The success of modern medicine rests on the ability to control infections. But decades of antibiotic overuse—in hospitals, communities, and farms—have fueled a global surge in resistant microbes. These "superbugs" thrive where antibiotics are freely used and poorly regulated, spreading silently through humans, animals, and the environment. International monitoring has revealed sharp differences between countries, driven by distinct drug policies and healthcare systems. In developing regions, weak surveillance and over-the-counter antibiotic sales have worsened the crisis. Because of these challenges, researchers have turned to an urgent question: how can the world contain antimicrobial resistance (AMR) before it outpaces modern medicine?
A research team from Jilin University and Peking Union Medical College Hospital has issued a comprehensive review (DOI: 10.12290/xhyxzz.2025-0704) in the Medical Journal of Peking Union Medical College Hospital (September 2025). The study integrates global monitoring data and clinical insights to chart the spread of resistant bacteria and fungi. By revealing the molecular mechanisms and treatment challenges of AMR, it provides a scientific foundation for global action and highlights how strategic antibiotic use could slow the tide of resistance.
The authors examined data from international surveillance programs such as CARS, SENTRY, and One Health Trust–ResistanceMap, uncovering striking global variations. Escherichia coli and Klebsiella pneumoniae remain the most prevalent culprits, with β-lactamase–producing strains widespread in Asia and carbapenem-resistant variants rising across Europe and the Americas. The notorious Acinetobacter baumannii and Pseudomonas aeruginosa are particularly difficult to treat, showing resistance levels of over 70% in some regions. In contrast, northern Europe reports single-digit rates, reflecting effective stewardship.
On the fungal front, Candida auris has emerged as a near-pan-resistant pathogen, while Aspergillus fumigatus is evolving azole resistance, partly driven by agricultural fungicide use. The review dissects the genetic pathways—such as β-lactamase expansion, carbapenemase evolution, and efflux pump overexpression—that underlie these threats. In response, the authors recommend individualized treatment guided by pharmacokinetic and pharmacodynamic data, including the use of β-lactamase inhibitors, tigecycline, and polymyxin-based combinations. Their message is clear: smart prescribing and global cooperation are as vital as new drugs in fighting resistance.
"AMR represents a slow-moving pandemic," said Dr. Xuesong Xu, lead author of the study. "Our review shows that resistance patterns are constantly shifting, shaped by human behavior, healthcare systems, and environmental factors. No country can fight this battle alone. What’s needed is a unified One Health strategy that bridges medicine, agriculture, and ecology. Only by strengthening surveillance, optimizing antibiotic use, and fostering innovation can we prevent a future where routine infections once again become deadly."
The findings underscore a pivotal truth: AMR is not just a medical issue—it's a global systems challenge. The authors call for coordinated international surveillance, tighter prescription controls, and responsible use of antibiotics in agriculture. Hospitals must embrace genomic diagnostics and AI-assisted decision systems to tailor therapies in real time. Investment in next-generation antimicrobials and β-lactamase inhibitors is equally urgent. Beyond drugs, education and policy reform are key to preserving the efficacy of existing treatments. If global collaboration succeeds, the tide of resistance can still be turned—securing the foundation of modern medicine for generations to come.
###
References
DOI
10.12290/xhyxzz.2025-0704
Original Source URL
https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2025-0704
About Medical Journal of Peking Union Medical College Hospital
Medical Journal of Peking Union Medical College Hospital is a leading clinical medicine publication, supported by the multidisciplinary expertise of Peking Union Medical College Hospital. It features the latest research, advancements, and academic trends in clinical and translational medicine, pharmacy, and related interdisciplinary fields, catering to clinicians and medical students across China. The journal aims to promote the exchange of medical knowledge and serve as a high-quality platform for leading academic discussions and fostering scholarly debate in clinical medicine. The journal is listed in China's Core Journals of Science and Technology (CSTPCD), Chinese Science Citation Database (CSCD), A Guide to the Core Journals of China, and the Chinese Biomedical Literature Database (CMCC). Full-text content is accessible on platforms such as Wanfang Data, CNKI, and Chongqing VIP Database. It is indexed in Scopus (Netherlands), the Directory of Open Access Journals (DOAJ) in Sweden, and the Japan Science and Technology Agency Database (JST).