شيوع كلستريديوم ديفيسيل مقاوم به مترونيدازول در ايران: يك مطالعه‌ي متاآناليز

Prevalence of metronidazole-resistant clostridium difficile: a meta-analysis in Iran

زمينه و هدف: كلستريديوم ديفيسيل مقاوم به مترونيدازول يكي از هفت مقاومت ميكروبي مهم و از اورژانس‌هاي مقاومت ميكروبي اعلام شده از سوي سازمان جهاني بهداشت است كه ميزان شيوع مقاومت به آن در حال افزايش است. اين مطالعه با هدف تعيين شيوع كلستريديوم ديفيسيل مقاوم به مترونيدازول، به‌صورت متاآناليز در ايران انجام شد. روش بررسي: مطالعه حاضر به‌صورت متاآناليز مي‌باشد كه جستجوي مقالات در فاصله زماني آبان ماه تا اسفندماه 1396 توسط پژوهشگران دانشگاه علوم پزشكي كردستان انجام شد. جستجو در پايگاه‌هاي فارسي Magiran, Irandoc, Barakat و SID، پايگاه‌هاي انگليسي PubMed، ScienceDirect، Scopus در طول سال‌هاي 2007 تا 2016 انجام شد. با توجه به هتروژنيسيتي بالا (50%

Background: Metronidazole resistant clostridium difficile is one of significant pathogens in Iran. It is one of the WHO-declared microbial resistance emergencies. Prevalence of metronidazole resistant clostridium difficile is rising. The aim of this study was to detect prevalence of metronidazole-resistant clostridium difficile using meta-analysis in Iran. Methods: This study was conducted as a meta-analysis. Articles and derivatives were reviewed by two researchers. Initially, each of the researchers searched the databases separately and used all available Persian and English articles in Kurdistan University of Medical Sciences, Iran, from October 2017 to February 2018. Persian databases (including Magiran, Irandoc, Barakat and SID) and international databases (including PubMed, Sciencedirect, and Scopus) were searched during this period (2007-2016) with a combination of phrases and keywords. The list of references to these studies has also been evaluated and relevant articles have been included in the study. First, all the articles were extracted and then duplicated articles were deleted using the EndNote software, version X6 (Thomson Reuters™, New York, NY, USA) through the search for electronic banks. Such that the high heterogeneity (50% Results: From the search of medical databases at first, 68 articles were selected. In total, 19 remaining studies entered the meta-analysis phase. In this study, the overall prevalence of clostridium difficile is 32.57% (CI95%: 21.86-44.30); in 2016 it was 55.25% (CI95%: 50.22-60.19) and in 2009 was14.26% (CI95%: 12.32-16.37). The heterogeneity was estimated to be 98.7% (CI95%: 98.5-98.8). Conclusion: Based on the results of this study, the prevalence of metronidazole resistant clostridium difficile in Iran is high and increasing.