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Abstract：
Objectives: This study aimed at reviewing the correlation between biofilm formation and antibiotic resistance in methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) isolates. Materials and Methods: This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols. The literature search was conducted in PubMed, Web of Science (ISI), and Scopus databases. Combinations of Mesh terms such as \"biofilms\" OR \"biofilm formation,\" AND \"Drug Resistance\" OR \"Antimicrobial Drug Resistance\" OR \"Antibiotic Resistance\" AND \"Staphylococcus aureus\" OR \"Methicillin-resistant Staphylococcus aureus\" or \"MRSA\" AND \"Methicillin-sensitive Staphylococcus aureus\" OR \"MSSA\" AND \"biofilm-related genes\" AND \"Prevalence\" AND \"Iran\" were searched. Two reviewers independently searched the databases. Analyses were performed in Comprehensive Meta-Analysis software. The random-effects model was used to obtain the combined prevalence with a 95% confidence interval (CI). Results: The combined prevalence of MRSA retrieved from Iranian clinical samples was 48.3% (95% CI: 40.8-55.9). The pooled rate of biofilm formation in MRSA strains was reported as 80.9% (95% CI: 67.8-89.4). Overall, 52.9%, 45.3%, and 22.5% of MRSA isolates were strong, moderate, and weak biofilm producers, respectively. The highest frequency of biofilm-related genes was observed for icaD gene (67.7%) followed by clfA gene with a frequency of 64.7%. Among seven studies that addressed the relationship between biofilm formation and antibiotic resistance, six reported positive associations. Conclusions: Regarding the MRSA strains, they had a significantly higher ability of biofilm formation than MSSA strains; therefore, preventive measures against infections caused by them are required.
摘要：
目的：本研究旨在综述耐甲氧西林金黄色葡萄球菌（MRSA）和对甲氧西林敏感的金黄色葡萄球菌（MSSA）的生物膜形成与抗生素耐药性之间的相关性。材料和方法：本综述遵循系统评价和荟萃分析（PRISMA）方案的首选报告项目。文献检索在PubMed进行，WebofScience(ISI)和Scopus数据库。网格术语的组合，如\"生物膜\"或\"生物膜形成，搜索\"和\"耐药性\"或\"抗菌药物耐药性\"或\"抗生素耐药性\"和\"金黄色葡萄球菌\"或\"耐甲氧西林金黄色葡萄球菌\"或\"MRSA\"和\"甲氧西林敏感金黄色葡萄球菌\"或\"MSSA\"和\"生物膜相关基因\"和\"\"流行\"和\"伊朗\"。两名审阅者独立地搜索了数据库。在综合Meta分析软件中进行分析。随机效应模型用于获得具有95%置信区间(CI)的合并患病率。结果：从伊朗临床样本中检索到的MRSA的合并患病率为48.3％（95％CI：40.8-55.9）。据报道，MRSA菌株中生物膜形成的合并率为80.9％（95％CI：67.8-89.4）。总的来说,52.9%,45.3%,22.5%的MRSA分离株是强的，中度,和薄弱的生物膜生产者，分别。观察到生物膜相关基因的频率最高的是icaD基因（67.7％），其次是clfA基因，频率为64.7％。在研究生物膜形成与抗生素耐药性之间关系的七项研究中，六个报告了积极的关联。结论：关于MRSA菌株，它们的生物膜形成能力明显高于MSSA菌株；因此，需要采取预防措施来预防由它们引起的感染。
