Epidemiology of Antibiotic Resistance Pattern of Pseudomonas Aeruginosa in Cystic Fibrosis Patients in Iran: A Systematic Review and Meta-Analysis

Abstract

Objective: Pseudomonas aeruginosa is one of the most opportunistic pathogen involved in respiratory tract infection in cystic fibrosis (CF) patients. The present study aimed to assess the antibiotic resistance pattern of P. aeruginosa strains isolated from Iranian CF patients in using a systematic review and meta-analysis. Methods: A systematic search was done to identify studies which met our inclusion criteria in the Web of Science, PubMed, Embase, Scopus, and Google Scholar electronic databases from the beginning to the end of July 2019. Finally, seven articles with appropriate criteria was chosen for data extraction and analysis by Comprehensive Meta- Analysis Software. Results: Seven studies assessed antibiotic resistance pattern of P. aeruginosa in CF patients. Included studies were reported from North (Tehran), Central (Isfahan), and Northeast (Mashhad) of Iran. Piperacillin-tazobactam had the lowest resistance rate at 7.3 (95 CI: 1.8-25.4), while ceftazidime had the highest resistance rate at 34.7 (95 CI: 11.9-67.6). Conclusion: A high level of antibiotic resistance against ceftazidime and gentamicin in our results is an alarming and may be due to severe and complication caused by P. aeruginosa infections in CF patients. Moreover, piperacillin- tazobactam, tobramycin and amikacin are the most suitable antibiotics for the treatment of respiratory infections in our population. However, administration of control strategies and surveillance programs highly recommended.