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Alraddadi BM, Heaphy ELG, Aljishi Y, Ahmed W, Eljaaly K, Al-Turkistani HH, Alshukairi AN, Qutub MO, Alodini K, Alosaimi R, Hassan W, Attalah D, Alswaiel R, Saeedi MF, Al-Hamzi MA, Hefni LK, Almaghrabi RS, Anani M, Althaqafi A. Molecular epidemiology and outcome of carbapenem-resistant Enterobacterales in Saudi Arabia. BMC Infect Dis 2022; 22:542. [PMID: 35698046 PMCID: PMC9190113 DOI: 10.1186/s12879-022-07507-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/19/2022] Open
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.
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Affiliation(s)
- Basem M Alraddadi
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. .,Alfaisal University, Riyadh, Saudi Arabia.
| | - Emily L G Heaphy
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | | | - Khalid Eljaaly
- Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Abeer N Alshukairi
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.,Alfaisal University, Riyadh, Saudi Arabia
| | - Mohammed O Qutub
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.,Department of Pathology and Laboratory Medicine Clinical Microbiology Lab, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Kholoud Alodini
- Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Roaa Alosaimi
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | - Dalya Attalah
- Clinical Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | | | - Mohammed F Saeedi
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | - Lama K Hefni
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Reem S Almaghrabi
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | - Abdulhakeem Althaqafi
- Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia.,King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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