Molecular epidemiology and outcome of carbapenem-resistant Enterobacterales in Saudi Arabia.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Bacteremia*/drug therapy ; Bacteremia*/epidemiology ; Enterobacteriaceae Infections*/drug therapy ; Enterobacteriaceae Infections*/epidemiology ; Healthcare-Associated Pneumonia*/drug therapy; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Carbapenems/pharmacology ; Carbapenems/therapeutic use ; Escherichia coli ; Female ; Humans ; Male ; Middle Aged ; Molecular Epidemiology ; Prospective Studies ; Saudi Arabia/epidemiology
    • Abstract:
      Background: The burden of carbapenem resistance is not well studied in the Middle East. We aimed to describe the molecular epidemiology and outcome of carbapenem-resistant Enterobacterales (CRE) infections from several Saudi Arabian Centers.
      Methods: This is a multicenter prospective cohort study conducted over a 28-month period. Patients older than 14 years of age with a positive CRE Escherichia coli or Klebsiella pneumoniae culture and a clinically established infection were included in this study. Univariate and multivariable logistic models were constructed to assess the relationship between the outcome of 30-day all-cause mortality and possible continuous and categorical predictor variables.
      Results: A total of 189 patients were included. The median patient age was 62.8 years and 54.0% were male. The most common CRE infections were nosocomial pneumonia (23.8%) and complicated urinary tract infection (23.8%) and 77 patients (40.7%) had CRE bacteremia. OXA-48 was the most prevalent gene (69.3%). While 100 patients (52.9%) had a clinical cure, 57 patients (30.2%) had died within 30 days and 23 patients (12.2%) relapsed. Univariate analysis to predict 30-day mortality revealed that the following variables are associated with mortality: older age, high Charlson comorbidity index, increased Pitt bacteremia score, nosocomial pneumonia, CRE bacteremia and diabetes mellitus. In multivariable analysis, CRE bacteremia remained as an independent predictor of 30 day all-cause mortality [AOR and 95% CI = 2.81(1.26-6.24), p = 0.01].
      Conclusions: These data highlight the molecular epidemiology and outcomes of CRE infection in Saudi Arabia and will inform future studies to address preventive and management interventions.
      (© 2022. The Author(s).)
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    • Contributed Indexing:
      Keywords: Carbapenem-resistant Enterobacterales (CRE); Multidrug resistant gram negative bacteria; OXA-48; Saudi Arabia
    • Accession Number:
      0 (Anti-Bacterial Agents)
      0 (Carbapenems)
    • Publication Date:
      Date Created: 20220613 Date Completed: 20220615 Latest Revision: 20220716
    • Publication Date:
      20240105
    • Accession Number:
      PMC9190113
    • Accession Number:
      10.1186/s12879-022-07507-y
    • Accession Number:
      35698046