Molecular Microbiology Research, 2025, Vol.15, No.1, 18-27 http://microbescipublisher.com/index.php/mmr 24 and test which antibiotics it is sensitive to (Totsika et al., 2012; Zhou et al., 2023). Molecular detection methods, such as PCR (polymerase chain reaction), can also be used to check whether there are virulent genes carried by pathogenic bacteria (Rezatofighi et al., 2021). If it is diarrhea, doctors usually test stool samples. Methods include bacterial culture and PCR to find out if there is a specific E. coli toxin or related gene. In recent years, genomics and proteomics technologies have also developed rapidly. These new technologies can help us identify the source of infection faster and more accurately, and are particularly useful for controlling and treating these diseases (Mann et al., 2017; Biggel et al., 2020). 8 Antibiotic Resistance in Pathogenic E. coli 8.1 Mechanisms of antibiotic resistance in E. coli The problem of E. coli's "resistance" to antibiotics is very complicated. It is achieved not by one method, but by many ways. It can learn drug resistance from other bacteria through "horizontal gene transfer". This transfer may be accomplished by plasmids, transposons, or integrons (Szmolka and Nagy, 2013; Blair et al., 2014). These things are like "gene wraps" containing various drug-resistant genes. Once E. coli accepts these "packages", it can become a multidrug-resistant strain. In addition, it can also be mutations based on its own genes. For example, some mutations will change the target of drug action, while others will enhance its "outlet pump" function in the body. The efflux pump is like a "draining device" in the bacteria, which can actively expel antibiotics, so that the drug will not work (Gauba and Rahman, 2023). Another common method is the secretion of β-lactamase, which can break down or alter the structure of antibiotics and ineffective antibiotics (Džidić et al., 2008). It is important for us to understand these methods, because only in this way can we find ways to deal with them. 8.2 Global trends in antibiotic-resistant E. coli strains Now, drug-resistant E. coli has become a global health challenge. Strains that are resistant to drugs can be found in humans, animals, food or natural environments. Many studies have found that E. coli is increasingly resistant to common antibiotics. For example, an analysis found that in communities, especially in low- and middle-income countries (LMICs), drugs such as ampicillin, cefotaxime and ciprofloxacin, have an increasing resistance rate (Nji et al., 2021). There are also studies that indicate that there are a large number of multidrug-resistant E. coli in food animals. These bacteria are likely to “transfer” their drug-resistant genes to human pathogens (Szmolka and Nagy, 2013). This phenomenon is very worrying. Therefore, we need to continuously monitor this trend and strengthen global cooperation to address this problem (Pormohammad et al., 2019; Urban-Chmiel et al., 2022). 8.3 Implications for treatment and public health The increasing number of drug-resistant E. coli poses great challenges to treatment. The antibiotics used in the past may now be ineffective, which can lead to more people being infected, becoming more ill, and even increasing mortality (Urban-Chmiel et al., 2022). To address this, we must develop new treatments, while also using existing antibiotics more carefully to prevent them from continuing to fail (Munita and Arias, 2016). In public health, we should pay attention to several key points: first, regularly monitor drug-resistant bacteria; second, strengthen infection control in hospitals and communities; third, implement the "rational drug use" plan (Pormohammad et al., 2019; Nji et al., 2021). In addition, alternative therapies need to be explored, such as bacteriophage therapy or the use of more targeted “narrow spectrum antibiotics” (Gauba and Rahman, 2023). These methods may become new hope for the fight against drug-resistant bacteria. In general, in order to maintain the last line of defense against antibacterial drugs, we must attach great importance to the drug resistance of E. coli. Acknowledgments The Publisher sincerely thanks the two anonymous peer reviewers for their review of this manuscript and for providing constructive revision suggestions. Conflict of Interest Disclosure The author affirms that this research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.
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