Occurrence and Antibiotic Resistance of ESKAPE-E Bacteria in Urinary Tract Infections in Iraq: A Meta-Analysis
Abstract
Background: Urinary tract infection (UTI) is a medical problem in Iraq, where antimicrobial resistance complicates treatment and control of infection.
Objective: The aim of this meta-analysis was to estimate the prevalence of bacterial pathogens and their resistance.
Methods: A systematic search was used to locate 23 cross-sectional studies that published between 2000 and 2025. The prevalence and antibiotic resistance of ESKAPE-E bacteria was identified and extracted from international databases of Embase, Web of Science, and PubMed. Q test and I 2 were calculated and measured the heterogeneity, respectively, by Cochran and I 2. The case of I2 >50, we employed a random-effects model- DerSimonianLaird, and in low heterogeneity case, we employed fixed-effects model. To observe funnel plots visually and assess bias in publications, we employed two tests (Begg and Egger).
Results: 23 studies that included 7,958 bacterial isolates. The prevalence rates pooled were E. coli 43.50% (95% CI: 30.8256.63; I2=98.6%), K. pneumoniae 16.81% (95% CI: 12.7621.29; I2=94.1%), There was no significant bias in publications revealed by the test Begg or Egger on pathogens. The general rates of antibiotic resistance were (1.49 - 93.56) percent, with Ampicillin (AMP) having the highest resistance, especially K. pneumoniae, E. coli. The highest resistance in E. faecium was associated with nalidixic acid (NA).
Conclusion: E. coli and K. pneumoniae cause the largest number of infections in Iraq, but…
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Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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