SynthesisThe Journal of antimicrobial chemotherapy2025
Global prevalence of nitrofurantoin-resistant uropathogenic Escherichia coli (UPEC) in humans: a systematic review and meta-analysis.
Synthesis in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Trends in the Frequency and Antimicrobial Resistance of Common Gram-Negative Bacilli Isolated From Urine Cultures.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2026Article
- UropathogenicAntibiotics (Basel, Switzerland) · 2026Review
- Itaconic Acid Directly Binds to the Cysteine Residue of PurF: A Novel Mechanism for Inhibiting Purine Metabolism in Porcine PathogenicMicroorganisms · 2026Article
- Prevalence of antimicrobial resistance in acute community-acquired urinary tract infections in Sub-Saharan Africa: a systematic review.JAC-antimicrobial resistance · 2026Review
- An update on Escalating Drug Resistance among Uropathogenic Bacteria: Challenges in Treatment and Scope for Maneuver.Current microbiology · 2026Review
- Optimizing urinary tract infection outcomes: nitrofurantoin versus fluoroquinolones.Bioinformation · 2026Article
- Nitrofurantoin resistance mechanisms in uropathogenic Escherichia coli isolates from Iran.Annals of clinical microbiology and antimicrobials · 2025Article
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3 authors.
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Abstract
backgroundThe global rise in antimicrobial resistance (AMR) is a significant health concern. Nitrofurantoin is used as a first-line antibiotic against many uropathogenic bacterial pathogens, including uropathogenic Escherichia coli (UPEC), and an analysis is required to assess the current global prevalence of nitrofurantoin-resistant UPEC.
methodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search using PubMed and Google Scholar was performed to find studies reporting nitrofurantoin-resistant UPEC in humans. Studies were included/excluded based on predefined criteria and focused only on isolates collected from the urinary tract. The quality of the studies was assessed using the Joanna Briggs Institute's (JBI's) Checklist for Prevalence Studies. Statistical analysis was performed using Metafor and Meta (R packages) to estimate the pooled prevalence, assess publication bias and perform heterogeneity analysis.
resultsSixty-three studies comprising 774 499 UPEC isolates collected between 1996 and 2024 were analysed and demonstrated a global pooled prevalence of nitrofurantoin-resistant UPEC isolates to be 6.9% (95% CI: 4.8%-9.7%). Continent-wise subgroup analysis showed Europe to have the lowest prevalence, while Asia has the highest prevalence. Decade-wise subgroup analysis showed the global prevalence increased from 2.8% (1996-04) to 8.2% (2005-14) and then decreased to 7.6% in the last decade (2015-24). Substantial heterogeneity was seen among the studies examined, as well as statistically significant publication bias.
conclusionsThe findings show considerable global prevalence of nitrofurantoin-resistant UPEC isolates, with the prevalence being higher in low- and middle-income countries (LMICs). Sufficient education should be provided where possible, and antimicrobial stewardship should be intensified to slow the rate of AMR increase worldwide.
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