Systematic review and meta-analysis of imipenem-resistant Pseudomonas aeruginosa prevalence in Iran

Vaez, Hamid; Salehi‐Abargouei, Amin; Khademi, Farzad

doi:10.18683/germs.2017.1113

Cited by 19 publications

(16 citation statements)

References 31 publications

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“…Therefore, antimicrobial resistance surveillance programs are required, especially in developing countries such as Iran, to monitor and predict the trend of drug resistance and assess the overuse and misuse of antimicro- bial agents and associated consequences (18). The emergence of imipenem-resistant P. aeruginosa strains is a concerning issue because these strains show simultaneous resistance to multiple antibiotics (19). In the present study, the prevalence of imipenem-resistant P. aeruginosa strains was 57.1%, which is higher than reports from Tabriz (49%), Ahvaz (42.9%), Urmia (30.8%), Zanjan (29.2%), Guilan (23.3%), Zahedan (17.2%), and Hamadan (7.5%) and lower than in Tehran (70.4%) (5).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Metallo-beta-Lactamase-positive and High-risk Clone ST235 Pseudomonas aeruginosa at Ardabil Hospitals

Safarirad

Arzanlou

Mohammadshahi

et al. 2021

Jundishapur J Microbiol

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Background: Carbapenems are the most commonly administered drugs for the treatment of multidrug-resistant Pseudomonas aeruginosa (MDR-P. aeruginosa) infections. However, carbapenem-resistant P. aeruginosa is spreading rapidly and has led to a new threat to human health worldwide. Objectives: The current study aimed to determine the prevalence of imipenem-resistant P. aeruginosa, detect metallo-β-lactamase (MBL)-producer isolates, and evaluate their clonal relationships in strains isolated from patients referring to the hospitals of Ardabil city, Iran. Methods: The resistance rate to imipenem was evaluated using the disk diffusion method. Double-disk synergy test and PCR technique were used for phenotypic and genotypic screening of MBL-positive P. aeruginosa, respectively. Ultimately, ERIC-PCR and MLST methods were used for assessing clonal relatedness among the isolates. Results: The prevalence of imipenem-resistant P. aeruginosa strains was estimated at 57.1% (48 out of 84 isolates). In addition, 45 (93.7%) out of 48 imipenem-resistant P. aeruginosa isolates were phenotypically screened as MBL-positive, among which 16 (35.5%) and three (6.6%) isolates harbored blaIMP and blaVIM-1 genes, respectively. However, blaNDM, blaSIM-2, blaSPM, and blaGIM-1 genes were not detected in this study. MBL-producing P. aeruginosa strains were divided into 42 ERIC-PCR types. Based on the results of MLST, P. aeruginosa ST235 was the only identified sequence type. Conclusions: Our results revealed a high and alarming prevalence of imipenem-resistant and blaIMP-positive P. aeruginosa ST235 at Ardabil hospitals. Continuous monitoring is essential to control the further spread of this highly virulent and drug-resistant clone.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Metallo-beta-Lactamase-positive and High-risk Clone ST235 Pseudomonas aeruginosa at Ardabil Hospitals

Safarirad

Arzanlou

Mohammadshahi

et al. 2021

Jundishapur J Microbiol

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“…However, over the last decades, the emergence of carbapenem-resistant strains have been associated with a higher risk of treatment failure [13]. Results of recent studies showed that the pooled prevalence of carbapenem-resistant P. aeruginosa and A. baumannii in Iran is about 54% and 85.1%, respectively [14, 15]. Unfortunately, the rates of MDR isolates of P. aeruginosa (58%) and A. baumannii (72%) is also significant [16, 17].…”

Section: Introductionmentioning

confidence: 99%

In vitro activities of colistin, imipenem and ceftazidime against drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii isolates in the south of Iran

et al. 2019

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Objective The present study aimed to determine in vitro activity of colistin and other agents against drug-resistant isolates of Pseudomonas aeruginosa and Acinetobacter baumannii . Results This in vitro study performed on a collection of non-fermenting Gram-negative bacilli (NFB) consist of 18 A. baumannii and 21 P. aeruginosa isolates. Non-duplicated isolates (one per patient) were isolated from blood, endotracheal tube and sputum samples of hospitalized patients in the south of Iran. The minimum inhibitory concentrations (MICs) of each isolate was determined using Epsilometer (E)-test strips containing colistin, imipenem, and ceftazidime. In overall, all A. baumannii isolates were non-susceptible to imipenem and ceftazidime. In contrast, all isolates were susceptible to colistin with MIC50 and MIC90 of 0.75/1.5 µg/mL, respectively. Antibiotic susceptibility results showed that 81% and 23.8% of P. aeruginosa isolates were susceptible to ceftazidime and imipenem, respectively. While, all of the P. aeruginosa isolates were susceptible to colistin with MIC50 and MIC90 of 0.5/1 µg/mL, respectively. In summary, colistin showed the promising in vitro activity against drug-resistant strains of two clinically important NFB in our region. However, investigation on a larger collection of drug-resistant strains demands to support these observations in the near future.

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“…Multidrug-resistant Pseudomonas aeruginosa (MDR P. aeruginosa ) due to simultaneous resistance against different class of antibiotics is of paramount importance to health-care settings worldwide. [12] Treatment outcomes of patients infected with MDR P. aeruginosa owing to limited available antibiotics are considered to be a serious threat to health-care providers. [12] In fact, infection caused by MDR P. aeruginosa has several negative impacts on patient outcomes, including higher mortality, an increase in the length of hospital stay, and considerable increase in hospital costs.…”

Section: Introductionmentioning

confidence: 99%

Multidrug resistant Pseudomonas aeruginosa in Iran: A systematic review and metaanalysis

Vaez

Salehi‐Abargouei

Ghalehnoo

et al. 2018

J Global Infect Dis

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Background:Multidrug-resistant Pseudomonas aeruginosa (MDR P. aeruginosa) is known as a serious threat to human health worldwide. Limited information is available concerning the prevalence of MDR P. aeruginosa in Iran. The aim of the present study was to investigate the relative frequency of MDR P. aeruginosa in different parts of Iran.Materials and Methods:Using appropriate keywords and well-known English and Persian database, available data about MDR P. aeruginosa in Iran were retrieved. After applying predefined criteria, relevant studies were selected.Results:By using random-effect models, the pooled incidence of MDR P. aeruginosa was estimated 58% (95% confidence interval [CI]; 0.54–0.61). The highest and lowest prevalence of MDR P. aeruginosa were observed in Tehran (100%) (95% CI; 0.94–1.00) and Zahedan (16%) (95% CI; 0.10–0.24), respectively. The highest resistance rate was against ceftazidime (50%) (95% CI; 0.46–0.54) and amikacin (50%) (95% CI; 0.46–0.54).Conclusion:Our findings are of concern since they demonstrate the high prevalence rate of MDR P. aeruginosa in the majority of Iranian hospitals.

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Systematic review and meta-analysis of imipenem-resistant Pseudomonas aeruginosa prevalence in Iran

Abstract: The findings of this analysis show that in the majority of Iranian hospitals the relative frequency of IRPA is high, therefore, in order to prevent further dissemination of IRPA, more appropriate antibiotic prescription and infection control policies must be implemented by decision-makers.

Cited by 19 publications

References 31 publications

Prevalence and Characteristics of Metallo-beta-Lactamase-positive and High-risk Clone ST235 Pseudomonas aeruginosa at Ardabil Hospitals

Prevalence and Characteristics of Metallo-beta-Lactamase-positive and High-risk Clone ST235 Pseudomonas aeruginosa at Ardabil Hospitals

In vitro activities of colistin, imipenem and ceftazidime against drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii isolates in the south of Iran

Multidrug resistant Pseudomonas aeruginosa in Iran: A systematic review and metaanalysis

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