Risk of type III secretion systems in burn patients with Pseudomonas aeruginosa wound infection: A systematic review and meta-analysis.

Meysam Hasannejad-Bibalan, Alireza Jafari, Hoda Sabati, Rajendra Goswami, Zakiyeh Jafaryparvar, Farzaneh Sedaghat, Hadi Sedigh Ebrahim-Saraie

Journal: Burns : journal of the International Society for Burn Injuries 2021;47(3):538-544

PMID: 32532479

Full Text on Elsevier Science View on PubMed

Abstract

PURPOSE

The pathogenesis of Pseudomonas aeruginosa is multifactorial and attributed to the production of several cell-associated and extracellular virulence factors including those implicated in adherence, iron uptake, exoenzymes (Exo) and exotoxins. The present study aimed to determine the prevalence of type III secretion systems (T3SS) effectors in Iranian burn patients with P. aeruginosa wound infection.

METHODS

A systematic search was conducted to identify papers published by Iranian authors in the Web of Science, PubMed, Scopus, Embase, and Google Scholar electronic databases during the period of January, 2000 to December, 2018. Publications which met our inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The inclusion criteria were articles that include burn patients with a wound infection caused by P. aeruginosa, and reported the prevalence of aimed exoenzymes.

RESULTS

Ten publications were selected out of 15 full-text reviewed articles with the inclusion criteria. Of ten studies, the pooled prevalence of ExoS producing isolates was estimated at 57.1% (95% CI: 40.3-72.5%). Five studies reported the prevalence of ExoU and ExoT, from which, the pooled prevalence of ExoU and ExoT producing isolates was estimated at 51.4% (95% CI: 31.4-70.9%) and 86.4% (95% CI: 48.1-97.8%), respectively. Four studies reported the prevalence of ExoY, from which, the pooled prevalence of ExoY producing isolates was estimated at 79.0% (95% CI: 48.6-93.8%).

CONCLUSION

Our results showed a remarkable prevalence of T3SS-positive genotype in patients with burn injuries. These findings provided attractive targets for new therapeutic strategies for burn patients who were infected with cytotoxin-producing P. aeruginosa.

Address: Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.; Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.; Biotechnology and Biological Science Research Center, Faculty of Science, Shahid Chamran University of Ahvaz, Iran.; Institute for Tuberculosis Research, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.; Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.; Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.; Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: [email protected].

DOI: 10.1016/j.burns.2020.04.024