While the overall prevalence of hypervirulent, drug-resistant K pneumoniae in China appears to be low, Chen said, what he and his colleagues are worried about is that it will likely increase in Chinese hospitals, presenting clinicians with more severe infections that don’t respond to the current arsenal of antibiotics.But with few new antibiotics in the pipeline, physicians will be forced to keep using what they have, which will only hasten the further emergence of multidrug-resistant pathogens, said David van Duin, MD, PhD, an antimicrobial resistance researcher at the University of North Carolina School of Medicine. “Emergence of combined increased virulence and resistance will force doctors to treat patients even more broadly upfront with last-line antibiotics, thus inducing additional resistance,” he said.And if the rapid global spread of the resistance gene MCR-1 is any example, these types of infections won’t be limited to China. The plasmid-mediated gene, which confers resistance to the last-resort antibiotic colistin, was identified in Escherichia coli bacteria in China in 2015, and since then has been detected in more than 30 countries. Other antibiotic resistance genes have demonstrated similar ability to spread rapidly via horizontal gene transfer. The genes and plasmids, and the bacteria that carry them, know no boundaries.”Multidrug-resistant organisms in one part of the world are a threat to patients everywhere,” van Duin said.