Study of multidrug resistance in prevalent Gram-negative bacteria in burn patients in Iran: A systematic review and meta-analysis

Objectives: Recently, multidrug-resistant (MDR) Gram-negative bacteria (GNB) have become a serious concern causing infections in hospitalised burn patients. This meta-analysis was conducted to detect the prevalence of infections caused by MDR-GNB in hospitalised burn patients in Iran. Methods: An electronic search was performed using PubMed, Scopus, Web of Science, EMBASE and Iranian databases. Statistical analysis was performed using STATA13. According to the results of the heterogeneity test, a fixed- or random-effects model was used. Publication bias was detected based on Egger's test. Of 1292 articles identified in the initial search, 107 studies were included in this review. Results: According to the results, the lowest resistance rate was observed in Acinetobacter baumannii and Pseudomonas aeruginosa to colistin, estimated at 21% [95% confidence interval (CI) 2-49%; I-2 = 97.30%] and 27% (95% CI 0-82%; I-2 = 99.27%), respectively. Moreover, the highest rate was to cefepime, estimated 98% (95% CI 93-100%; I-2 = 88.28%) and 87% (95% CI 81-92%; I-2 = 96.27%). Conclusion: The prevalence of MDR-GNB in Iranian burn patients is very high. Thus, a comprehensive infectious control programme, a reduction in the use of antibiotic prophylaxis, and thorough information regarding antimicrobial resistance patterns is required. (C) 2019 International Society for Antimicrobial Chemotherapy. Published by Elsevier Ltd. All rights reserved.