Iran's Escherichia coli AMR Landscape (2010-2025): A One Health Systematic Review and Meta-Analysis
Abstract
Escherichia coli (E. coli) has developed resistance to multiple antibiotic classes, complicating treatment in both human and veterinary medicine. This study assesses the prevalence of antimicrobial resistance and antimicrobial resistance genes in E. coli in Iran, within a One Health framework encompassing humans, animals, foods, and the environment. We systematically searched Scopus, Google Scholar, Magiran, PubMed, Scientific Information Database Library (SID), and Web of Science, using keywords related to AMR and Escherichia coli, restricting to English and Persian publications from 2010 to January 2025. The risk of bias was evaluated using the JBI checklist for prevalence studies. Pooled prevalence and 95% confidence intervals (CIs) were calculated for each antibiotic using random-effects models. A total of 368 studies were included in the meta-analysis. The highest resistance was observed in the Classes of Penicillins (71.7, 95% CI: 65.6-76.6) and the lowest for Fosfomycins (6.8, 95% CI: 5.2-8.5). Resistance to Ceftizoxime, Ertapenem, Streptomycin, Piperacillin-Tazobactam, and Colistin increased over time. Phenotypically, 47.2%, 20.2%, and 14.1% of E. coli isolates were identified as extended-spectrum β-lactamase-producing (ESBL), AmpC, and metallo-beta-lactamase (MBL) producing, respectively. Among ESBL-producing isolates, the prevalence of blaCTX-M, blaTEM, and blaSHV genes was 68.2%, 58.5%, and 24.4%, respectively. The high prevalence of AMR highlights the critical…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.