A systematic review of 40 years of distribution and antimicrobial resistance of Vibrio cholerae in Iran with future perspective

Abstract

To assess the prevalence of incidence rate and antimicrobial susceptibility pattern of Vibrio cholerae in provinces of Iran, a systematic review was conducted during 1979–2019. This survey was performed using the following keywords ‘Vibrio cholerae’ and ‘Iran’ in the international databases including ISI Web of Science, PubMed, Scopus, and Google Scholar from January 1979 to December 2019. The statistical analysis was performed using SPSS software version 18.0 (IBM, New York, USA). In addition, P less than 0.05 was regarded as statistically significant. According to our results, the highest rate of incidence of cholera occurs in Sistan and Baluchestan (925/1636 cases), and after that Alborz (595/1636 cases) and Tehran (587/1636 cases) have shown high distribution. Among all provinces, Alborz province has demonstrated higher percentage of drug resistance than other ones (ampicillin 58.1%, co-trimoxazole 87%, erythromycin 87.5%, and furazolidone 74%). Moreover, lower antibiotic resistance has been shown in Golestan and Kermanshah, respectively. In spite of the fact that Iran has some big challenges in managing and controlling cholera incidence and antibiotic resistance, we believe that Iran has good perspective in future, as follows: special attention of the Iran government to cholera's free treatment, diagnosis and monitoring and eradication of it with coordination of WHO; Improving the level of food safety and quality; and finally, a ‘national action plan of Islamic Republic of Iran to combating antimicrobial resistance’ that were published to stop and reverse the trend of drug resistance in Iran.