Antimicrobial Resistance Pattern of Moraxella catarrhalis and Haemophilus influenza in Iran; a Systematic Review

Document Type : Systematic Review

Authors
F. Hatami 1
H. Allahverdi Nazhand 1
H. Ebadi 1
A. H. Zeininasab 1
F. Javandoust Gharehbagh 1
S. Shahrokhi 1
M. M. Rabiei 1
L. Lotfollahi 2
N. Kazeminia 3
1 Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Department of Nephrology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Clinical pharmacist, Clinical study and pharmacovigilance department, Food and Drug Administration, Tehran, Iran
10.61186/iem.10.1.21
Abstract
Background: Haemophilus influenzae and Moraxella catarrhalis are common pathogens in respiratory tract infections, causing some diseases like community-acquired pneumonia, acute sinusitis, and otitis media. Antimicrobial resistance in these pathogens occurs over the years. This systematic review aimed to investigate the antibiotic resistance pattern of these pathogens in Iran in the last 5 years.

Materials & Methods: All original articles related to the antimicrobial resistance of H. influenza and M. catarrhalis in Iran since 2018 were searched in English and Persian databases. The articles were screened primarily and secondary. After screening the articles (extracted blindly), conflicts were resolved, and the final data were reviewed.

Findings: This study included nine articles after primary and secondary screening steps, comprising 111 H. influenzae and 78 M. catarrhalis isolates. The lowest resistance of H. influenzae isolates was against levofloxacin (0.0%), cefotaxim (11.1%), and ceftriaxone (11.1%), while the highest resistance of these isolates was against tetracycline, co-trimoxazole, and ampicillin. M. catarrhalis isolates showed the highest resistance to penicillin (100%), cefazolin (87.5%), cefuroxime (84.4%), ampicillin (84.4%), and amoxicillin (81.2%). Co-trimoxazole resistance rates of M. catarrhalis isolates from adenoid tissue and pharynx were different. Resistance to fluoroquinolones was 0.0%; macrolides were the most effective antibiotics.

Conclusion: Fluoroquinolones and macrolides are the most effective antibiotics for M. catarrhalis, while fluoroquinolones and cefotaxime or ceftriaxone work best for H. influenzae. It is recommended to use fluoroquinolones and macrolides for managing outpatients and fluoroquinolones, macrolides, or ceftriaxone for managing inpatients. Prescription of β-lactams and/or co-trimoxazole is ineffective.

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Subjects

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Infection Epidemiology and Microbiology
Volume 10, Issue 1
February 2024
Pages 21-29