According to the CDC WeChat official account, drug resistance is no longer the "exclusive" of pathogenic bacteria under low pathogenicity conditions. More and more highly pathogenic infectious disease pathogens have also developed drug resistance, and even high resistant clones have emerged. Among the 39 legally recognized pathogens of infectious diseases in China, multiple pathogens such as Mycobacterium tuberculosis, Salmonella, and Shigella have been detected as "highly drug-resistant strains". In addition, pathogens of community-acquired pneumonia such as Mycoplasma pneumoniae and Streptococcus pneumoniae have also shown resistance to first-line treatment drugs. This article explains the key information for preventing and controlling antibiotic resistance in infectious diseases through 5 high-risk drug-resistant pathogens, 4 transmission routes, and 3 protective measures. Five high-risk drug-resistant pathogens, we must be alert to rifampicin resistant Mycobacterium tuberculosis. China is a high burden country for multi drug resistant tuberculosis. In 2024, the number of newly developed multi drug resistant/rifampicin resistant tuberculosis patients was estimated to be 28000, second only to India, and ranked second with the Philippines in the number of newly developed multi drug resistant/rifampicin resistant tuberculosis patients. The prevention and control still cannot be relaxed. Macrolide resistant Mycoplasma pneumoniae is mainly transmitted through droplets, and children, adolescents, and elderly people with weakened immunity are the main susceptible populations. In recent years, the resistance rate to first-line treatment drugs such as azithromycin and clarithromycin has rapidly increased, and some children are facing the dilemma of "no drugs available". Ceftriaxone+Azithromycin dual resistant Shigella is a common pathogenic bacterium for infectious diarrhea in children under 5 years old. In 2015, Shigella was first discovered in Guangxi to be dual resistant to ceftriaxone and azithromycin. Since then, dual resistant Shigella strains have been detected in multiple locations, posing a potential threat to children's health. Ceftriaxone and quinolone resistant Salmonella are the main pathogens causing infectious diarrhea. In the past decade, the resistance rate has been increasing year by year, and highly resistant clones have spread from aquaculture to dining tables and hospitals, posing a continuous threat to public health through the food chain. Cephalosporin+quinolone dual resistance Neisseria gonorrhoeae is the pathogen of gonorrhea, and cephalosporins and quinolones are its main therapeutic drugs. If the dual drug resistant strain spreads widely, gonorrhea may once again become an incurable disease. 4 transmission routes, pay attention to avoiding high-risk water sources. Shigella, Salmonella, and other bacteria can enter rivers, soil, farmland, and aquatic products with sewage, causing spread. Droplets spread tuberculosis, mycoplasma pneumonia, and other bacteria in enclosed spaces such as classrooms, cinemas, and subways through airborne droplets. Food borne Salmonella is commonly found in undercooked eggs, poultry, and other foods, and there is a risk of infection when consuming undercooked food. The awareness of protection is crucial for the direct transmission of gonorrhea, Neisseria gonorrhoeae, and other pathogens through sexual contact. Three key actions to jointly build a defense line against drug resistance: rational use of antibiotics. Antibiotics are not a panacea and must be used with a prescription. Once used, the dosage should be sufficient, the treatment course should be complete, and the medication should not be stopped arbitrarily. Cultivate good hygiene habits, wash hands frequently, ventilate, wear masks in enclosed public places, and avoid touching during hospital visits, effectively reducing the risk of infection. Active vaccination is an effective means of preventing infectious diseases. Reducing infection can reduce the use of antibiotics and control the development of drug resistance from the source. (New Society)