The increasing and widespread application of antibacterial drugs makes antibiotic resistance a prominent and growing concern in clinical practice. The emergence of multidrug-resistant bacteria presents a global threat. However, the development and use of novel antibacterial agents involves time-consuming and costly challenges that may lead to yet further drug resistance. More recently, researchers have turned to traditional Chinese medicine to stem the rise of antibiotic resistance in pathogens. Many studies have shown traditional Chinese medicines to have significant bacteriostatic and bactericidal effects, with the advantage of low drug resistance. Some of which when combined with antibiotics, have also demonstrated antibacterial activity by synergistic effect. Traditional Chinese medicine has a variety of active components, including flavonoids, alkaloids, phenols, and quinones, which can inhibit the growth of drug-resistant bacteria and be used in combination with a variety of antibiotics to treat various drug-resistant bacterial infections. We reviewed the interaction between the active ingredients of traditional Chinese medicines and antibiotic-resistant bacteria. At present, flavonoids and alkaloids are the active ingredients that have been most widely studied, with significant synergistic activity demonstrated when used in combination with antibiotics against drug-resistant bacteria. The reviewed studies show that traditional Chinese medicine and its active ingredients have antimicrobial activity on antibiotic-resistant bacteria, which may enhance the susceptibility of antibiotic-resistant bacteria, potentially reduce the required dosage of antibacterial agents and the rate of drug resistance. Our results provide direction for finding and developing alternative methods to counteract drug-resistant bacteria, offering a new therapeutic strategy for tackling antibiotic resistance.

In the intensifying global crisis of antimicrobial resistance (AMR), the “old” antibiotic fosfomycin has regained prominence because of its unique mechanism of action and potent activity against numerous multidrug-resistant (MDR) pathogens. However, its clinical application is hampered by the rapid emergence of resistance during monotherapy. Rational combination therapy represents a strategic necessity to preserve and enhance the efficacy of fosfomycin. This review systematically analyzes the antibacterial and molecular mechanisms of resistance to fosfomycin, with a focus on the growing threat posed by plasmid-mediated resistance genes. The preclinical and clinical evidence of key combination regimens (including β-lactams, aminoglycosides, fluoroquinolones, polymyxins, and daptomycin) has been comprehensively evaluated, with detailed discussions of the mechanistic foundations for the observed synergistic effects. Although in vitro and animal models show substantial promise, we critically examine the translational gap between positive preclinical results and clinical realities, discussing major barriers to clinical advancement. Finally, we outline a prospective research agenda, encompassing pharmacokinetic/pharmacodynamic (PK/PD)-guided precision dosing, exploring non-antibiotic adjuvants, and developing more predictive preclinical models to unlock the full potential of fosfomycin-based combinations against MDR infections.

Infectious diseases caused by various pathogens are among the major threats to human health, and the key to controlling these diseases is the early diagnosis of pathogens. Currently, standard methods for clinical pathogen diagnosis have issues such as high cost, long processing time, and limited sensitivity, which are difficult to overcome with existing technology. In recent years, clustered regularly interspaced short palindromic repeats (CRISPR) gene editing technology, which utilizes a programmable endonuclease-based gene editing system, has been widely applied in the fields of treatment and diagnosis. In pathogen detection, CRISPR technology offers the advantages of being fast, accurate, sensitive, and simple, enabling the detection of various pathogens early and instantly, thereby compensating for the shortcomings of existing nucleic acid detection methods. Moreover, the precise identification and characterization of mutant genes that cause virulence and drug resistance via CRISPR has further promoted its application in clinical pathogen diagnosis, providing a basis for controlling pathogen transmission and monitoring resistance. Currently, although the CRISPR/Cas system offers various advantages, there are still areas for improvement in clinical applications, including cumbersome operational processes, difficulty in achieving accurate quantitative, multiplex, and standardized detection, and reliance on specialized instruments. Therefore, continuous improvement is necessary to develop new and more convenient CRISPR-based tools for pathogen detection. This review focuses on various simplified strategies of the latest CRISPR diagnostic tools, including extraction-free, amplification-free, and integrated reactions, as well as sensitive and portable output strategies, to overcome these obstacles in clinical applications and propose the next strategic direction for providing researchers with innovative strategies for real-time pathogen diagnosis.

Infectious diseases caused by various pathogens are among the major threats to human health, and the key to controlling these diseases is the early diagnosis of pathogens. Currently, standard methods for clinical pathogen diagnosis have issues such as high cost, long processing time, and limited sensitivity, which are difficult to overcome with existing technology. In recent years, clustered regularly interspaced short palindromic repeats (CRISPR) gene editing technology, which utilizes a programmable endonuclease-based gene editing system, has been widely applied in the fields of treatment and diagnosis. In pathogen detection, CRISPR technology offers the advantages of being fast, accurate, sensitive, and simple, enabling the detection of various pathogens early and instantly, thereby compensating for the shortcomings of existing nucleic acid detection methods. Moreover, the precise identification and characterization of mutant genes that cause virulence and drug resistance via CRISPR has further promoted its application in clinical pathogen diagnosis, providing a basis for controlling pathogen transmission and monitoring resistance. Currently, although the CRISPR/Cas system offers various advantages, there are still areas for improvement in clinical applications, including cumbersome operational processes, difficulty in achieving accurate quantitative, multiplex, and standardized detection, and reliance on specialized instruments. Therefore, continuous improvement is necessary to develop new and more convenient CRISPR-based tools for pathogen detection. This review focuses on various simplified strategies of the latest CRISPR diagnostic tools, including extraction-free, amplification-free, and integrated reactions, as well as sensitive and portable output strategies, to overcome these obstacles in clinical applications and propose the next strategic direction for providing researchers with innovative strategies for real-time pathogen diagnosis.

Infectious diseases caused by various pathogens are among the major threats to human health, and the key to controlling these diseases is the early diagnosis of pathogens. Currently, standard methods for clinical pathogen diagnosis have issues such as high cost, long processing time, and limited sensitivity, which are difficult to overcome with existing technology. In recent years, clustered regularly interspaced short palindromic repeats (CRISPR) gene editing technology, which utilizes a programmable endonuclease-based gene editing system, has been widely applied in the fields of treatment and diagnosis. In pathogen detection, CRISPR technology offers the advantages of being fast, accurate, sensitive, and simple, enabling the detection of various pathogens early and instantly, thereby compensating for the shortcomings of existing nucleic acid detection methods. Moreover, the precise identification and characterization of mutant genes that cause virulence and drug resistance via CRISPR has further promoted its application in clinical pathogen diagnosis, providing a basis for controlling pathogen transmission and monitoring resistance. Currently, although the CRISPR/Cas system offers various advantages, there are still areas for improvement in clinical applications, including cumbersome operational processes, difficulty in achieving accurate quantitative, multiplex, and standardized detection, and reliance on specialized instruments. Therefore, continuous improvement is necessary to develop new and more convenient CRISPR-based tools for pathogen detection. This review focuses on various simplified strategies of the latest CRISPR diagnostic tools, including extraction-free, amplification-free, and integrated reactions, as well as sensitive and portable output strategies, to overcome these obstacles in clinical applications and propose the next strategic direction for providing researchers with innovative strategies for real-time pathogen diagnosis.