Microbial resistance has become a global problem

According to a study published in "The Lancet Microbe", typhoid bacillus has become increasingly resistant to antibiotics commonly used to treat typhoid fever, such as macrolides and quinolones, and resistant strains have spread widely over the past 30 years.

Typhoid fever is a global public health problem, causing 11 million infections and more than 100,000 deaths every year. Antibiotics can successfully treat typhoid infection, but their effectiveness has been threatened by drug-resistant strains in recent years. So far, the analysis on the rise and spread of drug-resistant typhoid bacillus is limited, and most studies are based on small samples.

The new study in "The Lancet" uses genetic databases to identify resistance conferring genes in 7658 typhoid bacillus strains from more than 70 countries. According to sequencing analysis, in the past 30 years, drug-resistant typhoid bacillus strains have been transmitted among countries in the world for at least 197 times.

In fact, in recent years, the drug resistance of bacteria and other microorganisms to antibiotics has been troubling the global medical community. In January this year, "The Lancet" published a comprehensive analysis on the global impact of microbial resistance to date. According to the analysis of data from 204 countries and regions, microbial resistance has become the main cause of death in the world, and the number of deaths resulting from it has exceeded that resulting from AIDS infection or malaria. The study estimates that in 2019, microbial drug-resistant infections directly caused 1.27 million deaths and indirectly caused 4.95 million deaths.

With the discovery of penicillin by British bacteriologist Alexander Fleming in 1928, human beings had a powerful weapon against many infectious diseases. However, in recent years, the emergence of superbacteria has put the clinic into an embarrassing situation where no drugs are available. Previous studies have predicted that by 2050, about 10 million people worldwide will die of antimicrobial resistance every year. However, the industry believes that this time node may come earlier.

The monitoring results of the national bacterial drug resistance monitoring network show that there has been a relatively serious phenomenon of bacterial drug resistance in China. For example, Streptococcus pneumoniae, which causes community-acquired pneumonia, has a resistance rate of more than 95% to conventional antibiotics such as erythromycin and azithromycin, and Escherichia coli, which causes common urinary tract infections, has a resistance rate of more than 50% to commonly used antibiotics such as levofloxacin, and Mycoplasma pneumoniae, a common pathogen of children's community - acquired pneumonia, has a resistance rate of nearly 90% to commonly used therapeutic drugs...

Not only China is facing this problem, but the world is also facing the same problem. For example, vancomycin used to be the last line of defense for the treatment of Gram-positive bacterial infections, but in some European countries, the resistance rate of enterococcus faecium to vancomycin has reached 40%.The reason is that Avoparcin, a similar drug of vancomycin, was used as a feed additive in Europe, and afterwards, plenty of vancomycin-resistant enterococcus were detected in the feces of poultry and livestock, and they passed to humans through various channels, so that many countries in Europe ever isolated a high proportion of vancomycin-resistant enterococci in the intestines of healthy people. In the United States, due to the long-term and large-scale clinical application of vancomycin, the resistance rate of enterococcus faecium to vancomycin is as high as 80%.

How should humans respond, faced with such a severe drug resistance situation? Stanford University professor Jason Andersen, lead author of the study published in "The Lancet Microbe", believes that there is an urgent need to take more large-scale actions, including optimizing the use of existing antibiotics, taking stronger actions to monitor and control infections, and providing more funds to develop new antibiotics and treatments.

Microbial resistance is something that clinicians do not want to see, but it is actually a natural phenomenon. It is the ability of microorganisms to gradually evolve and protect themselves from being killed by antimicrobial substances that exist in nature.

A large number of antimicrobial drugs used by human beings in the treatment and prevention of human and animal microbial infections and the prevention and control of food corruption have increased the number of antimicrobial drugs in humans, animals, food and the environment, destroyed the original microenvironment, reduced sensitive microorganisms and increased drug-resistant microorganisms. As a result, drug resistance genes are continuously transmitted among microorganisms, finally leading to the emergence of drug-resistant microorganisms. As drug-resistant microorganisms infect human beings, human beings continue to develop new antimicrobial drugs, and drug resistance soon appears in new antimicrobial drugs, thus forming a vicious circle.

Curbing microbial drug resistance requires the joint action of the whole society, but the public's understanding of the harm of microbial drug resistance is important. Only under the guidance of doctors, the rational use of antimicrobial drugs can effectively treat bacterial infections and reduce the occurrence of drug-resistant bacteria.