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

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.

Key words: Meta?analysis, nontuberculous mycobacteria, prevalence