Prevalence of Antibiotic Resistance Genes in Bacterial Isolates in Iran: A Systematic Review

Context: The widespread use of biocides containing quaternary ammonium compounds (QACs) in medical centers has led to resistant strains of microorganisms. This study aimed to evaluate the frequency of genes resistant to antiseptics in Iranian bacterial isolates. Methods: The present study was conducted as a systematic review. The keywords in the titles or abstracts of articles published in Persian and English were monitored. The search was performed in databases without a time limit. Results: The results showed a total of 975 bacterial isolates. The most common disinfectant-resistant genes in gram-positive isolates were QacAB genes, with an average of 28.48; SMR gene, with an average of 19.8; and qacE and qacEΔ1 genes, with an average of 45 in gram-negative isolates. Gram-negative isolates containing qacE and qacEΔ1 genes were mainly detected in patients hospitalized in intensive care, internal diseases, and infectious diseases wards and from trachea and urine samples. Conclusions: The unique conditions of the intensive care units and the use of invasive tools such as urinary catheters were the leading causes of infection with resistant pathogens. In addition, diversity in infection control measures like the type, amount, and concentration of disinfectants used in different hospital departments were other reasons for resistance to antiseptics in medical environments. Indiscriminate use of antibiotics caused microbial resistance in the same way antibiotics did not affect many microbial diseases, and arbitrary use caused the highest microbial resistance.