacteria and brought them back to the UK The infections may be acquired i
17、n the community or the hospital environments. Citizens in Indias and Pakistans many large cities harbor enterics with NDM 1. Even Dhaka, Bangladesh is positive for these strains. NDM 1 enterics have been isolated from patients with urinary tract infections, pneumonia, blood stream infections (bacter
18、mias/septicemias), burns, and wounds. Other tissues and organs may become infected with these enterics. Infection occurs in females:males at a ratio of about 2:1. Persons of all ages are susceptible to these infections and diseases. Resistance to amikacin, tobramycin, ciprofloxacin, and gentamicin i
19、s very high. Only colistin and tigecycline show reasonable effectiveness against these NDM 1 strains. New outbreaks of NDM 1 resistant strains may occur in other cities and countries and medical alerts for this possibility are in order. A somber sentence from Dr. Kumarasamy and his 30 collaborators
20、in The Lancet paper is: “Enterobacteriaceae with NDM-1 carbapenemases are highly resistant to many antibiotic classes and potentially herald the end of treatment with -lactams, fluoroquinolones, and aminoglycosidesthe main antibiotic classes for the treatment of Gram-negative infections.“ 为了更好地理解与 N
21、AD 的 1 内酰胺酶在这里涉及的问题是一些重要术语和定义: 细菌 (细菌,唱歌。) -单细胞生物,一个原始细胞的细胞核膜不与一个简单的。 每个细菌含有大约1000 个基因 革兰氏阳性菌 -菌而出现紫蓝色时,革兰氏染色的染色(如 葡萄球菌 , 链球菌 , 梭状芽胞杆菌 ) 革兰氏阴性菌 -菌的革兰氏染色时染色红(如 大肠杆菌 , 肠杆菌 , 克雷伯菌 , 假单胞菌 ) 抗生素 -微生物生化自然生成的,通常由某些微生物来抑制或杀死其他。 抗生素是在实验室分离,纯化及有效性和安全性测试,在动物和人类使用 半合成抗生素和合成 -是化学改性或合成抗生素,血管反应,产生特殊的化学 基因 -一种高分子和双
22、螺旋包含核苷酸(化学代码序列)的蛋白质叫做 基因 种为具体的制造 染色体 - 1 的 DNA 双螺旋结构和相关蛋白 - 基因 的 DNA 代码,指定的顺序和蛋白质的种类,使所需的氨基酸。 质粒 -片段或 DNA 各界不属于细菌染色体的一部分, 抗性基因 - DNA 的两种染色体或质粒的信息,或指示该代码或为因素,产品或酶,可以阻止,妨碍或破坏抗生素灭活 试用版内酰胺酶 -强大的酶来分解和破坏结构 -内酰胺环碳青霉烯类抗生素,对一些最重要的类型的抗生素(青霉素,头孢菌素类) 试用版内酰胺酶和细菌耐药性新民主运动一 在新德里,印度,巴基斯坦和英国 enterics 有一个碳青霉烯酶基因的质粒进行的
23、一个 金属 - 内酰胺酶 1 或新民主运动 1。 多城市,多调查研究发表在柳叶刀医学杂志及以下结果有显着: 在新民主运动- 1 抗性基因是质粒(核外 DNA)的,可在 enterics 交换。 这些抗性质粒可以被分离,表征和鉴定。 大多数新民主运动一细菌包含几个质粒和多达 8 个质粒已分离出一些细胞。 许多常见的 , Morganella 肠道细菌如 大肠杆菌 , 克雷白杆菌 ,肠杆菌, 变形杆菌,枸橼酸杆菌,普罗维登 包含这些质粒。 新民主运动- 1 是常见的抗 enterics 无论在印度以外的社区和医院。 这些突变和抗生素耐药细菌有耕地和滥用抗生素的过量使用,许多 非处方药 在整个印度的人口。 患者和到英国的旅客可能获得这些细菌 1 株,带来新民主运动中来,到该感染可在社区或医院环境中获得的英国。