Incidence of Dominant Metallo-β-Lactamase Resistance Genes Produced in Pseudomonas aeruginosa Burn Infections in Iran: A Systemic Review and Meta-Analysis

Backgrounds: Metallo-β-Lactamase (MBL) enzymes-producing Pseudomonas aeruginosa strains are one of the most important causes of nosocomial infections and are very difficult to treat, leading to high mortality rate. Therefore, control of these cases is very important, especially in burns. This study aimed to systematically review published data on MBL genes prevalence among P. aeruginosa strains isolated from burn patients. Materials & Methods: ISI Web of Science, Scopus, PubMed, and Google Scholar were searched using appropriate key terms as follows: P. aeruginosa, metallo-β-lactamase, burn patients, imipenem resistant, and Iran. Antibiotic susceptibility tests were conducted by Kirby-Bauer disc diffusion and broth microdilution methods according to the CLSI guidelines. The MBL producers was evaluated by the combination disk diffusion test (CDDT), and detection of genes such as blaIMP, blaVIM, blaSPM and blaNDM was performed with polymerase chain reaction (PCR). In this review statistical analyses were performed using STATA statistical software Ver.۱۳. Results: Out of ۴۱۰ retrieved articles, ۱۸ articles were eligible to be included in this systematic review and meta-analysis. These studies were carried out in Tehran, Shiraz, Yazd, Zahedan, and other locations. Pooled estimation of all P. aeruginosa strains included in ۱۸ studies showed that the prevalence of MBL-producing P. aeruginosa strains in Iranian population was about ۴۹% (۹۵% CI: ۳۳-۶۵). The present study findings also revealed that in Iranian population, the most prevalent MBL genes were blaIMP with ۱۷% (۹۵% CI) and blaVIM with ۱۳% (۹۵% CI), respectively. Conclusion: Detection of these bacterial resistance genes should be performed nationally, and strict control measures should be put on the agenda to reduce the incidence of these cases.

Keywords:

Pseudomonas aeruginosa , Imipenem resistant , Metallo-β-lactamase , Burn patients , Iran