During the long journey to combat bacteria, anti-bacterial products were once seen as “solvers” to protect health. However, as the problem of bacterial resistance becomes more acute, a number of misconceptions continue to spread, including that bacterial resistance will disappear after a period of time after the use of antibacterial products has ceased. This misdiagnosing has led many people to miscalculate in their response to the threat of bacteria, and the evolution of bacterial resistance is far more complex than expected.
Bacteria resistance arises from adaptive changes in survival pressure. When exposed to long-term “attacks” of antibacterial products, bacteria or genetic mutations alter their structure to make it difficult to combine antibacterial components; or develop special enzyme systems to decompose, meso and antibacterial substances and thus acquire resistance. This resistance characteristic, once rooted in a bacterial group, does not easily dissipate.
In the case of common family antibacterial hand-washing fluids, which contain antibacterial components such as trichlorfon, the hand bacteria are constantly “evolving” during frequent use. If it is suddenly discontinued, those bacteria that have produced resistance will not be “armed to surrender”. Their drug-resistant genes still exist and can be transmitted to other otherwise sensitive bacteria through lateral gene transfer between bacteria, further increasing the size of the drug-resistant strain. Even in an environment where no antibacterial products continue to be pressured, these resistant bacteria, with their pre-evolving survival advantage, can survive and reproduce in natural environments such as soil, water bodies and even the skin surface of humans.
In the field of health care, this phenomenon cannot be ignored. Hospitals have been using various types of antibacterial drugs to prevent infection, resulting in a large number of resistant bacteria. Even if the associated antibacterial drugs are temporarily discontinued, the resistance mechanisms for the drug-resistant bacteria have developed and are not self-reversible. For example, MRSA, which is a “frequent guest” of infection in a hospital, is able to rely on its own drug-resistant genes, even if it reduces the frequency of use of antibacterial drugs in a given section, to sleep in the corners of a medical device or ward, and, when the time is right, to cause re-infection, causing great suffering to the patient.
Moreover, bacteria in complex environments may also strengthen their resistance. Areas of life, such as sewage discharge systems, waste disposal sites, are rich in various chemical substances and heavy metal contaminants, and these environmental pressures, similar to those of the choice of antibacterial products, contribute to the maintenance and even strengthening of the resistance properties of bacteria for survival. Even when far away from antibacterial products, bacteria “crawl and roll” in these harsh environments will only increase their resistance.
This Zone of Mistakes has many hazards. At the family level, the mistaken assumption that the elimination of antibacterial products would allow bacteria to “restore” may lead to re-enactment with care, neglect of hygiene, and the use of drug-resistant bacteria to increase the risk of family infection. Medically, misperceptions affect the development of hospital infection prevention and control strategies, delay continuous monitoring and effective management of drug-resistant bacteria and endanger the life of patients.
In order to overcome this misdeed, the public needs to establish the right perception. It is understood that, once bacteria are produced, they will not easily disappear as antibacterial products are discontinued. Daily cleaning should rationalize the use of anti-bacterial products to avoid over-dependence; hospitals need to strengthen infection prevention and control systems to keep track of and precision in the control of drug-resistant bacteria; and researchers should intensify their research to explore new ways of reversing bacterial resistance, working in synergy to ensure that they are not passive in the competition with drug-resistant bacteria and are able to protect their health.
