Antibiotic Resistance of Uropathogenic Escherichia coli (UPEC) among Iranian Pediatrics: A Systematic Review and  Meta-Analysis

Aliasghar  Fakhri-Demeshghieh; Abolghasem Shokri; Saied  Bokaie

doi:10.18502/ijph.v53i3.15133

Aliasghar Fakhri-Demeshghieh Division of Epidemiology & Zoonoses, Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Uni-versity of Tehran, Tehran, Iran
Abolghasem Shokri Division of Epidemiology & Zoonoses, Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Uni-versity of Tehran, Tehran, Iran
Saied Bokaie Division of Epidemiology & Zoonoses, Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Uni-versity of Tehran, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v53i3.15133

Keywords: Uropathogenic Escherichia coli; Antibiotic resistance; Pediatrics; Urinary tract infection

Abstract

Background: Uropathogenic Escherichia coli is a major cause of urinary tract infections (UTIs). This systematic review and meta-analysis was conducted to determine the prevalence of antibiotic-resistant uropathogenic E. coli among Iranian children with confirmed bacterial UTIs from 2012 to 2022.

Methods: A systematic review was performed by searching PubMed, Scopus, Google Scholar, Web of Science, MagIran, Iranian Scientific Information Database, IranMedex, and Iranian Research Institute for Information Science and Technology. The antibiotic-specific pooled prevalence estimates were calculated by applying a random-effects model. Freeman-Tukey Double Arcsine transformation was applied. I-squared statistic, and Cochran’s Q test were computed and meta-regression was conducted on latitude of sampling location.

Results: The literature search retrieved 2159 articles, among which 19 articles were included. The highest antibiotic resistance was related to doxycycline, ticarcillin-clavulanic acid, cefazolin, cefuroxime, and amoxycillin-clavulanic acid, 59%, 57%, 54%, 53%, and 52%, respectively. Meta-regression on the latitude was statistically significant for nitrofurantoin (P=0.05).

Conclusion: Resistant uropathogenic Escherichia coli strains were observed in the majority of confirmed bacterial UTIs among Iranian children. The most effective antibiotics for uropathogens were colistin, meropenem, and imipenem.