Research Article
Prevalence of ESBL-Producing Enterobacter Species Resistant to Carbapenems in Iran: A Systematic Review and Meta-Analysis
Table 1
Required data were extracted from included articles in the meta-analysis.
| Author (Ref) | City | Year | Isolate (n) | AST | Resistance rate (n) | ESBL-positive (n) | IPM | MEM | ATM | CIP | NOR | LVX | GEN | AMK | TOB | TET | CHL | SXT | NAL | NIT | CRO | CFM | CTX | CAZ | CEP | ZOX | MDR |
| Amin et al. [9] | Ahvaz | 2015-2016 | 152 | Disk diffusion | 80 | 53 | ND | 84 | 70 | 63 | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | Afrugh et al. [10] | Ahvaz | 2013-2014 | 17 | Disk diffusion | 15 | 15 | ND | 15 | ND | ND | 14 | 16 | ND | 17 | ND | 12 | 16 | 13 | 16 | ND | 17 | 15 | 14 | 16 | ND | ND | Mousavian et al. [11] | Ahvaz | 2012 | 65 | Disk diffusion | 0 | ND | ND | 6 | ND | ND | 5 | 3 | ND | ND | ND | ND | ND | ND | 10 | ND | 11 | 9 | ND | 11 | ND | 27 | Khosravi et al. [12] | Ahvaz | 2009–2012 | 156 | Disk diffusion | 98 | ND | ND | 91 | ND | ND | 102 | 60 | ND | 64 | ND | 108 | 94 | 75 | 121 | 110 | ND | ND | ND | ND | ND | ND | Khosravi et al. [13] | Ahvaz | 2009-2010 | 209 | Disk diffusion | 124 | ND | ND | 88 | ND | ND | 143 | 117 | ND | 124 | ND | 146 | 119 | 117 | 143 | 148 | ND | ND | ND | ND | ND | ND | Didgar [14] | Arak | 2010–2012 | 47 | Disk diffusion | 6 | ND | ND | 19 | ND | ND | 19 | 18 | ND | ND | ND | 20 | ND | ND | 29 | ND | ND | 40 | 25 | 19 | ND | ND | Ghasemi et al. [15] | Babol | 2020 | 30 | Disk diffusion | 6 | ND | ND | 6 | ND | ND | 4 | 6 | ND | ND | ND | ND | ND | 9 | ND | ND | 10 | ND | 28 | ND | 28 | ND | Bayani et al. [16] | Babol | 2011-2012 | 30 | Disk diffusion | 2 | ND | ND | 2 | ND | ND | ND | 2 | ND | ND | ND | ND | ND | ND | ND | ND | ND | 5 | 4 | ND | 0 | ND | Ghafouri et al. [17] | Bojnurd | 2013 | 12 | Disk diffusion | 3 | 5 | ND | 8 | ND | ND | 8 | 2 | ND | 3 | 0 | 6 | ND | 1 | 6 | 0 | 0 | 1 | ND | ND | ND | ND | Peymani et al. [18] | Different cities | 2014 | 49 | Disk diffusion | 2 | 2 | 27 | 16 | ND | ND | 20 | 11 | ND | ND | ND | 25 | ND | ND | 28 | ND | 34 | 27 | ND | ND | 26 | ND | Peymani et al. [19] | Different cities | 2011-2012 | 137 | Disk diffusion | 2 | 1 | 67 | 22 | 16 | ND | 59 | ND | ND | ND | ND | 83 | ND | ND | 78 | ND | 80 | 71 | ND | ND | 83 | ND | Poorabbas et al. [20] | Different cities | 2008-2009 | 38 | Disk diffusion | 38 | ND | ND | 33 | ND | 35 | 24 | 26 | 0 | ND | ND | 22 | ND | 22 | 18 | 13 | 19 | 20 | 24 | ND | ND | ND | Molazade et al. [21] | Fasa | 2012-2013 | 28 | Disk diffusion | ND | ND | ND | 11 | ND | ND | 8 | 0 | ND | 11 | ND | 14 | 11 | 11 | 11 | 11 | 0 | ND | ND | ND | ND | ND | Esmaeili et al. [22] | Hamadan | 2011 | 15 | Disk diffusion | ND | ND | ND | 13 | ND | ND | 13 | ND | 13 | ND | ND | 10 | 6 | 4 | 11 | ND | ND | ND | ND | ND | ND | ND | Yasemi et al. [23] | Ilam | 2007–2009 | 20 | Disk diffusion | ND | ND | ND | ND | ND | ND | 3 | ND | ND | ND | ND | 9 | ND | 6 | ND | ND | ND | ND | ND | ND | ND | ND | Fatemi et al. [24] | Isfahan | 2014-2015 | 135 | Disk diffusion | 13 | 16 | 93 | 58 | ND | ND | 54 | 46 | 53 | 96 | 26 | 23 | ND | ND | ND | ND | 89 | 87 | 90 | ND | 98 | ND | Shokri et al. [25] | Isfahan | 2012-2013 | 35 | Disk diffusion | 3 | 3 | ND | 21 | ND | ND | 22 | 10 | ND | ND | ND | ND | ND | 6 | ND | ND | 24 | 22 | 12 | ND | 35 | ND | Kargar et al. [26] | Jahrom | 2011-2012 | 25 | Disk diffusion | ND | ND | ND | ND | ND | ND | 17 | 7 | 11 | 24 | ND | 20 | 24 | ND | ND | ND | 10 | 10 | ND | ND | ND | 1 | Shajari et al. [27] | Kashan | 2005-2006 | 35 | Disk diffusion | 10 | ND | ND | 13 | ND | ND | 14 | 12 | 11 | ND | ND | 21 | 28 | ND | ND | 18 | 22 | 22 | ND | ND | ND | ND | Sepehri et al. [28] | Kerman | 1996, 2000 | 72 | Disk diffusion | ND | ND | ND | ND | ND | ND | 43 | ND | ND | ND | ND | 46 | 12 | 28 | ND | ND | ND | ND | ND | ND | ND | ND | Mortazavi et al. [29] | Kermanshah | 2016-2017 | 72 | Disk diffusion | 7 | ND | 29 | 35 | 30 | ND | 36 | 35 | ND | ND | ND | 49 | 31 | 16 | ND | 40 | 37 | 38 | ND | ND | 54 | ND | Amini et al. [30] | Kermanshah | 2015 | 18 | Disk diffusion | ND | ND | ND | 7 | ND | ND | 8 | 9 | ND | ND | ND | 13 | 7 | 5 | 6 | 6 | ND | 10 | ND | ND | ND | ND | Karambin and Zarkesh [31] | Rasht | 2008–2010 | 50 | Disk diffusion | ND | ND | ND | 0 | ND | ND | 15 | 41 | ND | ND | ND | 40 | ND | ND | ND | ND | 43 | ND | ND | ND | ND | ND | Yaghubi et al. [32] | Rasht | 2013–2015 | 147 | Disk diffusion | 79 | 61 | ND | 80 | ND | ND | 81 | 66 | 78 | 0 | ND | 108 | 105 | 102 | 102 | 119 | 109 | 92 | ND | 80 | ND | ND | Rouhi et al. [33] | Sanandaj | 2013-2014 | 10 | Disk diffusion | 2 | ND | ND | 2 | 0 | ND | 0 | 5 | ND | 2 | ND | ND | 0 | 0 | 3 | ND | 5 | 4 | ND | 5 | ND | ND | Nikkhoo et al. [34] | Sanandaj | 2009-2010 | 11 | Disk diffusion | ND | ND | ND | 3 | ND | ND | 7 | 6 | ND | 7 | ND | 2 | ND | ND | 6 | 5 | 5 | ND | ND | ND | ND | ND | Ramazanzadeh et al. [35] | Sanandaj | 2007-2008 | 28 | Disk diffusion | ND | ND | ND | 14 | 22 | ND | 3 | 6 | ND | ND | ND | 13 | 23 | ND | 9 | ND | 7 | 7 | ND | 5 | ND | ND | Afkhamzadeh et al. [36] | Sanandaj | 2007-2008 | 15 | Disk diffusion | ND | ND | ND | 10 | ND | ND | 11 | 7 | ND | 10 | ND | 10 | ND | ND | 13 | ND | 13 | 4 | ND | ND | ND | ND | Jazayeri [37] | Semnan | 1999 | 11 | Disk diffusion | ND | ND | ND | 5 | ND | ND | 5 | ND | ND | ND | ND | 10 | 10 | 10 | ND | 8 | ND | ND | ND | ND | ND | ND | Khashei et al. [38] | Shiraz | 2016-2017 | 96 | Disk diffusion | 21 | ND | ND | 31 | ND | ND | 39 | 22 | ND | ND | ND | 45 | ND | 68 | ND | ND | ND | 70 | ND | ND | 93 | 35 | Malekzadegan et al. [39] | Shiraz | 2015-2016 | 61 | Disk diffusion | 26 | ND | ND | 30 | ND | ND | 46 | 61 | ND | ND | ND | 21 | 3 | 4 | ND | ND | ND | 55 | ND | ND | 56 | ND | Nematolahi et al. [40] | Shiraz | 2005–2014 | 90 | Disk diffusion | 4 | 1 | 44 | 14 | ND | ND | 33 | 27 | ND | ND | 30 | ND | ND | ND | 52 | 62 | 55 | 47 | 34 | ND | 10 | 14 | Mardaneh et al. [41] | Shiraz | 2013 | 33 | Disk diffusion | 2 | 7 | 14 | 5 | ND | ND | 11 | 7 | 14 | 24 | 8 | 9 | ND | ND | 14 | 19 | 15 | 13 | 13 | ND | ND | 13 | Rezaee and Abdinia [42] | Tabriz | 2010–2014 | 40 | Disk diffusion | ND | ND | ND | 0 | ND | ND | 20 | 0 | ND | ND | ND | 40 | 40 | 40 | 20 | ND | 40 | ND | ND | 10 | 40 | ND | Hamishehkar et al. [43] | Tabriz | 2010–2012 | 282 | Disk diffusion | 61 | ND | ND | 89 | ND | ND | 84 | 61 | ND | ND | 78 | 109 | ND | 25 | 79 | ND | 41 | 55 | ND | 49 | ND | ND | Azimi et al. [44] | Tehran | 2013–2018 | 45 | Disk diffusion | 8 | 23 | 11 | 9 | ND | 7 | 26 | 15 | 36 | 45 | ND | 20 | 9 | 45 | 30 | ND | 38 | 31 | 32 | 39 | 12 | ND | Akhavizadegan et al. [45] | Tehran | 2016-2017 | 18 | Disk diffusion | 0 | ND | ND | 7 | ND | 7 | ND | 0 | ND | ND | ND | 8 | 6 | 2 | 5 | 7 | ND | 4 | 2 | ND | ND | ND | Sohrabi fard et al. [46] | Tehran | 2014-2015 | 12 | Disk diffusion | ND | ND | ND | ND | ND | ND | ND | ND | ND | 4 | ND | ND | ND | ND | 5 | ND | ND | ND | ND | ND | ND | ND | Ghanavati et al. [47] | Tehran | 2013-2014 | 57 | Disk diffusion | 8 | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | ND | 28 | 21 | ND | ND | 10 | 30 | Salimian rizi et al. [48] | Tehran | 2012-2013 | 45 | Disk diffusion | 0 | ND | 14 | 6 | ND | ND | 10 | 6 | 10 | 26 | 8 | 28 | ND | ND | ND | ND | 13 | 15 | 7 | ND | 45 | ND | Mahmoudi et al. [49] | Tehran | 2011–2016 | 100 | Disk diffusion | 4 | ND | ND | ND | ND | ND | 27 | 30 | ND | ND | ND | 20 | ND | ND | ND | ND | 69 | ND | 36 | ND | 46 | ND | Rajabi et al. [50] | Tehran | 2011–2012 | 17 | Disk diffusion | ND | ND | ND | 2 | ND | ND | ND | ND | ND | 2 | ND | 2 | ND | 9 | ND | ND | ND | ND | ND | ND | ND | ND | Afsharpaiman et al. [51] | Tehran | 2011 | 33 | Disk diffusion | 5 | 0 | ND | ND | ND | ND | 17 | 14 | ND | ND | 16 | 18 | 11 | 30 | 14 | 14 | 30 | 22 | ND | 9 | ND | ND | Rahbar et al. [52] | Tehran | 2010-2011 | 101 | Disk diffusion | 2 | ND | 14 | ND | ND | ND | 15 | 3 | 19 | 19 | 19 | 20 | ND | ND | ND | ND | 20 | 23 | 5 | ND | ND | 33 | Ranjbar et al. [53] | Tehran | 2006-2007 | 83 | Disk diffusion | ND | ND | ND | 32 | ND | ND | 41 | 49 | 44 | ND | 22 | 47 | 47 | 60 | 45 | 50 | ND | 54 | ND | 53 | ND | ND | Taheri et al. [54] | Tehran | 2004–2012 | 14 | Disk diffusion | ND | ND | ND | ND | 0 | ND | 9 | 4 | ND | ND | ND | 6 | 1 | 5 | 2 | ND | ND | 0 | ND | 2 | ND | ND | Haghi et al. [55] | Tehran | 2003-2004 | 39 | Disk diffusion | ND | ND | ND | ND | ND | ND | 13 | 5 | 11 | ND | ND | 17 | 23 | 23 | 13 | 16 | ND | 16 | ND | 12 | ND | ND | Navidinia et al. [56] | Tehran | NA | 69 | Disk diffusion | 1 | 1 | ND | 12 | ND | ND | 5 | 2 | 4 | ND | ND | ND | ND | ND | 39 | ND | ND | ND | 43 | 67 | 4 | ND | Sadeghi bojd et al. [57] | Zahedan | 2013–2015 | 32 | Disk diffusion | ND | ND | ND | 3 | ND | ND | 2 | 3 | ND | ND | ND | 14 | 9 | 2 | 6 | 6 | 6 | ND | ND | ND | ND | ND |
|
|
IPM-imipenem; MEM-meropenem; ATM-aztreonam; CIP-ciprofloxacin; NOR-norfloxacin; LVX-levofloxacin; GEN-gentamicin; AMK-amikacin; TOB-tobramycin; TET-tetracycline; CHL-chloramphenicol; SXT-trimethoprim/sulfamethoxazole; NAL-nalidixic acid; NIT-nitrofurantoin; CRO-ceftriaxone; CFM-cefixime; CTX-cefotaxime; CAZ-ceftazidime; CEP-cefepime; ZOX-ceftizoxime; MDR-multidrug-resistant; ESBL-extended-spectrum β-lactamase; AST-antimicrobial susceptibility testing; ND-not determined.
|