Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Mar;47(3):317-326.

Prevalence of Drug-resistant Klebsiella pneumoniae in Iran: A Review Article

Mohsen Heidary  1 , Mohammad Javad Nasiri  2 , Hossein Dabiri  2 , Samira Tarashi  3
Affiliations
Review

Prevalence of Drug-resistant Klebsiella pneumoniae in Iran: A Review Article

Mohsen Heidary et al. Iran J Public Health. 2018 Mar.

Abstract

Background: The infections caused by drug resistant strains of Klebsiella pneumoniae are becoming an important health problem worldwide. There are several reports on antimicrobial resistant status of K. pneumoniae in Iran. However, a comprehensive analysis on drug-resistant K. pneumoniae from different parts of Iran has not yet been performed.

Methods: The searches were done according to several English and Persian databases including PubMed, Scopus, Iranmedex, and SID to identify studies addressing antibiotic resistant K. pneumoniae in Iran from Jan 1998 to Nov 2014. Comprehensive Meta-Analysis (V2.2, Biostat) software was used to analyze the data.

Results: The incidence rate of imipenem and ceftazidime resistance in K. pneumoniae isolates was 3.2% (95% confidence interval [CI], 1.5-6.5) and 55.7% (95% CI, 46.9-64.1), respectively. The highest rate of resistance in isolates of K. pneumoniae was seen against ampicillin (82.2%), aztreonam (55.4%) and nitrofurantoin (54.5%).

Conclusion: There is a relatively high prevalence of drug resistant K. pneumoniae isolates in Iran. Thus, a high degree of awareness among physicians and microbiologists, active infection control committee, appropriate antimicrobial therapy, improvement of hygiene condition and monitoring of drug resistant isolates are urgently needed in order to better control the emergence and spread of drug-resistant K. pneumoniae isolates in hospital settings.

Keywords: Drug resistance; Iran; Klebsiella pneumoniae.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interests The authors declare that there is no conflict of interests.

Figures

Fig. 1:
Fig. 1:
Summary of the literature search and study selection
Fig. 2:
Fig. 2:
Distribution of drug-resistant Klebsiella pneumoniae in different regions of Iran
Fig. 3:
Fig. 3:
Forest plot of the meta-analysis on imipenem resistance. CI, confidence interval
Fig. 4:
Fig. 4:
Forest plot of the meta-analysis on ceftazidime resistance. CI, confidence interval
Fig. 5:
Fig. 5:
Funnel plot of the meta-analysis on imipenem resistance
Fig. 6:
Fig. 6:
Funnel plot of the meta-analysis on ceftazidime resistance
See this image and copyright information in PMC

References

    1. Pages JM, Lavigne JP, Leflon Guibout V, et al. (2009). Efflux pump, the masked side of ß-Lactam resistance in Klebsiella pneumoniae clinical isolates. PLoS One, 4(3):e4817. - PMC - PubMed
    1. Heidary M, Goudarzi H, Hashemi A, et al. (2016). The prevalence of genes that encode quinolone resistance in Klebsiella pneumoniae strains isolated from hospitalized patients during 2013–2014. Arch Pediatr Infect Dis, (In press).
    1. Heidary M, Bahramian A, Goudarzi H, et al. (2016). To study the association between AcrAB and Qep A efflux pumps and ciprofloxacin resistance among Escherichia coli and Klebsiella pneumoniae clinical strains. Arak Med Univ J, 19(4):1–10.
    1. World Health Organization (2014). Antimicrobial resistance: global report on surveillance. http://apps.who.int/iris/bitstream/10665/112642/1/9789241564748_eng.pdf?...
    1. Vardakas KZ, Matthaiou DK, Falagas ME, et al. (2015). Characteristics, risk factors and outcomes of carbapenem resistant Klebsiella pneumoniae infections in the intensive care unit. J Infect, 70(6):592–9. - PubMed

LinkOut - more resources