Will multi-drug resistant bacteria last a lifetime?

There are many medicines in life, and their effects on the body are different. Some people think that when taking medicine, they just need to consult a doctor and take it according to the instructions. In addition, depending on each person's physical constitution, the dosage of the medicine taken is different. Whether multidrug-resistant bacteria will be lifelong, you still need to consult a doctor and read the following article.

Drug-resistant strains

MDRs are mostly conditional pathogens (opportunistic pathogens), and Gram-negative rods (GNR) account for a large proportion, such as Klebsiella pneumoniae, Escherichia coli, Escherichia cloacae, Serratia marcescens, Citrobacter, Shigella, Salmonella, etc. in the Enterobacteriaceae family, as well as Pseudomonas aeruginosa, Acinetobacter, and H. influenzae. Among Gram-positive bacteria there are methicillin-resistant Staphylococcus aureus (MRS), especially MRSA and MRSE; vancomycin-resistant enterococci (VRE), which have a significantly increased incidence in the intensive care unit (ICU); penicillin-resistant Streptococcus pneumoniae (PRSP), which often causes pneumonia, meningitis, bacteremia and otitis media, and human tuberculosis mycobacterium, etc. In addition, there are gonococci, meningococci, Vibrio cholerae, etc.

Mechanism of resistance

Multidrug resistance (MDR) refers to the resistance to multiple commonly used antimicrobial drugs at the same time. The main mechanism is the mutation of efflux membrane pump genes, followed by changes in outer membrane permeability and the production of ultra-broad-spectrum enzymes. The most common Gram-positive bacteria are MDR-TB and MDR-MRSA, as well as Acinetobacter baumannii and Pseudomonas aeruginosa, which often appear in the ICU and are only sensitive to penicillins; Stenotrophomonas maltophilia is resistant to almost all antibiotics except co-trimoxazole. The emergence of MDR determines the necessity of combined drug use; the high frequency of MDR strains means that the era of antimicrobial drugs is coming to an end.

The main reasons for the increasing rate of microbial resistance are: irrational use and abuse. For example, in the United States, drug use for human anti-infection and agricultural and animal husbandry applications each account for 50%, of which only 20% is used for hospital anti-infection, while 80% is used in the community, and the abuse rate is 20%~50%; in agriculture and animal husbandry, therapeutic applications account for only 20%, while preventive and growth promotion applications account for 80%, and the abuse rate is 40%~80%. 40,000 deaths are caused by drug-resistant bacteria each year. The abuse in my country is more serious than in the United States. The WHO's assessment of the abuse of antibiotics in my country is: 97% of patients with viral bronchial infections in China used antibiotics; and 30% to 60% of patients in the primary health care system used antibiotics.