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Review
. 2019 Oct 9:10:169.
doi: 10.4103/ijpvm.IJPVM_419_17. eCollection 2019.

Pattern of Antibacterial Resistance in Urinary Tract Infections: A Systematic Review and Meta-analysis

Seyed Abdol Reza Mortazavi-Tabatabaei  1 , Jalal Ghaderkhani  2 , Ali Nazari  3 , Kourosh Sayehmiri  4 , Fatemeh Sayehmiri  5 , Iraj Pakzad  6
Affiliations
Review

Pattern of Antibacterial Resistance in Urinary Tract Infections: A Systematic Review and Meta-analysis

Seyed Abdol Reza Mortazavi-Tabatabaei et al. Int J Prev Med. .

Abstract

Background: Urinary tract infection (UTI) is one of the most common infectious diseases ranking next to upper respiratory tract infections. UTIs are often significantly associated with morbidity and mortality. The inappropriate administration of antibiotics to treat these infections increased infection resistance to antibiotics. The aim of this study is to determine the frequency of antibiotic resistance pattern in UTIs.

Methods: We searched several databases including PubMed, Web of Science, Scopus, Google Scholar, Iran Medex, Magiran, IranDoc, MedLib, and Scientific Information Database to identify the studies addressing antibacterial resistance patterns of the most common uropathogenic bacteria in UTIs in Iran. A total of 90 reports published from different regions of Iran from 1992 to May 2015 were involved in this study.

Results: It is shown that the most common pathogen causing UTIs is Escherichia coli with 62%. The resistance among the isolates of E. coli was as follows: ampicillin (86%), amoxicillin (76%), tetracycline (71%), trimethoprim-sulfamethoxazole (64%), cephalexin (61%), and cefalothin (60%). The highest sensitivity among isolates of E. coli was as follows: imipenem (86%), nitrofurantoin (82%), amikacin (79%), chloramphenicol (72%), and ciprofloxacin (72%).

Conclusions: The results of this study showed that the most common resistance are antibiotics that are commonly used. The most effective antibiotics for E. coli were imipenem, nitrofurantoin, amikacin, chloramphenicol, and ciprofloxacin. Considering this study, it had better, use less gentamicin, second-generation cephalosporins, and nalidixic acid in the initial treatment of infections caused by E. coli, and no use penicillins, tetracyclines, cotrimoxazole, and first-generation cephalosporins.

Keywords: Antibiotics; Gram-negative bacteria; Gram-positive bacteria; antimicrobial resistance; urinary tract infections.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Studies entry to systematic review and meta-analysis
Figure 2
Figure 2
Resistances rate of Escolar isolates to Ampicillin based on a random-effects model. The midpoint of each piece represents an estimate of the prevalence, each piece represents a confidence interval of 15% in each study and diamond mark is indicative of all the studies in the whole country
Figure 3
Figure 3
Resistances rate of E.coli isolates to Imipenem based on a random-effects model. The midpoint of each piece represents an estimate of the prevalence, each piece represents a confidence interval of 15% in each study and diamond mark is indicative of all the studies in the whole country
See this image and copyright information in PMC

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