Pattern of Antibacterial Resistance in Urinary Tract Infections: A Systematic Review and Meta-analysis

Background: Urinary tract infection (UTI) is one of the most common infectious diseases ranking next to upper respiratory tract infections. UTIs are often significantly associated with morbidity and mortality. The inappropriate administration of antibiotics to treat these infections increased infection resistance to antibiotics. The aim of this study is to determine the frequency of antibiotic resistance pattern in UTIs. Methods: We searched several databases including PubMed, Web of Science, Scopus, Google Scholar, Iran Medex, Magiran, IranDoc, MedLib, and Scientific Information Database to identify the studies addressing antibacterial resistance patterns of the most common uropathogenic bacteria in UTIs in Iran. A total of 90 reports published from different regions of Iran from 1992 to May 2015 were involved in this study. Results: It is shown that the most common pathogen causing UTIs is Escherichia coli with 62. The resistance among the isolates of E. coli was as follows: ampicillin (86), amoxicillin (76), tetracycline (71), trimethoprim-sulfamethoxazole (64), cephalexin (61), and cefalothin (60). The highest sensitivity among isolates of E. coli was as follows: imipenem (86), nitrofurantoin (82), amikacin (79), chloramphenicol (72), and ciprofloxacin (72). Conclusions: The results of this study showed that the most common resistance are antibiotics that are commonly used. The most effective antibiotics for E. coli were imipenem, nitrofurantoin, amikacin, chloramphenicol, and ciprofloxacin. Considering this study, it had better, use less gentamicin, second-generation cephalosporins, and nalidixic acid in the initial treatment of infections caused by E. coli, and no use penicillins, tetracyclines, cotrimoxazole, and first-generation cephalosporins

Chronic Kidney Disease in Iran: First Report of the National Registry in Children and Adolescences

Purpose: Knowing the epidemiological aspects of chronic kidney disease (CKD) in children is crucial for early recognition, identification of reversible causes, and prognosis. Here, we report the epidemiological characteristics of childhood CKD in Iran. Materials and Methods: This cross-sectional study was conducted during 1991 � 2009. The data were collected using the information in the Iranian Pediatric Registry of Chronic Kidney Disease (IPRCKD) core dataset. Results: A total of 1247 children were registered. The mean age of the children at registration was 0.69 ± 4.72 years (range, 0.25 �18 years), 7.79 ± 3.18 years for hemodialysis (HD), 4.24 ± 1.86 years for continuous ambulatory peritoneal dialysis (CAPD), and 3.4±1.95 years for the children who underwent the renal transplantation (RT) (P < .001). The mean year of follow-up was 7.19 ± 4.65 years. The mean annual incidence of CKD 2�5 stages was 3.34 per million age-related population (pmarp). The mean prevalence of CKD 2�5 stages was 21.95 (pmarp). The cumulative 1-, 5-, and 10-year patients� survival rates were 98.3, 90.7, and 84.8, respectively. The etiology of the CKD included the congenital anomalies of the kidney and urinary tract (CAKUT) (40.01), glomerulopathy (19.00), unknown cause (18.28), and cystic/hereditary/congenital disease (11.14). Conclusion: The incidence and prevalence rate of pediatric CKD in Iran is relatively lower than those reported in Europe and other similar studies. CAKUT was the main cause of the CKD. Appropriate management of CAKUT including early urological intervention is required to preserve the renal function. Herein, the long-term survival rate was higher among the children with CKD than the literature. © 2021. All Rights Reserved