Abstract
Purpose: The incidence of carbapenem-resistant Enterobacteriaceae (CRE) has increased in the last two decades, causing significant morbidity and mortality. Our study investigated the factors associated with mortality from CRE bloodstream infection in a single center in Oman. Methods: Data from adult patients with CRE bacteremia, over a 10-year period, were retrospectively collected. Demographic and clinical characteristics were compared according to intensive care unit (ICU) admission status and mortality. A logistic regression model was used to evaluate factors associated with mortality. Results: 169 cases of CRE bacteremia were identified, of whom 93 (55%) required ICU admission and 96 (56.8%) died. Patients who required ICU care were more likely to require organ transplant (15% vs 4.0%; p = 0.02), be on immunosuppressants (31% vs 17%; p = 0.035), be transferred from other hospitals (40% vs 14%; p < 0.001), be colonized with CRE (73% vs 43%; p < 0.001), have vascular lines (85% vs 42%; p < 0.001), be on mechanical ventilation (91% vs 9.2%; p < 0.001), require a longer stay (37 vs 17 days; p < 0.001), and have increased mortality (80% vs 29%; p < 0.001). In the multivariate analysis, mechanical ventilation (adjusted odds ratio (aOR) 15.3; 95% confidence interval 5.39–43.2; p < 0.001) and prior use of the broad-spectrum antibiotics meropenem (p = 0.01) and piperacillin/tazobactam (p = 0.026) were associated with CRE mortality. Conclusion: CRE bacteremia carries a high mortality rate in patients requiring ICU care. Implementation of infection control measures and antimicrobial stewardship programs are essential in reducing the rates of CRE BSI.
Original language | English |
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Pages (from-to) | 165-170 |
Number of pages | 6 |
Journal | IJID Regions |
Volume | 4 |
DOIs | |
Publication status | Published - Sept 2022 |
Keywords
- Enterobacteriaceae
- Klebsiella pneumoniae
- Klebsiella pneumoniae carbapenemase
- bacteremia
- bloodstream infection
- carbapenem resistance
- carbapenem-resistant Enterobacteriaceae
- carbapenemase
- carbapenemase-producing
- deaths
- mortality
- outcome
- prognostic factor
ASJC Scopus subject areas
- Infectious Diseases
- Epidemiology
- Public Health, Environmental and Occupational Health