Fatemeh Javanmardi1, Amir Emami2, Neda Pirbonyeh1, Mahrokh Rajaee1, Gholamreza Hatam3, Abdolkhalegh Keshavarzi4. 1. Burn and Wound Healing Research Center, Microbiology Department, Shiraz University of Medical Sciences, Shiraz, Iran. 2. Burn and Wound Healing Research Center, Microbiology Department, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: emami.microbia@gmail.com. 3. Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 4. Burn and Wound Healing Research Center, Surgical Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
OBJECTIVES: Recently, multidrug-resistant (MDR) Gram-negative bacteria (GNB) have become a serious concern causing infections in hospitalised burn patients. This meta-analysis was conducted to detect the prevalence of infections caused by MDR-GNB in hospitalised burn patients in Iran. METHODS: An electronic search was performed using PubMed, Scopus, Web of Science, EMBASE and Iranian databases. Statistical analysis was performed using STATA13. According to the results of the heterogeneity test, a fixed- or random-effects model was used. Publication bias was detected based on Egger's test. Of 1292 articles identified in the initial search, 107 studies were included in this review. RESULTS: According to the results, the lowest resistance rate was observed in Acinetobacter baumannii and Pseudomonas aeruginosa to colistin, estimated at 21% [95% confidence interval (CI) 2-49%; I2=97.30%] and 27% (95% CI 0-82%; I2=99.27%), respectively. Moreover, the highest rate was to cefepime, estimated 98% (95% CI 93-100%; I2=88.28%) and 87% (95% CI 81-92%; I2=96.27%). CONCLUSION: The prevalence of MDR-GNB in Iranian burn patients is very high. Thus, a comprehensive infectious control programme, a reduction in the use of antibiotic prophylaxis, and thorough information regarding antimicrobial resistance patterns is required.
OBJECTIVES: Recently, multidrug-resistant (MDR) Gram-negative bacteria (GNB) have become a serious concern causing infections in hospitalised burn patients. This meta-analysis was conducted to detect the prevalence of infections caused by MDR-GNB in hospitalised burn patients in Iran. METHODS: An electronic search was performed using PubMed, Scopus, Web of Science, EMBASE and Iranian databases. Statistical analysis was performed using STATA13. According to the results of the heterogeneity test, a fixed- or random-effects model was used. Publication bias was detected based on Egger's test. Of 1292 articles identified in the initial search, 107 studies were included in this review. RESULTS: According to the results, the lowest resistance rate was observed in Acinetobacter baumannii and Pseudomonas aeruginosa to colistin, estimated at 21% [95% confidence interval (CI) 2-49%; I2=97.30%] and 27% (95% CI 0-82%; I2=99.27%), respectively. Moreover, the highest rate was to cefepime, estimated 98% (95% CI 93-100%; I2=88.28%) and 87% (95% CI 81-92%; I2=96.27%). CONCLUSION: The prevalence of MDR-GNB in Iranian burn patients is very high. Thus, a comprehensive infectious control programme, a reduction in the use of antibiotic prophylaxis, and thorough information regarding antimicrobial resistance patterns is required.