Abstract
Background: Carbapenem-resistant Enterobacteriaceae (CRE) are multidrug-resistant microorganisms. Infections caused by these microorganisms have limited treatment options, frequently leading to high mortality rates. 
Objective: This study aimed to identify the microbiological and clinical characteristics of CRE infections among hospitalized patients in a university hospital, and included treatment regimens, duration, infection-related mortality, and risk factors associated with death.  
Methods: the study analyzed the consecutive CRE infections in patients admitted to King Abdulaziz University Hospital (Jeddah, Saudi Arabia) between January 2014 and December 2016. Patients’ records for CRE infections at any sterile site during the study period were reviewed to analyze patient demographics, CRE risk factors, comorbidities, site of infection, antibiotic treatment, and septic shock. Therapeutic regimens including monotherapies, combination therapies, as well as different durations of treatment were also reviewed. The clinical outcome in this study was 30-day mortality. Statistical analyses were conducted by IBM© SPSS© Statistics version 21 using multiple logistic regression model, Chi-square, independent-sample t-test, and Fisher’s exact test. A p value of ≤0.05 was considered significant.
Results: Klebsiella pneumoniae was the most frequently (89.8%) isolated organism. Chest (22%) and urinary tract infections (22%) were the main sources of CRE infections. Combined therapy resulted in significantly more deaths than the monotherapy (p=0.005). By logistic regression, the significant predictors were septic shock (Odds ratio=8.82), Charlson Comorbidity index (CCI) of two (Odds ratio=2.39) and renal impairment (Odds ratio=4.4). About 66% of patients for whom the antibiotics were initiated after >24 h (65.2%), died (Chi-square =1.55, p=0.22).
Conclusions: This study showed high mortality in infected patients with CRE infections and that the drug monotherapy and combination therapies were not effective in reducing patient mortality. Knowledge on risk factors associated with CRE infections could be useful for designing future treatment regimens to combat such infections and reduce mortality.
 
Keywords: Carbapenems, Enterobacteriaceae Infections, Mortality, Multiple Drug Resistance, Risk, Treatment

 

» HTML Fulltext    » PDF Fulltext    » doi: 10.19082/7602

Current Issue

July-September 2019 (Volume 11, Issue 3)


 

Previous Issue

In the second issue of the journal Electronic Physician for 2019, we have several papers including four Randomized Controlled Trials, a model development study, a case report, an editorial, a letter to editor (LTE), and several original research including two studies with qualitative approach. Authors of this issue are from nine countries: Iran, The Netherlands, Sweden, Italy, India, Thailand, Saudi Arabia, United Arab Emirates (UAE), and Jordan. Read more...


 

The 6th World Conference on Research Integrity (WCRI) is to be held on June 2-5, 2019 in Hong Kong.

The WCRI is the largest and most significant international conference on research integrity. Since the first conference in Lisbon in 2007, it has given researchers, teachers, funding agencies, government officials, journal editors, senior administrators, and research students opportunities to share experiences and to discuss and promote integrity in research. Read more:


 

TDR Clinical Research and Development Fellowships

Call for applications

Deadline for submission: 7 March 2019, 16:00 (GMT)

TDR provides fellowships for early- to mid-career researchers and clinical trial staff (e.g. clinicians, pharmacists, medical statisticians, data managers, other health researchers) in low- and middle-income countries (LMICs) to learn how to conduct clinical trials. Read more:


Meta-Analysis Workshops in New York, USA, and London, UK, in April and May 2019

Don't miss this exceptional opportunity to learn how to perform and report a Meta-analysis correctly. Two Meta-analysis workshops are organized in April and May 2019 by Dr. Michael Borenstein in New York, USA (April 08-10, 2019) and London, UK (May 27-29).

About the Instructor

Dr. Michael Borenstein, one of the authors of Introduction to Meta-Analysis, is widely recognized for his ability to make statistical concepts accessible to researchers as well as to statisticians. He has lectured widely on meta-analysis, including at the NIH, CDC, and FDA. Read more: