Microbial drug resistance has become a global problem

Salmonella typhi has become increasingly resistant to antibiotic drugs commonly used to treat typhoid, such as macrolides and quinolones, and over the past 30 years, a study published in The Lancet Microbiology Drug-resistant strains have spread widely.

        Typhoid fever is a global public health problem, causing 11 million infections and more than 100,000 deaths each year. Antibiotics have been successful in treating typhoid infections, but their effectiveness has been threatened in recent years by resistant strains. To date, analyzes of the rise and spread of drug-resistant Salmonella typhi have been limited, and most studies have been based on small samples.

        The new Lancet study used genetic databases to identify resistance-conferring genes in 7,658 Salmonella typhi strains from more than 70 countries. Sequencing analysis revealed that, over the past 30 years, drug-resistant strains of Salmonella typhi had spread at least 197 times between countries around the world.

        In fact, in recent years, the problem of antibiotic resistance of bacteria and other microorganisms has been plaguing the global medical community. In January of this year, The Lancet published a comprehensive analysis of the global impact of microbial resistance so far. Analysis of data from 204 countries and regions shows that microbial resistance has become the main cause of death worldwide, and the number of deaths has surpassed that of AIDS infection or malaria. The study estimated that in 2019, microbial resistant infections directly caused 1.27 million deaths and indirectly caused 4.95 million deaths.

        With the discovery of penicillin in 1928 by the British bacteriologist Alexander Fleming, humans have a powerful weapon against many infectious diseases. However, in recent years, the emergence of superbugs has brought the clinic into an embarrassing situation where no medicine is available. Previous research predicts that by 2050, about 10 million people worldwide will die from antimicrobial resistance each year. However, the industry believes that this time node may come earlier.

        According to the monitoring results of the National Bacterial Resistance Surveillance Network, serious bacterial resistance has emerged in my country. 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; More than 50%, and the resistance rate of Mycoplasma pneumoniae, a common pathogen that causes community-acquired pneumonia in children, to commonly used therapeutic drugs is close to 90%...

        Not only our country is facing such a problem, but the whole world is also facing the same problem. For example, vancomycin used to be the last line of defense in the treatment of Gram-positive bacterial infections, but in some European countries, the resistance rate of Enterococcus faecium to vancomycin has reached 40%. This is because avopacin, a drug similar to vancomycin, was once used as a feed additive in Europe. Since then, a large number of vancomycin-resistant enterococci have been detected in the feces of poultry and livestock, and have been transmitted to humans through various channels. Therefore, Many European countries have 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 use of vancomycin, the resistance rate of Enterococcus faecium to it is as high as 80%.

        Facing such a severe situation of drug resistance, how should human beings deal with it? Jason Andreessen, lead author of the study in The Lancet Microbiology and a professor at Stanford University in the United States, believes that larger-scale action is urgently needed, including optimizing the use of existing antibiotics, taking stronger actions to monitor and Control infections and provide more funding to develop new antibiotics and treatments.

        Although microbial resistance is something that clinicians don't want to see, it is actually a natural phenomenon. It is the ability of microorganisms to gradually evolve to protect themselves from being killed by antimicrobial substances that exist in nature itself.

        A large number of antimicrobial drugs used by humans in the treatment and prevention of microbial infections in humans and animals, and in the prevention and control of food spoilage have resulted in an increase in antimicrobial drugs in humans, animals, food, and the environment, destroying the original microecology, reducing sensitive microorganisms, Drug-resistant microorganisms increase, drug-resistant genes continue to pass among microorganisms, and eventually drug-resistant microorganisms infect humans. Humans continue to develop new antimicrobial drugs, and new antimicrobial drugs soon become resistant to such a vicious circle.

        Containing microbial resistance requires the joint action of the whole society, but the public's awareness of the harm of microbial resistance is important. Only under the guidance of doctors and the "double-edged sword" of rational use of antibacterial drugs can effective treatment of bacterial infections be achieved. At the same time, reduce the occurrence of drug-resistant bacteria.