Prevalence of enterohemorrhagic Escherichia coli in Iran: A systematic review

Background and Objectives: Enterohemorrhagic Escherichia coli (EHEC) is a foodborne pathogen causing gastroenteritis, hemorrhagic colitis and hemolytic uremic syndrome (1). The aim of this study was to identify the prevalence of EHEC in Iran. Search Methods: This study is a systematic review study on original articles that have been published in English or Persian which present the prevalence of EHEC in Iran. The databases of PubMed, Web of Science, Scopus, Embase, Cochrane Library, Google Scholar, Iranmedex, SID and Magiran were searched for studies published from January 1990 to April 2017. The following keywords in titles or abstracts were used: diarrheagenic Escherichia coli, enterohemorrhagic Escherichia coli, EHEC, shiga-toxigenic Escherichia coli, shiga toxin-producing Escherichia coli, STEC, verotoxin-producing Escherichia coli, verotoxigenic Escherichia coli, VTEC, and Iran. For all articles, the compiled information contains: place of study, source of samples, and number of cases analyzed and prevalence of EHEC. Findings: The presence of STEC was examined in 9185 isolates in 38 publications (43 data). Overall, 953 of 9185 (9%) E. coli isolates were positive for the EHEC pathotype. The prevalence of EHEC isolated from diarrheic samples was 21/43, from acute diarrhea samples was 9/43, from healthy stool samples was 6/43, from urinary tract infection samples was 3/43, from bloody diarrhea samples was 2/43 and from persistent diarrhea and mixed samples each one was 1/43. Based on previous reports from various regions in Iran, a high prevalence of the EHEC of E. coli was detected in Shahrekord (48.3%) (1), central, western and northern (44.5%) (2), Shiraz (35.3%) (3), Yasuj (34.7%) (4) and Khuzestan (31.6%) (5). Conclusions: In conclusion, by combining the results from 38 studies, this systematic review identified the lower frequency of EHEC in Iran. However, the prevalence of EHEC is diverse in different regions of Iran.

کلیدواژه ها:

Enterohaemorrhagic E. coli ، systematic review ، Iran