A systematic review and meta-analysis of urinary tract infection, frequency of IS elements and MDR isolates retrieved from adult patients

Abstract

Urinary Tract Infection (UTI) is one of the most common and problematic infections that infecting the urinary system. This study aimed to investigate the epidemiology of urinary tract infection (UTI), is elements and MDR isolates in Escherichia coli isolated from adult patients.We searched through International databases such as Scopus, PubMed, Web of Science (ISI), and Google scholar from 2010-15th march 2020 for original studies covering the prevalence of class 1 integron and antibiotic resistance pattern. Search strings conducted using the following MeSH (Medical Subject Headings) and text keywords: “uropathogenic Escherichia coli”, “uropathogenic E. coli”, “multidrug resistant”, “MDR”, “urinary tract infections”, “UTI”, “prevalence”, “Integron”, “Inti1”, “correlation”, “prevalence”, and “Iran”. Finally, Data analyzed using CMA software.The pooled prevalence of class 1 integrons was 62 (95% Cl 45.5–76.1), and heterogeneity indices of the included articles were as Q2 = 205.3, I2 = 96.1, t = 1.1, and p = 0.27. The combined prevalence rate of MDR isolates of uropathogenic E. coli isolated from UTI was reported by 81.1%. The combined prevalence of UTI in women and men was 65.5%, and 30.7%, respectively. All the studies included in this review article showed a significant relationship between the presence of class 1 integrons and antibiotic resistance.Our findings showed a high combined prevalence of class 1 integrons, and MDR isolates. Also, all studies included in the present review reported the correlation between class1 integrons with MDR phenotype and antibiotic resistance. Therefore, suitable surveillance and control measures are needed to prevent further dissemination of integron carrying strains.