title: Epidemiology of Multidrug Resistant Uropathogenic Escherichia coli in Iran: a Systematic Review and Meta-Analysis.
abstract: Urinary tract infection (UTI) is one of the most common infections in humans. It is primarily caused by uropathogenic Escherichia coli (UPEC), which has a high multidrug resistance (MDR). In consideration of the prevalence of MDR-UPEC strains, the aims of the present study were to systematically review the published data about the prevalence rate of MDR-UPEC from different parts of Iran and to establish the overall relative frequency (RF) of these strains in Iran. We searched several databases including PubMed, ISI Web of Science, Scopus, Google Scholar, IranMedex, and Iranian Scientific Information Database by using the following keywords: "Escherichia coli", "multidrug resistant", "MDR", "urinary tract infections", "UTI", "uropathogenic". and "Iran". Articles or abstracts that reported the prevalence of MDR-UPEC were included in this review. We found 15 articles suitable for inclusion in this study. A pooled estimation of 10,247 UPEC strains showed that 49.4% (95% confidence interval = 48.0-50.7%) of the stranis were MDR positive. The RF of MDR-UPEC in different studies varied from 10.5% to 79.2% in the Kashan and Hamedan provinces, respectively. According to the results of the present study, the RF of MDR-UPEC in Iran is high. Thus, measures should be taken to keep the emergence and transmission of these strains to a minimum.
authors.affiliation: Department of Microbiology, Pasteur Institute of Tehran.
authors.forename: Shima
authors.initials: S
authors.lastname: Hadifar
authors.forename: Mohsen
authors.initials: M
authors.lastname: Moghoofei
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Nematollahi
authors.forename: Rashid
authors.initials: R
authors.lastname: Ramazanzadeh
authors.forename: Mansour
authors.initials: M
authors.lastname: Sedighi
authors.forename: Amin
authors.initials: A
authors.lastname: Salehi-Abargouei
authors.forename: Ali
authors.initials: A
authors.lastname: Miri
mesh_terms: D024901:Drug Resistance, Multiple, Bacterial; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D015995:Prevalence; D019371:Topography, Medical; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology*; D056689:Uropathogenic Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification*