Evaluate the presence of class 1 integrons among uropathogenic Escherichia coli recovered from children urinary tract infection; a systematic review and meta-analysis

Uropathogenic E. coli is the main agent of urinary tract infection with frequency > 80%. This study aimed to evaluate the prevalence of class 1 integrons in uropathogenic E. coli recovered from UTI samples from Iranian children during 2008-2020. We searched electronic databases including ISI, MEDLINE, Scopus, also Scientific information database (SID.ir) from Iran for studies reported the prevalence of class 1 integrons in uropathogenic E. coli isolated from children with urinary infection from 2008 to 2020. We used of following key keywords: "children", "pediatric", "pediatrics" "Escherichia coli", "uropathogenic Escherichia coli", "urinary tract infections", "UTI", "prevalence", "Iran", "class 1 integron", "Inti1", and "distribution". Comprehensive Meta-Analysis (CMA) Software was used for analysis. Random effect model was used to calculate pooled prevalence. 4 articles entered in the present study. The prevalence of class1 integrons varied from 6.2% to 52%. The combined prevalence of Int1 in included studies was reported 32.7% (95% CI: 27.6-38.3), z = 5.7, Q = 41.6, I2 = 92.8, t = 2.5, p = 0.09. Findings of funnel plot didn't show any publication bias between studies. Likewise, regarding p value = 0.09 achieved from Egger's linear regression test, no publication bias was observed. According to the high prevalence of class 1 integrons in UPEC isolates from UTI samples of children in the present review and their significance in the spread of antibiotic resistance among species of a genus and other bacteria, we must use molecular techniques for detection of integrons. Also, serious infection control measures must be done for the prevention of the spread of antibiotic resistance among bacteria in Pediatrics units.