Epidemiology of multidrug-resistantAcinetobacter baumanniistrains in Iran: a systematic review and meta-analysis

Abstract

Acinetobacter baumannii is an important opportunistic pathogen that causes major public health concern especially in hospitalized patients due to the acquisition of multidrug resistance (MDR). The aim of this study was to systematically review published data about the prevalence rate of MDR-A. baumannii (MDR-AB) from different parts of Iran and provide an overall relative frequency (RF) using meta-analysis. All available national and international databanks were searched to find published studies up to June 2016. Quality of studies was assessed by STROB and PRISMA forms. Because of the significant heterogeneity observed, random effects model was used to combine the results. STATA SE version 11.2 was used for statistical analysis. Out of the 9646 results, 37 suitable articles were extracted according to inclusion and exlusion criteria. The pooled prevalence of MDR-AB was estimated 72% annually. Relative frequency of MDR-AB in different studies varied from 22.8 to 100%. Since the prevalence of MDR-AB is higher than many other countries, measures should be taken to keep the emergence and transmission of these strains to a minimum.

Antibiotic resistance trends of ESKAPE pathogens in Kwazulu-Natal, South Africa: A five-year retrospective analysis

“…Even in the face of directed therapy, Acinetobacter has the ability to develop resistance, 27 and the isolation of colistin-resistant subpopulations of Acinetobacter is of great concern. 28 Drawing a comparison to the global burden of MDR A. baumannii , a recent systemic review and meta-analysis by Bialvaei et al (2017) highlighted that the pooled prevalence of MDR A. baumannii was 72% annually, with frequencies of between 22% and 100%, 29 similar to the findings in the present study.…”

Prevalence of extended-spectrum beta-lactamase genes in Acinetobacter baumannii strains isolated from nosocomial infections in Tehran, Iran

“…Antimicrobial resistance in A. baumannii has become a worldwide problem, especially in healthcare centers and hospitalized patients. The emergence of clinical A. baumannii isolates with diverse antibiotic resistance phenotypes leads to difficulties in treating infections caused by this pathogen [ 3 ], [ 27 ]. In recent years, A. baumannii has been commonly reported as multiple-drug resistant (MDR); the resistance rates to Imipenem, Meropenem, Ceftazidime, Piperacillin/Tazobactam, Ciprofloxacin and Gentamicin in Latin America seem to be among the world's largest [ 28 ].…”

“…Acinetobacter species are aerobic gram-negative microorganisms responsible for various types of infections such as pneumonia, urinary tract infection and septicemia [ 1 ]. Acinetobacter baumannii (A. baumannii) is an important opportunistic pathogen that has caused global outbreaks of nosocomial infections [ 2 ].The Acenitobacter infections have been recognized as an emerging problem (one of major cause of nosocomial infections) and appeared to be associated with high mortality rates throughout the world [ 3 ].…”

<p>Molecular mechanisms related to colistin resistance in Enterobacteriaceae</p>

“…Colistin is a narrow-spectrum antimicrobial agent that has significant activity against most members of the Enterobacteriaceae family, including Escherichia coli , Enterobacter spp., Klebsiella spp., Citrobacter spp., Salmonella spp., and Shigella spp. It also has activity against common nonfermentative Gram-negative bacteria, such as Acinetobacter baumannii , Pseudomonas aeruginosa , and Stenotrophomonas maltophilia 14,22–24. In addition, Haemophilus influenzae , Legionella pneumophila , Aeromonas spp., and Bordetella pertussis are naturally susceptible to colistin 15,22,25,26…”