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Review
. 2021 Apr;24(4):428-436.
doi: 10.22038/IJBMS.2021.48628.11161.

An updated systematic review and meta-analysis on Mycobacterium tuberculosis antibiotic resistance in Iran (2013-2020)

Farzad Khademi  1 , Amirhossein Sahebkar  2   3   4
Affiliations
Review

An updated systematic review and meta-analysis on Mycobacterium tuberculosis antibiotic resistance in Iran (2013-2020)

Farzad Khademi et al. Iran J Basic Med Sci. 2021 Apr.

Abstract

This updated systematic review and meta-analysis follows two aims: 1) to assess Mycobacterium tuberculosis (M. tuberculosis) antibiotic resistance in Iran from 2013 to 2020 and, 2) to assess the trend of resistance from 1999 to 2020. Several national and international databases were systematically searched through MeSH extracted keywords to identify 41 published studies addressing drug-resistant M. tuberculosis in Iran. Meta-analysis was done based on the PRISMA protocols using Comprehensive Meta-Analysis software. The average prevalence of resistance to first- and second-line anti-TB drugs, multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) in new and previously treated tuberculosis (TB) cases in Iran during 2013-2020 were as follows: isoniazid 6.9%, rifampin 7.9%, ethambutol 5.7%, pyrazinamide 20.4%, para-aminosalicylic acid 4.6%, capreomycin 1.7%, cycloserine 1.8%, ethionamide 11.3%, ofloxacin 1.5%, kanamycin 3.8%, amikacin 2.2%, MDR-TB 6.3% and XDR-TB 0.9%. Based on the presented data, M. tuberculosis resistance to first- and second-line anti-TB drugs, as well as MDR-TB, was low during 2013-2020 in Iran. Furthermore, there was a declining trend in TB drug resistance from 1999 to 2020. Hence, to maintain the current decreasing trend and to control and eliminate TB infection in Iran, continuous monitoring of resistance patterns is recommended.

Keywords: Antibiotic; Iran; Meta-analysis; Mycobacterium tuberculosis; Resistance.

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Figures

Figure 1
Figure 1
Summary of the literature search and study selection in the meta-analysis
Figure 2
Figure 2
Antimicrobial resistance trends of Mycobacterium tuberculosis strains to isoniazid, rifampin, ethambutol, streptomycin, as well as MDR-TB, among new and previously treated cases in Iran from 1999 to 2020
Figure 3
Figure 3
Forest plot (a) and funnel plot (b) showing streptomycin-resistant Mycobacterium tuberculosis prevalence among new and previously treated cases between 2013 and 2020 in Iran
See this image and copyright information in PMC

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