Prevalence of Antibiotic Resistance of Haemophilus Influenzae in Iran- A Meta-Analysis

Document Type : Original

Authors

1 Department of Microbiology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran.

2 Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran.

4 Department of Microbiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Department of Microbiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

Abstract

Introduction:
Based on the World Health Organization reports, infections caused by ampicillin-resistant Haemophilus influenzae strains are a major threat to public health and need urgent therapy with new antibiotics. Given the lack of a previous comprehensive study on the prevalence of the antibiotic resistance of H. influenzae in Iran, this systematic review and meta-analysis was performed to increase the knowledge about antibiotic resistance status of this pathogenic agent.
 
Materials and Methods:
For the purpose of the study, the articles related to the subject of interest and published up to August 2018 were searched in several English and Persian databases, including PubMed, Scopus, Web of Science, Scientific Information Database, and Magiran. The search process was accomplished using the following keywords: “Antibiotic resistance”, “H. influenzae”, and “Iran”. The data were pooled from 13 eligible studies reporting the prevalence of antibiotic resistance of H. influenzae in Iran.
 
Results:
The prevalence of H. influenzae resistance to various antibiotics in Iran, including ampicillin, amoxicillin, cephalexin, cefixime, ceftazidime, cefotaxime, and ceftizoxime, were obtained as 54.8%, 66.6%, 28.6%, 62%, 21.3%, 22.3%, 23.2%, respectively.These rates were reported as 27.7%, 46.7%, 53%, 82.6%, 40.3%, 30.8% for chloramphenicol, tetracycline, trimethoprim/sulfamethoxazole, penicillin, erythromycin, and ciprofloxacin, respectively. Additionally, ceftriaxone, gentamicin, amikacin, kanamycin, rifampin, azithromycin, and clindamycin had the H. influenzae resistance rates of  33.1%, 40.2%, 45.8%, 44.4%, 18.5%, 17.4%, and 71.3%, respectively.
 
Conclusion:
The majority of the antibiotics tested in Iran showed a high rate of resistance to H. influenzae. This may cause serious problems in the treatment of infections in the future. Therefore, precautionary measures, such as monitoring antibiotic prescription and resistance and using the new classes of antibiotics, are necessary.

Keywords

Main Subjects


  1. Carroll KC, Butel JS, Morse SA. Jawetz Melnick & Adelbergs Medical Microbiology. 27th ed. McGraw Hill Professional; 2016, p. 263-6.
  2. Murray PR, Rosenthal KS, Pfaller MA. Medical microbiology. 8th ed. Elsevier Health Sciences; 2015, p. 243-8.
  3. Ladhani S, Neely F, Heath PT, Nazareth B, Roberts R, Slack MP, et al. Recommendations for the prevention of secondary Haemophilus influenzae type b (Hib) disease. J Infect. 2009; 58(1): 3-14.
  4. Skoczyńska A, Kadłubowski M, Empel J, Hryniewicz W. Characteristics of Haemophilus influenzae type b responsible for meningitis in Poland from 1997 to 2004. J Clin Microbiol. 2005; 43(11): 5665-9.
  5. Rennie RP, Ibrahim KH. Antimicrobial resistance in Haemophilus influenzae: how can we prevent the inevitable? Commentary on antimicrobial resistance in H. influenzae based on data from the TARGETed surveillance program. Clin Infect Dis. 2005; 41(Supplement_4): S234-S8.
  6. World Health Organization. Estimated Hib and pneumococcal deaths for children under 5 years of age, 2008. http:// www.who.int/ immunization/monitoring_surveillance/burden/estimates/Pneumo_hib/en/
  7. Tristram S, Jacobs MR, Appelbaum PC. Antimicrobial resistance in Haemophilus influenzae. Clin Microbiol Rev 2007;20(2):368-89.
  8. Organization WH. WHO publishes list of bacteria for which new antibiotics are urgently needed. WHO: Geneva, Switzerland. 2017.
  9. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009; 6(7): e1000100.
  10. Farajzadeh SA, Mosavy N, Tavacol H. Isolation and antibiogram pattern of Haemophilus influenzae isolated from bronchial washing of patients undergoing bronchoscopy. Arch Iran Med. 2004; 7(2): 108-12.
  11. Mashouf RY, Hashemi SH, Bijarchi M. Bacterial agents of meningitis in children and detection of their antibiotic resistance patterns in Hamadan, Western Iran. Pak J Biol Sci. 2006; 9(7): 1293-8.
  12. Mojgani N, Rahbar M, Taqizadeh M, Ashtiani MP, Mohammadzadeh M. Biotyping, capsular typing, and antibiotic resistance pattern of Haemophilus influenzae strains in Iran. Jpn J Infect Dis. 2011; 64(1): 66-8.
  13. Ghazvini K, Bakhshaee M, Naderi H, Zamanian A, Ghanaat J, Bagheri M. Prevalence and Antimicrobial susceptibility of Haemophilus influenza among healthy children in Mashhad. Iran J Otorhinolaryngol. 2007; 19(48): 101-6.
  14. Moafi N, Issazadeh K. Frequency of neonataland children bacterial meningitis and determining their antibiotic sensitivity patterns in Hospitals of Iran. International Journal of Molecular and Clinical Microbiology (IJMCM). 2016; 6(1): 608-12.
  15. Imani R, Rouhi-Boroujeni H, Ganji F. Prevalence of antibiotic resistance among bacteria isolates of lower respiratory tract infection in COPD Shahrekord Iran, 2005. Pak J Med Sci. 2007;23(3, 2): 438-40.
  16. Shishegar M, Faramarzi A, Kazemi T, Bayat A, Motamedifar M. Polymerase chain reaction, bacteriologic detection and antibiogram of bacteria isolated from otitis media with effusion in children, shiraz, Iran. Iran J Med Sci. 2011; 36(4): 273-80.
  17. Boroumand M, Irani S, Siadat SD, Bouzari S. Molecular detection of genomic islands associated with class 1 and 2 integron in Haemophilus influenzae isolated in Iran. Jundishapur J Microbiol. 2015; 8(4): e17249.
  18. Kalantari N, Taherikalani M, Parvaneh N, Mamishi S. Etiology and antimicrobial susceptibility of bacerial septic arthritis and osteomyelitis. Iranian J Publ Health. 2007; 36(3): 27-32.
  19. Fahimzad A, Karimi A, Alborzi A, Tabatabae SR, Jadali F, Sharifian M. Antibiotic susceptibility patterns in H. Influenzae type B isolated from Healthy Children oropharynx in day care Centers of Tehran. Iran J Pediatr. 2007; 17(Suppl 2): 155-60.
  20. Haghiashteiani M, Mohammadi-Yeganeh S, Soroush S, Sadeghifard N, Sayadi S, Dabyri H, et al. Frequency and antimicrobial susceptibility of Haemophilus influenzae Type b isolated from children suspected to meningitis. Iranian J Publ Health. 2008; 37(4): 52-8.
  21. Soltan Dallal MM, Rahimi Forushani A, Heidarzadeh S, Jabbari H, Sedigh Maroufi S, Sharifi Yazdi MK. Identification and determination antimicrobial resistance pattern of Haemophilus influenza isolated from patients with otitis media. RJMS. 2014, 21(125): 17-24.
  22. Abdinia B, Rezaee MA, Oskouie SA. Etiology and antimicrobial resistance patterns of acute bacterial meningitis in children: a 10-year referral hospital-based study in northwest Iran. Iran Red Crescent Med J. 2014; 16(7): e17616.
  23. Ghotaslou R, Yeganeh-Sefidan F, Salahi-Eshlaqi B, Ebrahimzadeh-Leylabadlo H. Etiology of acute bacterial meningitis in Iran: A systematic review. Acta Medica Iranica. 2015; 53(8): 454-61.
  24. Houri H, Pormohammad A, Riahi SM, Nasiri MJ, Fallah F, Dabiri H, et al. Acute bacterial meningitis in Iran: Systematic review and meta-analysis. PloS one. 2017; 12(2): e0169617.
  25. Heydari B, Khalili H, Karimzadeh I, Emadi-Kochak H. Clinical, paraclinical, and antimicrobial resistance features of community-acquired acute bacterial meningitis at a large infectious diseases ward in Tehran, Iran. Iran J Pharm Res. 2016; 15(1): 347.
  26. Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004; 39(9): 1267-84.
  27. Peltola H. Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates. Clin Microbiol Rev. 2000; 13(2): 302-17.
  28. Bradley JS. Management of community-acquired pediatric pneumonia in an era of
    increasing antibiotic resistance and conjugate vaccines. Pediatr Infect Dis J. 2002; 21(6): 592-8.
  29. Dagan R, Leibovitz E. Bacterial eradication in the treatment of otitis media. Lancet Infect Dis. 2002; 2(10): 593-604.
  30. Kassaa I, Hamze M, Dabboussi F, Mallat H, Achkar M, Hlais S. Prevalence of type b Haemophilus influenzae and antibiotic resistance in 52 clinical isolates in north Lebanon. East Mediterr Health J. 2013; 19: 105-10.
  31. Gür D, Özalp M, Sümerkan B, Kaygusuz A, Töreci K, Köksal If, et al. Prevalence of antimicrobial resistance in Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis and Streptococcus pyogenes: results of a multicentre study in Turkey. Int J Antimicrob Agents. 2002; 19(3): 207-11.
  32. Bae S, Lee J, Lee J, Kim E, Lee S, Yu J,
    et al. Antimicrobial resistance in Haemophilus influenzae respiratory tract isolates in Korea: results of a nationwide acute respiratory infections surveillance. Antimicrob Agents Chemother. 2010; 54(1): 65-71.
  33. Campos J, Román F, Pérez-Vázquez M, Aracil B, Oteo J, Cercenado E. Antibiotic resistance and clinical significance of Haemophilus influenzae type f. J Antimicrob Chemother. 2003; 52(6): 961-6.
  34. Levy SB, Marshall B. Antibacterial resistance worldwide: causes, challenges and responses. Nat Med. 2004; 10(12s): S122-S9.