Prevalence and Mechanisms of Carbapenem Resistance in Klebsiella pneumoniae and Escherichia coli: A Systematic Review and Meta-Analysis of Cross-Sectional Studies from Iran

Mohammad Javad Nasiri; Mehdi Mirsaeidi; Seyyed Mohammad Javad Mousavi; Mania Arshadi; Fatemeh Fardsanei; Behnaz Deihim; Sara Davoudabadi; Samin Zamani; Bahareh Hajikhani; Hossein Goudarzi; Mehdi Goudarzi; Zahra Sadat Seghatoleslami; Hossein Dabiri; Payam Tabarsi

doi:10.1089/mdr.2019.0440

Prevalence and Mechanisms of Carbapenem Resistance in Klebsiella pneumoniae and Escherichia coli: A Systematic Review and Meta-Analysis of Cross-Sectional Studies from Iran

Microb Drug Resist. 2020 Dec;26(12):1491-1502. doi: 10.1089/mdr.2019.0440. Epub 2020 Apr 28.

Authors

Affiliations

¹ Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Miami, Miller School of Medicine, Miami, Florida, USA.
³ Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
⁴ Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Department of Bacteriology and Virology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran.
⁶ Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
⁷ Department of Infectious Diseases, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
⁸ Clinical TB and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

PMID: 32348701
DOI: 10.1089/mdr.2019.0440

Abstract

Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) represents an urgent threat worldwide. We aimed to investigate the frequency of carbapenem-resistant Klebsiella pneumoniae and Escherichia coli in Iran. Materials and Methods: PubMed/Medline, Embase, Scopus, Web of Sciences, and Iranian databases were searched to find potentially relevant articles. Statistical analyses were performed using STATA version 14. Results: Forty-nine studies fulfilled the inclusion criteria. The pooled rates of resistance to carbapenem in K. pneumoniae and E. coli were 24.0% (95% confidence interval [CI] 18.0-31.0) and 5.0% (95% CI 2.0-8.0), respectively. bla_OXA-48 gene was the most common cause of carbapenem resistance in K. pneumoniae and E. coli. Conclusions: CRE is prevalent in Iran, which confers the importance of strength prevention and control measures.

Keywords: Escherichia coli; Iran; Klebsiella pneumoniae; carbapenem resistance.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Anti-Bacterial Agents / pharmacology*
Carbapenem-Resistant Enterobacteriaceae / drug effects
Carbapenem-Resistant Enterobacteriaceae / genetics*
Cross-Sectional Studies
Drug Resistance, Multiple, Bacterial / drug effects
Drug Resistance, Multiple, Bacterial / genetics*
Escherichia coli / drug effects
Escherichia coli / genetics*
Genes, Bacterial
Humans
Iran
Klebsiella pneumoniae / drug effects
Klebsiella pneumoniae / genetics*
Microbial Sensitivity Tests

Substances

Anti-Bacterial Agents