Medical Principles and Practice最新文献

{"title":"Prevalence of Urinary Tract Infections and Antibiotic Susceptibility Patterns of Uropathogens among Neonates in Maternity Hospital, Kuwait: A Six-year Retrospective Study.","authors":"Ola H Moghnia, Hessah S Al Otaibi, Aisha M Al Haqqan, Elie S Sokhn, Seema S Pathan, Nawar E Abdulaziz, Habiba Y Mohammed, Noura A Al-Sweih","doi":"10.1159/000543368","DOIUrl":"https://doi.org/10.1159/000543368","url":null,"abstract":"<p><strong>Objective: </strong>Urinary tract infections (UTIs) are common in neonates. Understanding the changes in the prevalence of common uropathogens is essential for early diagnosis and effective treatment of UTIs. This study aims to identify etiological agents and determine the local antibiotic susceptibility patterns of uropathogens causing UTIs.</p><p><strong>Subjects and methods: </strong>A retrospective cross-sectional descriptive study from January 2017 to December 2022 was conducted on hospitalized neonates at Maternity Hospital, Kuwait. Urine samples from neonates were analyzed to identify isolates, and antimicrobial susceptibility testing was determined using the VITEK® 2 system.</p><p><strong>Results: </strong>Out of 3996 urine samples processed, 282 (7%) samples yielded significant bacteriuria, mostly from male 185 (65.6%). Gram-negative isolates were the most common 141 (50%), followed by yeasts 84 (29.8%) and Gram-positive isolates 57 (20.2%). The common uropathogens were Klebsiella pneumoniae 50 (17.7%), followed by Escherichia coli 47 (16.8%), Candida albicans 39 (13.8%), Enterococcus faecalis 34 (12%) and Staphylococcus epidermidis 17 (6%). High resistance rates were observed among Enterobacterales against ampicillin, cephalothin, cefuroxime, cefotaxime, nitrofurantoin, amoxicillin-clavulanic acid, ceftazidime and trimethoprim-sulfamethoxazole. A total of 28 (56%) K. pneumoniae and 18 (38.3%) E. coli were ESBL producers.</p><p><strong>Conclusion: </strong>Gram-negative isolates are considered the predominant causative agents of UTIs in neonates at Maternity Hospital. Reduced antibiotic susceptibility to commonly used antibiotics poses a notable challenge in the clinical management of neonates with UTIs. This study underscores the importance of proactive surveillance in monitoring causative organisms and antibiotic susceptibility in neonates.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-21"},"PeriodicalIF":2.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Oral Adverse Effects following COVID-19 Vaccination and Similarities with Oral Symptoms in COVID-19 Patients: Taste and Saliva Secretory Disorders.","authors":"Hironori Tsuchiya, Maki Mizogami","doi":"10.1159/000543182","DOIUrl":"https://doi.org/10.1159/000543182","url":null,"abstract":"<p><p>Although COVID-19 vaccines exhibit diverse side effects, taste and saliva secretory disorders have remained poorly understood despite their negative impact on the overall quality of life. The present study aimed to characterize oral adverse effects following COVID-19 vaccination and assess their similarities with oral symptoms in COVID-19 patients. A literature search was conducted in databases, including PubMed, LitCovid, and Google Scholar, to retrieve relevant studies. The narrative review indicated that a certain number of vaccinated people develop ageusia, dysgeusia, hypogeusia, xerostomia, and dry mouth, while they are rare compared with COVID-19 oral symptoms. The prevalence of oral adverse effects varies by country/region and such geographical differences may be related to the type of vaccine used. Similar to SARS-CoV-2 infection, COVID-19 vaccination adversely affects taste perception and salivary secretion in females and older subjects more frequently than in males and younger subjects. Their impairments mostly appear withing three days after vaccination, and bitter taste is specifically impaired in some cases. Considering that oral adverse effects following COVID-19 vaccination share some characteristics with oral symptoms in COVID-19 patients, it is speculated that the spike protein derived from COVID-19 vaccination and SARS-CoV-2 infection may be pathophysiologically responsible for taste and saliva secretory disorders. This is because such spike protein has the potential to interact with ACE2 expressed on the relevant cells, produce proinflammatory cytokines, and form antiphospholipid antibodies. Our results do not deny the advantage of COVID-19 vaccination, but attention should be paid to post-vaccination oral effects in addition to COVID-19 oral symptoms.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-33"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Discrimination and Multiple Health Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses.","authors":"Jun Hyuk Lee, Hyeri Lee, Yejun Son, Hyeon Jin Kim, Jaeyu Park, Hayeon Lee, Guillaume Fond, Laurent Boyer, Lee Smith, Masoud Rahmati, Damiano Pizzol, Jiseung Kang, Dong Keon Yon, Hans Oh","doi":"10.1159/000542988","DOIUrl":"https://doi.org/10.1159/000542988","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to systematically investigate the associations between racial discrimination and various health outcomes and to evaluate the certainty of evidence from existing meta-analyses of observational studies.</p><p><strong>Method: </strong>We systemically searched the associations between racial discrimination and health outcomes for PubMed/MEDLINE, Embase, WoS, and Google Scholar up until January 31, 2024. Notably, the included studies were predominantly conducted in the United States and Europe, limiting the generalizability of our findings to a global context.</p><p><strong>Results: </strong>Eight meta-analyses of observational studies involving over 1 million individuals were included, describing 15 potential health outcomes related to racial discrimination. The quality assessment revealed that most included meta-analyses were of low quality. For oncological health outcomes, significant associations were found with the mortality of hepatocellular carcinoma (HCC); Black patients had a higher risk, while Asian patients had a lower risk when compared to White patients. In addition, Black patients with disparities on the cancer care continuum are a protective factor for early-stage HCC diagnosis. For gastroenterological health outcomes, Hispanic patients with nonalcoholic fatty liver disease and Black patients with socioeconomic status/differential access to health care, compared to white patients (reference) showed significant associations. For mental health outcomes, racial discriminations were significantly associated with increased odds of psychotic experiences, suicidal ideation, and suicidal attempts. Numerous significant associations were from weak to suggestive evidence levels, indicating variability in the evidence.</p><p><strong>Conclusion: </strong>Despite the complexity of measuring its impact, racial discrimination shows a profound influence across clinical areas, including an unexpected protective association in early-stage hepatocellular carcinoma diagnosis among Black patients.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-19"},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole-Genome Sequencing of Brucella melitensis Isolates from Kuwait for the Identification of Biovars, Variants, and Relationship within a Biovar.","authors":"Abu Salim Mustafa, Mohd Wasif Khan, Nazima Habibi, Wadha Alfouzan","doi":"10.1159/000542867","DOIUrl":"10.1159/000542867","url":null,"abstract":"<p><strong>Objective: </strong>The identification of Brucella genotypes is essential for epidemiological studies. The whole-genome sequencing is emerging as a novel tool for genetic characterization of infectious microbes. The aim of this study was to genotype Brucella melitensis isolates from Kuwait using whole-genome sequencing and variant analysis of the sequence data.</p><p><strong>Methods: </strong>DNA was purified from 15 heat-inactivated B. melitensis isolates and used to prepare sequencing libraries employing Nextera XT DNA Sample Preparation Kit (Illumina San Diego, CA, USA) and sequenced on a MiSeq (Illumina). The sequence files were aligned to three biovars of B. melitensis, i.e., biovar 1 str. 16M, biovar 2 str. 63/9, and biovar 3 str. Ether. The alignment and variant calling were performed using \"bwa-mem\" and SAMtools/VCFtools, respectively.</p><p><strong>Results: </strong>The genome size of all the isolates was around 3.3 mega base pairs and resembled B. melitensis biovar 2. Single-nucleotide polymorphisms (SNPs), insertions, and deletions (indels) were spread all over the genome; but 138 SNPs were common among the 14 isolates, supporting the same ancestral origin. A neighbor-joining tree analysis identified isolate 2 as an outlier. In addition, SNPs (2-478) specific to each isolate were also identified, which divided the B. melitensis biovar 2 into two major groups/genotypes. A further analysis showed that the Kuwaiti isolates of the present study shared phylogeny mainly with strains from the Middle Eastern countries.</p><p><strong>Conclusions: </strong>Among the 15 studied isolates from Kuwait, biovar 2 is the most prevalent biovar of B. melitensis. Furthermore, isolate-specific genetic variations were identified, which may be useful in epidemiological investigations.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Anti-Elixir Triad: Non-Synced Circadian Rhythm, Gut Dysbiosis, and Telomeric Damage.","authors":"Anup Kumar Mani, Venkatachalam Deepa Parvathi, Sumitha Ravindran","doi":"10.1159/000542557","DOIUrl":"10.1159/000542557","url":null,"abstract":"<p><p>Aging is an inevitable life process which is accelerated by lifestyle and environmental factors. It is an irreversible accretion of molecular and cellular damage associated with changes in the body composition and deterioration in physiological functions. Each cell (other than stem cells) reaches the limit of its ability to replicate, known as cellular or replicative senescence, and consequently, the organs lose their physiological functions, resulting in overall impairment. Other factors that promote aging include smoking, alcohol, UV rays, sleep habits, food, stress, sedentary lifestyle, and genetic abnormalities. These stress factors can alter our endogenous clock (the circadian rhythm) and the microbial commensals. As a result of the effect of these stressors, the microorganisms that generally support human physiological processes become baleful. The disturbance of natural physiology instigates many age-related pathologies, such as cardiovascular diseases, chronic obstructive pulmonary disorder, cerebrovascular diseases, opportunistic infections, high blood pressure, cancer, diabetes, kidney diseases, dementia, and Alzheimer's disease. The present review covers the three most essential processes of the circadian clock; the circadian gene mechanism and regulation, the mitotic clock (which plays a vital role in the telomere's attrition) and the gut microbiota and their metabolome that drive aging and lead to age-related pathologies. In conclusion, maintaining a synchronized circadian rhythm, a healthy gut microbiome, and telomere integrity is essential for mitigating the effects of aging and promoting longevity. The interplay among these factors underscores the importance of lifestyle choices in enhancing overall health and lifespan.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-14"},"PeriodicalIF":2.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sublethal Disinfectant Exposure on Antibiotic Resistance Patterns of Pseudomonasaeruginosa.","authors":"Mohemid Maddallah Al-Jebouri","doi":"10.1159/000542322","DOIUrl":"10.1159/000542322","url":null,"abstract":"<p><strong>Objective: </strong>The problem of hospital cross-infection due to contamination of disinfectants has been recognized elsewhere. The passage of bacteria through diluted disinfectants may not only bring about phenotypic changes in their antibiograms but also changes in phage susceptibility patterns. Contact with disinfectants in sublethal concentrations allows survival and multiplication of bacteria.</p><p><strong>Methods and materials: </strong>Serial passage, through disinfectants at subminimal inhibitory concentrations, induced antibiotic resistance in 18% of derived phenotypic variants of fifty strains of Pseudomonas aeruginosa which were isolated from diarrheal stools of infants in children's hospital.</p><p><strong>Results: </strong>A proportion of these strains became susceptible to an increased number of antibiotics. The present study revealed that all the isolates were resistant to tetracycline and carbenicillin and 40% of these isolates became sensitive to both antibiotics after exposure to disinfectants. The exposure to disinfectants induced neomycin resistance among two isolates. The resistance patterns were three before disinfectants exposure which increased to be nine different patterns after exposure. No antibiotic resistance was transferred between P. aeruginosa and Escherichia coli K12 as a recipient strain.</p><p><strong>Conclusions: </strong>Almost 50% of the isolates tested became sensitive to tetracycline, carbenicillin and co-trimoxazole after exposure to disinfectants. The resistance patterns among the 50 isolates were three which changed to be nine different patterns after exposure to disinfectants. Unjustifiable use of disinfectants might give a chance for survival and multiplication of pathogenic bacteria to develop new resistance patterns to antibiotics in use with a short time. These new resistance variants of bacteria which multiply in hospital environment could lead to serious epidemic conflicts particularly the epidemiological reporting and management.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Statin Use and Pulp Chamber Calcification: A Pilot Retrospective Case-Control Study Using Cone-Beam Computed Tomography.","authors":"Selen Nihal Sisli, Birgul Ozasir, Tufan Ozasir, Derin Bugu Yuzer, Kamran Gulsahi","doi":"10.1159/000542398","DOIUrl":"10.1159/000542398","url":null,"abstract":"<p><strong>Objectives: </strong>This pilot retrospective case-control study questioned whether systemic statin use causes pulp calcification using cone-beam computed tomography (CBCT) images from the patients prescribed oral statins and comparing those of healthy individuals.</p><p><strong>Subjects and methods: </strong>CBCT scans of 54 patients, including 27 age- and sex-matched patients for the study and control groups, were analysed using Mimics Innovation Suite software. The study included patients using statins regularly for at least 1 year. Only intact teeth with opposing teeth were selected for the study group and matched with the control group. Dental crown and pulp chamber volumes were calculated and proportioned. The data were analysed with chi-square and Shapiro-Wilk tests to assess normal distribution, followed by Mann-Whitney U test if necessary.</p><p><strong>Results: </strong>Statistical analysis showed no difference between the study and control groups (p = 0.505). Statin use duration did not cause statistically significant difference in terms of the reduction of pulp chamber volume (p = 0.141).</p><p><strong>Conclusion: </strong>Within the limitations of the study, systemic statin use did not cause dental pulp calcification. The results suggest, oral administration of the statin drugs is not an unfavourable condition for dental practice. Further studies with larger numbers of patients are needed to support this conclusion.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoplasmic Reticular Stress and Pathogenesis of Experimental Colitis: Mechanism of Action of 5-Amino Salicylic Acid.","authors":"Zahraa A Baydoun, Muddanna Rao, Islam Khan","doi":"10.1159/000541791","DOIUrl":"10.1159/000541791","url":null,"abstract":"<p><strong>Objectives: </strong>Inflammatory bowel diseases which are characterized by endoplasmic reticulum (ER) stress and activation of the unfolded protein response (UPR) signaling pathway are commonly treated with 5-amino salicylic acid (5-ASA). The objective of this study was to investigate the role of 5-amino salicylic acid in the UPR-signaling pathway in experimental colitis.</p><p><strong>Materials and methods: </strong>Colitis was induced in male Sprague-Dawley rats by intrarectal instillation of trinitrobenzene sulfonic acid. Animals received 5-amino salicylic acid (100 mg/kg body weight) 2 h before the induction of colitis and repeated daily until day 7. The animals were sacrificed on day 7 and tissues were collected for analysis.</p><p><strong>Results: </strong>The expression of protein kinase R (PKR)-like ER kinase (PERK), a mediator of UPR signaling increased significantly (p < 0.05), while inositol-requiring enzyme type-1 (IRE1) and the CCAAT/enhancer-binding homologous protein (CHOP) remained unaltered in the inflamed colon. The expression of glucose-regulated protein-78, activator of transcription factor-4, and phosphorylated-eukaryotic initiation factor-2α (eIF2αP) increased (p < 0.05) in the inflamed colon. However, the levels of eIF2α protein and mRNA expression remained unchanged. Myeloperoxidase activity, colon weight, and infiltration of inflammatory cells increased significantly (p < 0.05) in the submucosa whereas the body weight decreased. These changes were significantly inhibited by 5-amino salicylate treatment.</p><p><strong>Conclusion: </strong>These findings suggest that the anti-inflammatory properties of 5-amino salicylic acid are mediated through the inhibition of the PERK signaling pathway.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative Importance of Defined Mycobacterium tuberculosis Antigens in the T-Cell Recognition Repertoire of Latently Infected Individuals Not Progressing to Active Disease.","authors":"Fredrik Oftung, Abu Salim Mustafa","doi":"10.1159/000542324","DOIUrl":"10.1159/000542324","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we have mapped the relative importance of well-defined recombinantly expressed Mycobacterium tuberculosis antigens in the T-cell recognition repertoire of latently infected individuals not progressing to active disease.</p><p><strong>Materials and methods: </strong>Peripheral blood mononuclear cells from healthy latently infected long-term non-progressors were screened for antigen-induced proliferation and Th1 cytokine interferon-γ (IFN-γ) responses.</p><p><strong>Results: </strong>The panel of antigens tested showed a clear spectrum of responsiveness and lead to the identification of a subgroup of frequently recognized antigens (MPT59, CFP7, CFP10, CFP21, TB37.6/PPE68, ESAT-6, MPT51, and DnaK) with a high cellular response level as measured in both proliferation and IFN-γ assays. Among a subgroup of antigens also screened for responses in tuberculosis patients, CFP21 was identified as differentially recognized in non-progressors. For both cellular assays, we found a positive correlation between responder frequency and magnitude of response. A significant correlation between the level of antigen-specific proliferation and INF-γ secretion was also observed.</p><p><strong>Conclusion: </strong>We have identified a defined set of M. tuberculosis antigens frequently recognized by T cells at a high response level from latently infected long-term non-progressors which warrant further investigation for a potential role in immune regulation and protection against progression to active disease.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking Nitrofurantoin: Understanding Molecular Mechanisms of Action and Resistance in Enterobacterales.","authors":"Balaram Khamari, Eswarappa Pradeep Bulagonda","doi":"10.1159/000542330","DOIUrl":"10.1159/000542330","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a global health crisis that has already claimed millions of lives and is projected to affect millions more unless urgent action is taken. Effective control of AMR requires the correct choice and dosage of antibiotics, as well as robust surveillance and research. Understanding the mechanisms of antibiotic action and the emergence of resistance phenotypes along with their genotypes is essential. This knowledge, combined with insights into resistance prevalence and spread, empowers clinicians to propose alternative therapies. Nitrofurantoin, a 70-year-old antibiotic, remains effective for the treatment of uncomplicated lower UTIs. Preventing emergence and spread of nitrofurantoin-resistant superbugs would preserve the efficacy of this antibiotic which is crucial for ongoing and future AMR efforts. Nitrofurantoin resistance evolves slowly, leading to low prevalence compared to other antibiotics. However, it is often linked with extensive drug resistance, complicating treatment outcomes. Even a minor percentage of nitrofurantoin-resistant bacteria can cause significant clinical challenges due to irreversible evolution. While detailed study of these mechanisms can guide the development of strategies to combat nitrofurantoin resistance, early detection of resistant infections is critical for saving lives. The current review aimed to provide a comprehensive analysis of nitrofurantoin's mechanisms of action, resistance evolution, prevalence, and resistance prediction. Our goal is to offer valuable insights for researchers and clinicians to enhance nitrofurantoin use and address the challenges posed by AMR.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-17"},"PeriodicalIF":2.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}