title: Epidemiology of VIM-1-imipenem resistant Pseudomonas aeruginosa in Iran: A systematic review and meta-analysis.
abstract: BACKGROUND
  Pseudomonas aeruginosa is an opportunistic human pathogen which causes serious problems, especially in people who have immunodeficiency. Metallo beta-lactamase (MBL) resistance in this bacterium has led some difficulties in treating bacterial infections. MBLs are being reported with increasing frequency worldwide. The aim of the present systematic review and meta-analysis was to collect data about the relative frequency (RF) of VIM-1-imipenem resistant P. aeruginosa (VIM-1-IRPA) in different regions of Iran and report an overall prevalence if possible.
  
  
  METHODS
  PubMed, ISI web of science, Scopus and Google Scholar were searched using following key terms: "P. aeruginosa," "imipenem," "VIM-1" and "Iran" were. Articles/abstracts, which used clinical specimens and had done polymerase chain reaction to detect the VIM-1 gene of MBL genes, were included in this review. STATA SE version 11.2 (StataCorp, College Station, TX, USA) was used for statistical analysis.
  
  
  RESULTS
  Out of 5457 results found, 10 articles were eligible to be included in our systematic review and meta-analysis. These studies were carried out in Tehran, Isfahan, Kurdistan, Ahvaz, Markazi and Northwest of Iran (Orumieh and Tabriz). Pooled estimation of 1972 P. aeruginosa samples showed that 13% (95% confidence interval = 10.5-16.5%]) of strains were VIM-1 positive. VIM-1-IRPA RF in different studies varied from 0% to 19.5% in Isfahan and Markazi provinces, respectively. We found a moderate heterogeneity (Chochran Q-test, P = 0.032, I-squared = 50.7%) of VIM-1-IRPA RF among studies.
  
  
  CONCLUSIONS
  According to the results of this study VIM-1-IRPA RF in Iran is in low-level Prevention strategies to reduce the prevalence rates of VIM-1 positive strains in Iran are needed.
authors.affiliation: Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mansour
authors.initials: M
authors.lastname: Sedighi
authors.affiliation: Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ; Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Salehi-Abargouei
authors.affiliation: Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Golfam
authors.initials: G
authors.lastname: Oryan
authors.affiliation: Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Faghri
keywords: Imipenem resistant Pseudomonas aeruginosa; Iran; VIM-1; systematic review