ESPN 51th Annual Meeting

ESPN 2018


 
THE FREQUENCY OF ESCHERICHIA COLI PRODUCING SHIGA TOXIN IN PATIENTS WITH URINARY TRACT INFECTION IN IRAN: SYSTEMATIC REVIEW AND META-ANALYSIS
NAKYSA HOOMAN 1 Amjad Ahmadi 2 Shahrbanoo Nakhaie 1 Rama Nagh shizadian 2 Mohsen Yaghoubi 3

1- ALI-ASGHAR CHILDREN HOSPITAL , IRAN UNIVERSITY OF MEDICAL SCIENCES
2- Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
3- School of Public Health, University of Saskatchewan, Saskatoon, Canada
 
Introduction:

 Escherichia coli is the main cause of urinary tract infection regardless of age. If it harbors shiga- toxin, hemolytic uremic syndrome may occur. The aim of this study was to find the incidence and prevalence of shiga -toxin producing E.coli as a cause of urinary tract infection in Iran.

Material and methods:

 Major medical search engines, Iran scientific search engines, and Iran database for thesis were surveyed for relevant English or Persian keywords for urinary tract infection , shiga-toxin Escherichia coli, hemolytic uremic syndorme in Iran that have been published between 1985 and 2017. The study followed by PRISMA statement. Point prevalence, proportion, and incidence were calculated and expressed as 95% confidence intervals. Random effect and I2 for heterogeneity were used. MedCalc version 15 and SPSS IBM were used for statistical analysis.

Results:

 A total of six articles containing 13349 specimens met all the inclusion criteria and were eligible for the final analysis.  Cross sectional was designing of all studies. The qualities of two studies were poor for low to moderate risk of bias.  Considering 32 reported positive about STEC, the pooled prevalence was 2.14 (95% CI, 0.26- 5.76, I2= 93.8%).  Besides that, 3.46 (95% CI, 0.89- 7.65, I2 =86%) of E.coli was harboring shiga-toxin. The study was heterogeneous for publication bias. The incidence of infection with STEC uropathogen was 31.67(95% CI, 12.35- 55.1, I2= 78.6%) per105 populations.

Conclusions:

 This review presented that STEC compromised some percentage of uropathogenic E.coli that required to be considered during culture processing and longer clinical follow up of the patients for occurrence of STEC related morbidities.