A small outbreak of NDM-1, a drug-resistant superbug that is resistant to most antibiotics, has recently been reported in countries such as the United Kingdom, the United States and India. The bacterium, which has a special enzyme that can enter the DNA mitochondria of most bacteria and survive, making it widely resistant to drugs, has been dubbed by the Western media because it was first discovered in plastic surgeons and surgeons traveling to India for medical treatment. The “New Delhi” bacterium. In fact, drug-resistant types of bacteria are not new; they have always existed and evolved strong resistance with human abuse of antibiotics, and humans are behind the superbugs in this particular game. Superbugs are not really a name for a bacterium, but rather a name for a group of bacteria that have in common a strong resistance to almost all antibiotics. Over time, the list of superbugs has grown longer and longer, including ultra-broad-spectrum enzyme-producing E. coli, multi-drug resistant Pseudomonas aeruginosa, multi-drug resistant Mycobacterium tuberculosis, pan-drug resistant Mycobacterium pneumoniae, and pan-drug resistant Pseudomonas aeruginosa. The most famous of the superbugs is a methicillin-resistant Staphylococcus aureus (MRSA for short). MRSA is now extremely common and can cause infections of the skin, lungs, blood and joints, and it was this bacterium that Fleming used to deal with when he stumbled upon penicillin back then. But as antibiotics became more common, some S. aureus began to develop resistance, producing penicillinase to destroy the effectiveness of penicillin. By the late 1980s, MRSA had become one of the most prevalent hospital-acquired infections in the world (and the first of the world’s three most intractable infectious diseases), and the only proven effective agent against MRSA worldwide is vancomycin. The latest superbug to emerge is called NDM-1 A special bacterium was found by medical research institutes at Cardiff University in the UK, the UK Health Protection Agency and the University of Madras in India in a number of patients who had visited India for surgical procedures. The article, published in the medical professional journal Needlepoint, points out that the bacterium, called New Delhi metallo-beta-lactamase-1 (NDM-1), contains a rare enzyme that can be present in the DNA of E. coli bacteria thus making it widely resistant to drugs, making it difficult to cure or even kill a person after being infected. NDM-1 has a high replication capacity, spreads quickly and is prone to genetic mutations, making it a very dangerous superbug given the current misuse of antibiotics. The “superbug” can spread widely The superbug NDM-1 can be found across almost all bacterial species, meaning that it can be found in the NDA mitochondria of a wide variety of bacteria. The NDM-1 superbug in various bacterial species appears as a DNA structure and is therefore called a plasmid. It can replicate and move freely in bacteria, thus giving this pathogen an amazing potential to spread and mutate, being resistant to all antibiotics except tigecycline and polymyxin. Researchers are determining the prevalence of the NDM-1 germ that infected these patients. The researchers found that the UK had already seen an increase in NDM-1 infections in 2009, including some fatal cases. David Livermore, a specialist with the U.K. Health Protection Agency who participated in the study, said that most of the NDM-1 infections in the U.K. have been reported in the past. Livermore said most NDM-1 infections were associated with people who had traveled to or received treatment in South Asian countries such as India. Of the 37 patients studied in the U.K., at least 17 had traveled to India or Pakistan in the past year, and at least 14 of them had received treatment in those two countries, including kidney transplants, bone marrow transplants, dialysis, childbirth, burn treatment or cosmetic surgery. However, there were also 10 cases of infection in the UK in patients who had not received any overseas treatment at all. The current study found that E. coli infections carrying NDM-1 cause urinary tract infections and blood poisoning in many patients. Antibiotic abuse shaped superbugs The discovery and purification of penicillin is one of the greatest discoveries in human history. Since the application of penicillin in 1941, tens of thousands of antibiotics have been discovered one after another, and more than 200 antibiotics have been used in clinical practice. The widespread use of antibiotics has saved countless lives, and to this day antibiotics are still indispensable drugs for doctors in the treatment of infections. However, with the use of antibiotics, many of the bacteria that cause human disease have become resistant to its opponents. Hospitals where antibiotic use is more concentrated are breeding grounds for the superbug MRSA. The bacteria spreads silently among patients, health care workers, and patients and can be present in the body for months. The Centers for Disease Control and Prevention reported that MRSA accounted for 2.4% of all Staphylococcus aureus infections in 182 hospitals in 1975, rising to 24.8% in 1991, especially in teaching and central hospitals with more than 500 beds, because these hospitals have more opportunities for MRSA infection, and drug-resistant strains can be brought into the hospital by infected patients as well as by misuse of Antibiotic abuse can also occur in the hospital. The superbug NDM-1 was spread from patients in orthopedic and surgical hospitals in India. China: 80,000 deaths per year due to antibiotic abuse At an international conference held in early August, the head of the Ministry of Health’s National Bacterial Resistance Monitoring Network pointed out that the current antibacterial drug resistance rate in China remains high, with the top five pathogenic bacteria in nosocomial infections deteriorating and the clinical isolation rate of “super-resistant bacteria” increasing. This indicates that it is becoming increasingly difficult for existing drugs to deal with super-resistant germs. Among them, the problem of antibiotic resistance is particularly prominent. According to the 2006-2007 national bacterial drug resistance monitoring results of the Ministry of Health, the annual rate of antimicrobial drug use in hospitals nationwide was as high as 74%. No other country in the world uses antibiotics on such a large scale, and in developed countries such as the United States and Britain, the rate of antibiotic use in hospitals is only 22% to 25%. Obstetrics and gynecology departments in China have long been the hardest hit by antibiotic abuse, and statistics from the Obstetrics and Gynecology Department of Shanghai Changning District Central Hospital for many years show that current penicillin resistance is almost 100%. In contrast, the rate of antibiotic use among Chinese inpatients is as high as 70%, with almost everyone in surgery using antibiotics at a rate of 97%. According to the 1995-2007 disease classification survey, infectious diseases in China accounted for 49% of the total number of diseases, of which bacterial infectious accounted for 18%-21% of all diseases, which means that more than 80% belong to the misuse of antibiotics, and 80,000 people die every year as a result. The number of children under 7 years old who are deaf due to irrational use of antibiotics in China is up to 300,000, accounting for 30% to 40% of the overall deaf children, compared to 0.9% in some developed countries. Among hospitalized patients with infections, the morbidity and mortality rate for drug-resistant bacterial infections is 11.7 percent, compared to 5.4 percent for common infections. These figures make China one of the countries with the most serious problem of antibiotic abuse in the world. The irrational use of drugs and insufficient awareness of the consequences of drug resistance are the main reasons for the high rate of drug resistance. Although China has promulgated the Guidelines for Clinical Application of Antibiotics and the Notice on Further Strengthening the Management of Clinical Application of Antibacterial Drugs in 2004 and 2009, respectively, the implementation of the above guidelines and regulations by medical institutions is still not in place. According to statistics, the annual increase in medical costs due to antibiotic abuse is 80 billion RMB, and the overuse of third-generation cephalosporins alone costs the whole China more than 700 million RMB a year. In China, the most common phenomenon is for patients to ask their doctors to prescribe antibiotics à la carte. But in the United States, buying antibiotics is more difficult than buying a gun – antibiotics are part of a more strictly controlled prescription class of drugs, and doctors can only prescribe antibiotics based on a patient’s specific condition and type of bacterial infection. If a prescription is written in violation of the law, you can receive a warning or even have your license revoked. And no hospital pharmacy or drugstore is allowed to sell antibiotics to the public without the signature of a professional doctor’s permission. The list of “superbugs” that exist in China today and are resistant to almost all antibiotics is getting longer and longer, and they have become important pathogens of hospital-acquired infections. For example, Pseudomonas aeruginosa can change the permeability of cell membranes to prevent the entry of penicillins; Mycobacterium tuberculosis can prevent antibiotics from binding to it by changing the structure of proteins in the body; what’s more, some gram-negative bacteria can take the initiative and hydrolyze penicillins and cephalosporins with hydrolases. This resistance can be acquired both horizontally by other bacteria and vertically passed on to future generations. Many such clinical situations occur: infections caused by drug-resistant bacteria are uncontrollable by antibiotics and eventually lead to the death of the patient. As for the current NDM-1 superbug, the first case was in fact found in Hong Kong as early as 2009, when a 66-year-old man of Indian origin had a urine sample containing NDM-1 E. coli, but the patient was cured. The transmission route of the bacteria has not yet been finally determined, but the main sources of the bacteria, India and Pakistan, are both close to China, and based on the current rate of transmission and frequent international travel, the possibility of NDM-1 entering China cannot be ruled out. On the other hand, according to the current trend of antibiotic abuse in China, new superbugs will appear one after another within 10-20 years and all antibiotics will be ineffective against them. Andreas Heddini of the Swedish Institute for Infectious Disease Control warns that if the momentum of antibiotic abuse is not effectively curbed, humanity is likely to return to the pre-antibiotic era.