Resistance to Aminoglycoside Antibiotics in Escherichia coli Isolated from Urinary Tract Infection in Iran in 2000-2012: A Systematic Review

Resistance to aminoglycosides has become a major problem in the treatment of urinary tract infection due to the extensive use of this antibiotic group. Due to the increased resistance of Escherichia coli to aminoglycosides, this study systematically evaluated the resistance to aminoglycosides by Escherichia coli isolated from urinary tract infection (UTI) in Iran over the past 12 years. In this systematic review, data on resistance to aminoglycosides in UTI isolates of E. coli in Iran from 2000 to 2012 were studied by evalution of 43 studies (14129 cases) including English and Persian articles, accredited domestic and international websites (magiran , PubMed, ScienceDirect), dissertations and microbiology conferences summaries. Resistance to amikacin, gentamicin and tobaramycin was evaluated in 5, 24, 37 studies, respectively. Totally,  24 studies were done on outpatients, 11 on inpatients and 8 on both outpatient and inpatients. In 39 studies disc diffusion, 2 sudies E test and 2 studes MIC (Minimum inhibitory concentration) were used. According to the statistical analysis, the resistance to amikacin, gentamicin and tobramycin was estimated  20.84, 12.30 and 43.66 precent, respectively. According to different methods of resistance measurement and statistical indices, there is a heterogeneity and fluctuation in the level of resistance to aminoglycosides, including the increasing trend of resistance to gentamicin and tobramycin in Iran. The appropriate use of this antibiotic group with the evaluation of isolated resistance along with continuous monitoring on epidemiology of regional resistance is needed.