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Multicenter Study
. 2022 Jun 13;22(1):542.
doi: 10.1186/s12879-022-07507-y.

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

Basem M Alraddadi  1   2 , Emily L G Heaphy  3 , Yamama Aljishi  4 , Waleed Ahmed  5 , Khalid Eljaaly  6 , Hanan H Al-Turkistani  7 , Abeer N Alshukairi  3   8 , Mohammed O Qutub  3   9 , Kholoud Alodini  10 , Roaa Alosaimi  3 , Waseem Hassan  5 , Dalya Attalah  11 , Rakan Alswaiel  12 , Mohammed F Saeedi  3 , Mohammed A Al-Hamzi  3 , Lama K Hefni  3 , Reem S Almaghrabi  13 , Mushira Anani  12 , Abdulhakeem Althaqafi  10   14
Affiliations
Multicenter Study

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

Basem M Alraddadi et al. BMC Infect Dis. .

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.

Keywords: Carbapenem-resistant Enterobacterales (CRE); Multidrug resistant gram negative bacteria; OXA-48; Saudi Arabia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Percentages of CRE molecular typing identified in different regions of Saudi Arabia
See this image and copyright information in PMC

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