Recent crisis in human health is mostly due to spread of multidrug-resistant bacteria or superbugs. Molecular analysis has indicated integrons and R-plasmids (2-15 kb) have combined with F’-conjugative plasmid (62 kb) producing large MDR-Plasmids (50-500 kb) that could donate mdr genes to all bacteria present in the intestine. We used >20,000 tons antibiotics each year to remove bacteria from our body and thus eradicated >35,000 species of gut microbiota from intestine that produce vitamins (riboflavin, pantothenate, niacin, folate, biotin, etc.). We now use probiotic capsule with ~10 bacteria (Lactobacillus, Bifidobacterium, Streptococcus, etc.) but many gut microbes are hard to grow and study in vitro. Thus, antibiotics have produced a greater crisis that human would be extinct unless mdr genes are created and diversified to withstand the new drug derivatives discovered every year! The crisis of vitamins is obvious as bacterial plasmids have been acquiring vitamin synthesizing genes and other genes related to complex biomolecules synthesis. Bacteria know that a further great war will be awaited as scientists will produce more deadly antibiotics and are acquiring multiple (20-60) gene rearrangement cassettes (IntI, Tn3, Tn5, Tn30, IS-26, etc.) in large plasmids for mdr gene creation. Moreover, intestinal cells also need lipopolysaccharides, linolinic acid, taurocholic acids and butyrate, etc., and stay in a tight symbiotic control over producing cytokines, interleukins and immuloglobins. Superbugs NDM1 Escherichia coli, MRSA Staphylococcus aureus, MDR Acinetobacter baumannii and XDR Mycobacterium tuberculosis, etc., are hard to treat due to accumulations of amp, blaNDM1, blaOXA23, tetA/C, mexAB, arr3, catB3, sul1/2, dhfr, penA, acrAB, mtrCD, aacC1, aadA2, aphA4, aacA4, mcr-1, etc., MDR genes and DEGs (acrAB, tetA/C, mcr, mtrCD, mexAB-EF) in plasmids and chromosome(s) as well as mutations in the antibiotic targets like gyrB, parC, porB, 16S rRNA, rpsL genes. WHO has warned for reduced antibiotic use and G-20 Nations are together to address the anticipated antibiotic horror, not superbug horror. Perhaps, phage therapy, gene medicines, heterogeneous phyto-antibiotics and drug nano-carriers will be future agenda to replace antibiotics.
