Trends in the Antibiotic Resistance of Non-Tuberculous Mycobacteria in Iran: A Systematic Review and Meta-Analysis

Hamid  Heidari; Parisa  Kalantari; Mohammad  Sholeh; Sahel Hamze  Pour; Atieh  Darbandi; Abbas  Maleki; Abbas  Ghaysouri; Hossein  Kazemian

doi:10.18502/ijph.v52i11.14028

Hamid Heidari Department of Microbiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Parisa Kalantari Department of Paramedical, Faculty of Medical Sciences, Islamic Azad University, Arak, Iran
Mohammad Sholeh Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran
Sahel Hamze Pour Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran
Atieh Darbandi Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
Abbas Maleki Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
Abbas Ghaysouri Department of Internal Medicine, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
Hossein Kazemian Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran

DOI: https://doi.org/10.18502/ijph.v52i11.14028

Keywords: Non-tuberculous mycobacteria (NTM); Antibiotic; Resistance; Systematic review; Meta-analysis

Abstract

Background: Non-tuberculous mycobacteria (NTM) infections have been continuously increasing as major concerns of public health in Iran. Because innate resistance of NTM species, the treatment of these infections is difficult task, but until now resistance pattern of NTM and suitable regimens are not determined.

Methods: We systematically searched the relevant studies in PubMed, Scopus, and Embase (Until Dec 2022). All statistical analyses were carried out using the statistical package R.

Results: Eleven studies included in the analysis were performed in 6 provinces and investigated 1223 NTM clinical species. The majority of the studies originated in Tehran. Among the first-line anti-TB drugs, almost all NTM species were highly resistant to first-line anti-TB drugs. No significant difference in the isoniazid resistance rate was found in the slow or rapid-growing species and Runyon's classification of NTM isolates. A decreased in the prevalence of ciprofloxacin, clarithromycin, and moxifloxacin resistance were showed in during 2013-2022 years.

Conclusion: Most investigated antibiotics have a minor effect on NTM species and a steady increase of resistance has been seen in last few years then, need more-effective alternative regimens is clear