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Prevalence of nontuberculous mycobacteria isolated from environmental samples in Iran: A meta-analysis

View Article: PubMed Central - PubMed

ABSTRACT

Background:: While the most nontuberculous mycobacteria (NTMs) species are considered as opportunistic pathogens, some of them are related to several human infections. It is believed that environment is the main source for these infections. Distribution and scattering pattern of NTMs has not been well studied in Iran and a few studies about this subject have been done, so the aim of this study was to determine prevalence of NTMs in environmental samples from Iran.

Materials and methods:: Data about prevalence of NTMs in environmental samples from Iran were obtained by searching databases. The studies presenting cross-sectional or cohort and the papers with sample size ≥30 were included. Then, the meta-analysis was performed using Comprehensive Meta-Analysis software and Cochran's Q and I2 tests. The strategy search was based PRISMA protocol is available online (PRISMA, http://www.prisma-statement.org).

Results:: The results of this meta-analysis showed that overall combined prevalence of NTMs in environmental samples from Iran was 38.3%. The frequency of NTM was higher in the north of Iran (73.2%). The most prevalent rapid-growing mycobacterium was Mycobacterium fortuitum (19.8%), and the most dominant slow-growing mycobacterium was Mycobacterium flavescens (16.8%).

Conclusion:: In regard to increasing incidence of disease in immunocompromised patients and existence of different types of mycobacteria species in environmental samples, efforts should be focused on measures that will specifically remove NTMs from habitats where susceptible individuals are exposed.

No MeSH data available.


A study inclusion process for meta-analysis
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Figure 1: A study inclusion process for meta-analysis

Mentions: The study inclusion process is shown in Figure 1. In brief, initially using multiple databases, 83 relevant papers were recognized. Forty papers were excluded because of duplication, and due to the irrelevant titles, 19 papers were excluded. Then, 15 full texts papers were evaluated, nine papers were excluded (due to topic of four papers were irrelevant, four papers were case report, and one were review article). Eight papers were deleted after full-text evaluation because they did not report NTM prevalence. Finally, seven papers were included in this meta-analysis. The features of included papers in this meta-analysis are summarized in Table 1. Majority of studies were directed in Center of Iran [Table 1]; among total seven studies from three geographical locations of Iran, five cases (71.4%) were reported from Center of Iran (two cases from Tehran province and three from Isfahan province), from both West (West Azarbań≥an) and North (Golestan) provinces was reported one case(14.2%). In included studies, the prevalence of NTMs varied from 18.6% to 73.2% [Table 1 and Figure 2]. The primary detection carried out based on phenotypic tests such as smear microscopy and culture on Lowenstein-Jensen medium, and identification was done by morphology, biochemical tests, pigment production, and growth rate. From total studies, 2 (28.5%) of those have used from molecular methods and the other studies have used only from phenotypic tests for identification.


Prevalence of nontuberculous mycobacteria isolated from environmental samples in Iran: A meta-analysis
A study inclusion process for meta-analysis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121994&req=5

Figure 1: A study inclusion process for meta-analysis
Mentions: The study inclusion process is shown in Figure 1. In brief, initially using multiple databases, 83 relevant papers were recognized. Forty papers were excluded because of duplication, and due to the irrelevant titles, 19 papers were excluded. Then, 15 full texts papers were evaluated, nine papers were excluded (due to topic of four papers were irrelevant, four papers were case report, and one were review article). Eight papers were deleted after full-text evaluation because they did not report NTM prevalence. Finally, seven papers were included in this meta-analysis. The features of included papers in this meta-analysis are summarized in Table 1. Majority of studies were directed in Center of Iran [Table 1]; among total seven studies from three geographical locations of Iran, five cases (71.4%) were reported from Center of Iran (two cases from Tehran province and three from Isfahan province), from both West (West Azarbań≥an) and North (Golestan) provinces was reported one case(14.2%). In included studies, the prevalence of NTMs varied from 18.6% to 73.2% [Table 1 and Figure 2]. The primary detection carried out based on phenotypic tests such as smear microscopy and culture on Lowenstein-Jensen medium, and identification was done by morphology, biochemical tests, pigment production, and growth rate. From total studies, 2 (28.5%) of those have used from molecular methods and the other studies have used only from phenotypic tests for identification.

View Article: PubMed Central - PubMed

ABSTRACT

Background:: While the most nontuberculous mycobacteria (NTMs) species are considered as opportunistic pathogens, some of them are related to several human infections. It is believed that environment is the main source for these infections. Distribution and scattering pattern of NTMs has not been well studied in Iran and a few studies about this subject have been done, so the aim of this study was to determine prevalence of NTMs in environmental samples from Iran.

Materials and methods:: Data about prevalence of NTMs in environmental samples from Iran were obtained by searching databases. The studies presenting cross-sectional or cohort and the papers with sample size ≥30 were included. Then, the meta-analysis was performed using Comprehensive Meta-Analysis software and Cochran's Q and I2 tests. The strategy search was based PRISMA protocol is available online (PRISMA, http://www.prisma-statement.org).

Results:: The results of this meta-analysis showed that overall combined prevalence of NTMs in environmental samples from Iran was 38.3%. The frequency of NTM was higher in the north of Iran (73.2%). The most prevalent rapid-growing mycobacterium was Mycobacterium fortuitum (19.8%), and the most dominant slow-growing mycobacterium was Mycobacterium flavescens (16.8%).

Conclusion:: In regard to increasing incidence of disease in immunocompromised patients and existence of different types of mycobacteria species in environmental samples, efforts should be focused on measures that will specifically remove NTMs from habitats where susceptible individuals are exposed.

No MeSH data available.