Antimicrobial resistance pattern of enterococcus species among clinical isolates in Iran: A systematic review and meta-analysis

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-10-13 DOI:10.1016/j.jiph.2025.103006

Farzaneh Jabbari , Mohammad Nikoohemmat , Maryam Ahmadian , Ali Akhgarzad , Navid Ebrahimi , Farid Javandoust Gharehbagh , Ilad Alavi Darazam

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Abstract

Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E. faecium) are leading pathogens responsible for both community-acquired and nosocomial infections, with escalating antibiotic resistance reported worldwide. This meta-analysis evaluated resistance patterns in Iran by reviewing 46 studies published between 2017 and 2023, retrieved from PubMed, Scopus, and national Iranian databases (SID, Magiran, Scimed). Among 2379 E. faecalis and 1219 E. faecium isolates, resistance was markedly higher in E. faecium. The highest resistance rate in E. faecalis was observed against trimethoprim/sulfamethoxazole (82.0 %), whereas E. faecium demonstrated the highest resistance to ampicillin-sulbactam (91.7 %). Vancomycin-resistant Enterococci (VRE) prevalence was notably elevated (E. faecium: 52.3 %; E. faecalis: 15.8 %). Linezolid remained the most effective agent, with low resistance rates reported for E. faecalis (1.6 %) and E. faecium (3.1 %). These findings highlight a critical level of antimicrobial resistance in clinical Enterococcus isolates in Iran, underscoring the urgent need for strengthened infection control measures and comprehensive antibiotic stewardship policies.

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伊朗临床分离肠球菌物种的抗微生物药物耐药性模式：系统回顾和荟萃分析。

粪肠球菌（E. faecalis）和屎肠球菌（E. faecium）是导致社区获得性和医院感染的主要病原体，据报道，全世界抗生素耐药性不断上升。本荟萃分析通过回顾2017年至2023年间发表的46项研究来评估伊朗的耐药性模式，这些研究检索自PubMed、Scopus和伊朗国家数据库（SID、Magiran、scied）。在2379株粪肠杆菌和1219株粪肠杆菌中，粪肠杆菌的耐药性明显较高。对甲氧苄啶/磺胺甲恶唑的耐药率最高（82.0 %），对氨苄西林-舒巴坦的耐药率最高（91.7 %）。万古霉素耐药肠球菌（VRE）患病率明显升高（粪肠球菌：52.3% %；粪肠球菌：15.8% %）。利奈唑胺仍然是最有效的药物，对粪肠杆菌（1.6 %）和粪肠杆菌（3.1 %）的耐药率较低。这些发现突出了伊朗临床分离肠球菌的抗微生物药物耐药性达到临界水平，强调了加强感染控制措施和全面抗生素管理政策的迫切需要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.