{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T02:22:19Z","timestamp":1789266139066,"version":"build-2803163510"},"reference-count":91,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T00:00:00Z","timestamp":1638921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Introduction<\/jats:title><jats:p>Antibiotic-associated diarrhea (AAD) is a major hospital problem and a common adverse effect of antibiotic treatment. The aim of this study was to investigate the prevalence of the most important bacteria that cause AAD in hospitalized patients.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Materials and methods<\/jats:title><jats:p>PubMed, Web of Science and Scopus databases were searched using multiple relevant keywords and screening carried out based on inclusion\/exclusion criteria from March 2001 to October 2021. The random-effects model was used to conduct the meta-analysis.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Of the 7,377 identified articles, 56 met the inclusion criteria. Pooling all studies, the prevalence of<jats:italic>Clostridioides<\/jats:italic>(<jats:italic>Clostridium<\/jats:italic>)<jats:italic>difficile<\/jats:italic>,<jats:italic>Clostridium perfringens<\/jats:italic>,<jats:italic>Klebsiella oxytoca<\/jats:italic>, and<jats:italic>Staphylococcus aureus<\/jats:italic>as AAD-related bacteria among hospitalized patients were 19.6%, 14.9%, 27%, and 5.2%, respectively. The prevalence of all four bacteria was higher in Europe compared to other continents. The highest resistance of<jats:italic>C<\/jats:italic>.<jats:italic>difficile<\/jats:italic>was estimated to ciprofloxacin and the lowest resistances were reported to chloramphenicol, vancomycin, and metronidazole. There was no or little data on antibiotic resistance of other bacteria.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>The results of this study emphasize the need for a surveillance program, as well as timely public and hospital health measures in order to control and treat AAD infections.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0260667","type":"journal-article","created":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T18:40:29Z","timestamp":1638988829000},"page":"e0260667","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":34,"title":["A worldwide systematic review and meta-analysis of bacteria related to antibiotic-associated diarrhea in hospitalized patients"],"prefix":"10.1371","volume":"16","author":[{"given":"Hamid","family":"Motamedi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matin","family":"Fathollahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Abiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepide","family":"Kadivarian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1071-7019","authenticated-orcid":true,"given":"Mosayeb","family":"Rostamian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4963-2485","authenticated-orcid":true,"given":"Amirhooshang","family":"Alvandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,8]]},"reference":[{"key":"pone.0260667.ref001","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.nmni.2014.10.003","article-title":"Prevalence 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