超级细菌及其产生英文论文(有译文).doc

National Antimicrobial Resistance Monitoring System (NARMS)
Antibiotics kill or inhibit the growth of susceptible bacteria. 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。 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 bacteria that were killed off. 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。 Exposure to antibiotics therefore provides selective pressure, which makes the surviving bacteria more likely to be resistant. 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。 In addition, bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria. 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。 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.

抗生素杀死或抑制细菌生长的敏感。 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 bacteria that were killed off.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。 Exposure to antibiotics therefore provides selective pressure, which makes the surviving bacteria more likely to be resistant.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。 In addition, bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria.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。 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.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. 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。 An 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. 这些新的抗生素的抗药性肠道细菌含有新民主运动1β内酰胺酶。 These new antibiotic-resistant enteric bacteria contain NDM 1 Beta Lantanas. 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。 This is no false alarm, nor minor claim – it is a very real, clear and present danger. 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 。 The background of antibiotic resistance and The Lancet paper are overviewed and summarized here for important facts and details on these superbugs . 疾病控制中心还提供抗微生物和抗菌的见解。 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。 An 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.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。 These new antibiotic-resistant enteric bacteria contain NDM 1 Beta Lactamase.这些新的抗生素的抗药性肠道细菌含有新民主运动1β内酰胺酶。 This is no false alarm, nor minor claim – it is a very real, clear and present danger.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。 The background of antibiotic resistance and The Lancet paper are overviewed and summarized here for important facts and details on these superbugs .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 。 The CDC also provides antimicrobic and antimicrobial insights.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
为了更好地理解与NAD的1β内酰胺酶在这里涉及的问题是一些重要术语和定义： To better understand the issues involved with NAD 1 Beta lactamases here are some important terms and definitions:
· 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。 Bacteria (bacterium, sing.) – Single-celled, primitive cells with a simple nucleus without a membrane. 每个细菌含有大约1000个基因 Each bacterium contains about 1,000 genes
· 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 ） Gram-positive Bacteria – bacteria which appear purple-blue when stained with the Gram stain (eg, Staphylococcus , Streptococcus , Clostridium )
· 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 ） Gram-negative Bacteria – bacteria which stain red when Gram stained (eg, Escherichia , Enterobacter , Klebsiella , Pseudomonas )
· 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。 Antibiotics – biochemicals normally produced naturally by certain microbes to inhibit or kill other microbes. 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 Antibiotics are isolated in the lab, purified and tested for effectiveness and safety for use in animals and humans
· 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 Semi-synthetic and Synthetic Antibiotics – are chemically-modified or synthesized antibiotics that are produced in special chemical reaction vessels
· 基因 -一种高分子和双螺旋包含核苷酸（化学代码序列）的蛋白质叫做基因种为具体的制造 DNA – a macromolecule and double helix that contains nucleotides (chemical code sequences) called genes for the manufacture of specific kinds of proteins
· 染色体 - 1的DNA双螺旋结构和相关蛋白 Chromosome – a double helix of DNA and associated protein
· - 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。 Gene – a DNA code that specifies the order and kinds of amino acids needed to make proteins.
· 质粒 -片段或DNA各界不属于细菌染色体的一部分， Plasmids – segments or circles of DNA that are not part of the bacterial chromosome
· 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 Resistance 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
· 试用版内酰胺酶 -强大的酶来分解和破坏结构β-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） Beta Lactamases – powerful enzymes that can break and destroy the structural beta-lactam ring of some of the most important types antibiotics (penicillins, cephalosporins, carbapenems)
试用版内酰胺酶和细菌耐药性新民主运动一 Beta Lactamase NDM 1 and Bacterial Resistance
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一个金属β-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： The New Delhi, India, Pakistan and UK enterics have a carbapenemase gene carried on plasmids which is a metallo-β-lactamase 1 or NDM 1. The multi-city, multi-investigator research is reported in The Lancet medical journal and the following findings are significant:

· 在新民主运动- 1抗性基因是质粒（核外DNA）的，可在enterics交换。 The NDM-1 resistance gene is on plasmids (extranuclear DNA) that can be exchanged among enterics.
· 这些抗性质粒可以被分离，表征和鉴定。 These resistance plasmids can be isolated, characterized and identified.
· 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。 Most NDM 1 bacteria contain several plasmids and up to 8 plasmids have been isolated from some cells.
· 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。 Many common enteric bacteria such as Escherichia , Klebsiella , Enterobacter, Proteus, Citrobacter, Providencia, Morganella contain these plasmids.
· 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。 NDM-1 resistant enterics are common both in outside communities and hospitals in India.
· 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。 These mutant and antibiotic-resistant bacteria have been cultivated by excessive and indiscriminate use of many non-prescription antibiotics throughout the Indian population.
· 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。 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 in the community or the hospital environments.
· 公民在印度和巴基斯坦的许多大城市港口与新民主运动一enterics。 Citizens in India's and Pakistan's many large cities harbor enterics with NDM 1. 即使达卡，孟加拉国是这些菌株呈阳性反应。 Even Dhaka, Bangladesh is positive for these strains.
· 新民主运动已经从1 enterics与尿路感染，肺炎病人身上分离出来，血流感染（bactermias /菌血症），烧伤和创伤。 NDM 1 enterics have been isolated from patients with urinary tract infections, pneumonia, blood stream infections (bactermias/septicemias), burns, and wounds. 其他组织和器官可能成为这些enterics感染。 Other tissues and organs may become infected with these enterics.
· 感染的发生：女性在男性的比例约为2:1。 Infection occurs in females:males at a ratio of about 2:1. 所有年龄的人很容易受到这些感染和疾病。 Persons of all ages are susceptible to these infections and diseases.
· 抗阿米卡星，妥布霉素，环丙沙星，庆大霉素是非常高的。 Resistance to amikacin, tobramycin, ciprofloxacin, and gentamicin is very high. 只有粘杆菌素和tigecycline表明对这些新民主运动1株合理有效性。 Only colistin and tigecycline show reasonable effectiveness against these NDM 1 strains.
· 新民主运动爆发一新的耐药菌株的发生可能是这种可能性，以便在其他城市和国家，医疗警报。 New outbreaks of NDM 1 resistant strains may occur in other cities and countries and medical alerts for this possibility are in order.
阿柳叶刀纸判决博士Kumarasamy的忧郁和他的合作者是30： A somber sentence from Dr. Kumarasamy and his 30 collaborators in The Lancet paper is:
“与新民主运动- 1具有高度耐碳青霉烯酶肠杆菌科对许多抗生素类和可能预示着与β-内酰胺类，氟喹诺酮类，为革兰阴性感染治疗氨基糖苷类，主要类别的抗生素治疗结束。” "Enterobacteriaceae with NDM-1 carbapenemases are highly resistant to many antibiotic classes and potentially herald the end of treatment with β-lactams, fluoroquinolones, and aminoglycosides—the main antibiotic classes for the treatment of Gram-negative infections."

为了更好地理解与NAD的1β内酰胺酶在这里涉及的问题是一些重要术语和定义：
· Bacteria (bacterium, sing.) – Single-celled, primitive cells with a simple nucleus without a membrane. 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。 Each bacterium contains about 1,000 genes每个细菌含有大约1000个基因
· Gram-positive Bacteria – bacteria which appear purple-blue when stained with the Gram stain (eg, Staphylococcus , Streptococcus , Clostridium ) 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 ）
· Gram-negative Bacteria – bacteria which stain red when Gram stained (eg, Escherichia , Enterobacter , Klebsiella , Pseudomonas ) 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 ）
· Antibiotics – biochemicals normally produced naturally by certain microbes to inhibit or kill other microbes. 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。 Antibiotics are isolated in the lab, purified and tested for effectiveness and safety for use in animals and humans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
· Semi-synthetic and Synthetic Antibiotics – are chemically-modified or synthesized antibiotics that are produced in special chemical reaction vessels 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
· DNA – a macromolecule and double helix that contains nucleotides (chemical code sequences) called genes for the manufacture of specific kinds of proteins 基因 -一种高分子和双螺旋包含核苷酸（化学代码序列）的蛋白质叫做基因种为具体的制造
· Chromosome – a double helix of DNA and associated protein 染色体 - 1的DNA双螺旋结构和相关蛋白
· Gene – a DNA code that specifies the order and kinds of amino acids needed to make proteins. - 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。
· Plasmids – segments or circles of DNA that are not part of the bacterial chromosome 质粒 -片段或DNA各界不属于细菌染色体的一部分，
· Resistance 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 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
· Beta Lactamases – powerful enzymes that can break and destroy the structural beta-lactam ring of some of the most important types antibiotics (penicillins, cephalosporins, carbapenems) 试用版内酰胺酶 -强大的酶来分解和破坏结构β-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）
Beta Lactamase NDM 1 and Bacterial Resistance试用版内酰胺酶和细菌耐药性新民主运动一
The New Delhi, India, Pakistan and UK enterics have a carbapenemase gene carried on plasmids which is a metallo-β-lactamase 1 or NDM 1. The multi-city, multi-investigator research is reported in The Lancet medical journal and the following findings are significant: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一个金属β-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：

· The NDM-1 resistance gene is on plasmids (extranuclear DNA) that can be exchanged among enterics.在新民主运动- 1抗性基因是质粒（核外DNA）的，可在enterics交换。
· These resistance plasmids can be isolated, characterized and identified.这些抗性质粒可以被分离，表征和鉴定。
· Most NDM 1 bacteria contain several plasmids and up to 8 plasmids have been isolated from some cells.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。
· Many common enteric bacteria such as Escherichia , Klebsiella , Enterobacter, Proteus, Citrobacter, Providencia, Morganella contain these plasmids.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。
· NDM-1 resistant enterics are common both in outside communities and hospitals in India.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。
· These mutant and antibiotic-resistant bacteria have been cultivated by excessive and indiscriminate use of many non-prescription antibiotics throughout the Indian population.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。
· 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 in the community or the hospital environments.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。
· Citizens in India's and Pakistan's many large cities harbor enterics with NDM 1.公民在印度和巴基斯坦的许多大城市港口与新民主运动一enterics。 Even Dhaka, Bangladesh is positive for these strains.即使达卡，孟加拉国是这些菌株呈阳性反应。
· NDM 1 enterics have been isolated from patients with urinary tract infections, pneumonia, blood stream infections (bactermias/septicemias), burns, and wounds.新民主运动已经从1 enterics与尿路感染，肺炎病人身上分离出来，血流感染（bactermias /菌血症），烧伤和创伤。 Other tissues and organs may become infected with these enterics.其他组织和器官可能成为这些enterics感染。
· Infection occurs in females:males at a ratio of about 2:1.感染的发生：女性在男性的比例约为2:1。 Persons of all ages are susceptible to these infections and diseases.所有年龄的人很容易受到这些感染和疾病。
· Resistance to amikacin, tobramycin, ciprofloxacin, and gentamicin is very high.抗阿米卡星，妥布霉素，环丙沙星，庆大霉素是非常高的。 Only colistin and tigecycline show reasonable effectiveness against these NDM 1 strains.只有粘杆菌素和tigecycline表明对这些新民主运动1株合理有效性。
· New outbreaks of NDM 1 resistant strains may occur in other cities and countries and medical alerts for this possibility are in order.新民主运动爆发一新的耐药菌株的发生可能是这种可能性，以便在其他城市和国家，医疗警报。
A somber sentence from Dr. Kumarasamy and his 30 collaborators in The Lancet paper is:阿柳叶刀纸判决博士Kumarasamy的忧郁和他的合作者是30：
"Enterobacteriaceae with NDM-1 carbapenemases are highly resistant to many antibiotic classes and potentially herald the end of treatment with β-lactams, fluoroquinolones, and aminoglycosides—the main antibiotic classes for the treatment of Gram-negative infections." “与新民主运动- 1具有高度耐碳青霉烯酶肠杆菌科对许多抗生素类和可能预示着与β-内酰胺类，氟喹诺酮类，为革兰阴性感染治疗氨基糖苷类，主要类别的抗生素治疗结束。”
Also worrying was that the gene was found on plasmids — bits of mobile DNA that can jump easily from one bacteria strain to another. And it is found in gram-negative bacteria, for which not many new antibiotics are being developed. (MRSA, by contrast, is a gram-positive bacteria, and there are more drug candidates in the works.)
令人担忧的是，该基因被发现质粒 - 可移动的dna从一个细菌容易跳位到另一株。它被发现在革兰阴性菌，对此没有太多正在研制新的抗生素。 （mrsa的，相反，是革兰氏阳性菌，以及作品中有更多的候选药物。）
Drug-resistant bacteria like those with the NDM-1 mutation are usually a bigger threat in hosp