title: Prevalence of vancomycin-resistant Enterococcus in Iran: a systematic review and meta-analysis.
abstract: Vancomycin-resistant Enterococcus (VRE) is considered to be a major nosocomial pathogen that results in serious morbidity and mortality worldwide. Limited information is available concerning the prevalence of VRE infections in Iran. We carried out a systematic search by using different electronic databases including: Medline (via PubMed), Embase, Web of Science, and the Iranian Database. Meta-analysis was performed using comprehensive meta-analysis software. The meta-analyses revealed that the prevalence of VRE infections was 9.4 % (95 % confidence interval [95 % CI] 7.3-12) among culture-positive cases for Enterococcus species. The prevalence of VRE in Iran is compared with the results of developed countries. The prevalence of VRE in Germany, the United Kingdom (UK), and Italy was 11.2 %, 8.5-12.5 %, and 9 % respectively. Additionally, the frequency of vancomycin resistance among E. faecalis isolates was higher than for E. faecium. The results of this study indicate that a comprehensive infection control strategy based on hand hygiene, educating the hospital staff members, providing clinical guidance and principles for the appropriate use of antibiotics, sanitizing the hospitals, contact precautions, and active surveillance systems on the basis of international criteria is urgently needed.
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina Street, Keshavarz Boulevard, Tehran, 14167-53955, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Emaneini
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina Street, Keshavarz Boulevard, Tehran, 14167-53955, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Hosseinkhani
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina Street, Keshavarz Boulevard, Tehran, 14167-53955, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Jabalameli
authors.affiliation: Department of Medical Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: M J
authors.initials: MJ
authors.lastname: Nasiri
authors.affiliation: Department of Medical Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Dadashi
authors.affiliation: School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: R
authors.initials: R
authors.lastname: Pouriran
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina Street, Keshavarz Boulevard, Tehran, 14167-53955, Iran. rbeigverdi@tums.ac.ir.
authors.forename: R
authors.initials: R
authors.lastname: Beigverdi
mesh_terms: D013293:Enterococcus faecalis / Q000302:isolation & purification; D016984:Enterococcus faecium / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D017053:Infection Control; D007492:Iran / Q000453:epidemiology; D015995:Prevalence; D065507:Vancomycin-Resistant Enterococci / Q000302:isolation & purification*