Zhang Wenhong: after the new crown, antimicrobial resistance will become an important global public health problem

“Antimicrobial resistance has become an important public health problem to be solved in the world. According to the current trend, when the new coronavirus epidemic is over, or after extensive vaccination, people’s fear of death caused by drug-resistant bacterial infection will certainly exceed the fear brought by the new coronavirus. ”

August 7-9 China’s novel coronavirus pneumonia treatment expert group leader and Zhang Wenhong, director of infectious diseases division of Huashan Hospital Affiliated to Fudan University, called on China to take out the new crown prevention and control half of the strength to implement the prevention and control measures of antibiotic resistance, and strive to avoid the death caused by drug-resistant bacteria, Zhang Wenhong, director of infectious disease division of Huashan Hospital Affiliated to Fudan University, held in Shanghai. 。

Zhang Wenhong called at the meeting that our country should devote half of the force of new crown prevention and control to implement the prevention and control measures of antimicrobial drug resistance, and strive to avoid death caused by drug-resistant bacteria. CHEN Si Si, a journalist Photo

Zhang Wenhong frankly said that the mortality rate caused by antimicrobial resistance has reached a very alarming number, and this mortality rate has even exceeded that of influenza. “Now, many patients have infection after surgery, or pneumonia in the community. Before, the proportion of community pneumonia caused by drug-resistant bacteria is very small, but the proportion has increased in recent years.”

Zhang Wenhong further analyzed that there are many death rates caused by drug-resistant bacteria in critically ill patients, including cancer patients, chemotherapy patients and blood patients. The ultimate cause of death is infection, and the main cause of death is infection. “We have a strong ability to control general infections, but we are still weak in controlling drug-resistant infections. According to the United States statistics, the death rate of drug-resistant bacteria infection is absolutely higher than that of influenza. ”

Zhang Wenhong stressed that “the number of drug-resistant bacteria, which is what we call” super bacteria “, is increasing. Although new drugs will appear every year, we do not know when these new drugs will be resistant.”

Zhang Wenhong believes that on the whole, rational use of antibiotics and prevention of the spread of drug-resistant bacteria will become the top priority of the work. “Otherwise, the infection of drug-resistant bacteria will become a super infectious disease, and its influence will be no less than that of the new crown, but the death will not happen immediately.”

he said that the death of critically ill patients in Xinguan will be within 2-4 weeks, but the infection of super bacteria may occur slowly in the infection of senile diseases and chronic diseases. Finally, many people did not realize that it was caused by drug-resistant bacteria infection.

as early as June this year, WHO released its message in its WeChat official account. The increased use of antibiotics due to the 2019 coronavirus pandemic will eventually lead to higher bacterial resistance, thereby affecting the disease burden and death toll during and after the pandemic. China’s novel coronavirus pneumonia is not used in the treatment of new crown pneumonia cases in China, but

patients are different from those with severe pneumonia, Zhang Wenhong said. The hospitalization time of patients after tracheal intubation is generally more than one month. During hospitalization, they will contact many bacteria in the air and their own intestinal endogenous bacteria because of the airway opening. Therefore, some of these patients died of neocoronavirus in the later stage, but a considerable number of them died of bacterial infection. “Before the death of patients, a variety of antibiotics were used. If the new crown epidemic spread globally, and if 10% of the critically ill patients were judged to have used antibiotics, then the overuse of antibiotics, the initiation of drug resistance, and the nosocomial transmission of drug-resistant bacteria will become important problems.”

Zhang Wenhong said that Xinguan did not use antibiotics in the treatment of moderate and mild patients, only severe patients used antibiotics. Photo: Zhang Chengjun editing: Zou Qiao

Professor Yu Yunsong, director of infection department of run run run hospital affiliated to Zhejiang University Medical College, said frankly that on the one hand, prevention and control measures for nosocomial infection should be strengthened, and on the other hand, antibiotics should be used as much as possible to reduce the possibility of the emergence of super fine bacteria.

Chen Erzhen, vice president of Ruijin Hospital, said that it is necessary to continuously strengthen the education and training of grass-roots medical staff on the rational use of antibiotics, standardize the cognition of drug use behavior, and realize accurate prevention and control by means of information technology.

Professor Wang Minggui and Professor Zhang Jing of the Institute of antibiotics, Huashan Hospital Affiliated to Fudan University, said that the research and development of new antibacterial drugs is very important. At present, the state has also given great scientific research support to this area. Precise drug use is very important for rational use of antibacterial drugs. Timely monitoring of the concentration of antibacterial drugs should be done. In addition, clinicians, clinicians, and doctors should also be informed In order to provide individualized support for patients, multi-disciplinary cooperation was carried out by the experts of infection control, pharmacy and microbiology.

Zhang Wenhong believes that in terms of bacterial resistance itself, the actual prevention and control measures we have taken today are less than 1 / 10 of that of Xinguan. He believes that if the state can put half of its efforts into the prevention and control of new coronavirus, the number of deaths caused by drug-resistant bacteria in China can be reduced by at least hundreds of thousands every year. “Of course, there are elderly people, postoperative patients, tumor patients, blood patients and so on, but life is supreme.”

Zhang Wenhong said that in terms of bacterial resistance itself, the actual prevention and control measures we have taken today are less than 1 / 10 of the strength of the new crown. Photo: edited by Zhang Chengjun, Zou Qiao

Zhang Wenhong believes that all deaths caused by drug-resistant bacteria should be avoided, and drug-resistant bacteria should not be used as a means of natural selection. “What is natural selection? I mean an infection of a pathogen that completely eliminates the weakest and weakest group in the population. Nature has always been doing this in the process of evolution, but we are now a civilized society. The reason why we have civilization is because we follow natural selection against each other, which makes us live so long and so many weak people can live. “