Outcomes and mortality risk scoring for infections caused by carbapenem-resistant Escherichia coli and Klebsiella pneumoniae Journal Article
| Authors: | Sawda, J. E.; Abdulrahim, J.; Mkahal, R. W.; Doumat, G.; Nawar, T.; Saliba, A.; Kanj, S. S.; Kanafani, Z. A. |
| Article Title: | Outcomes and mortality risk scoring for infections caused by carbapenem-resistant Escherichia coli and Klebsiella pneumoniae |
| Abstract: | Introduction: Carbapenem-resistant Enterobacterales (CRE) are becoming increasingly prevalent and have been associated with increased mortality. Due to the paucity of data from the region, we evaluated the risk factors and outcomes of infections caused by CRE at a tertiary care center in Lebanon. Methodology: The study had three arms in a case-case-control design: patients with CRE infections, patients with infections due to ceftriaxoneresistant carbapenem-susceptible Enterobacterales (CSE), and uninfected controls (UC). Logistic regression was performed to identify risk factors uniquely associated with CRE. A CRE infection score was also created to assess the likelihood of having a CRE infection. Results: We included 337 patients (112 CRE, 75 CSE, 150 UC). Predictors unique to CRE infection included recent surgery (Odds Ratio (OR) 25.7; 95% confidence interval (CI95 5.7-115.2), carbapenem use within 30 days (OR 19.1; CI95 3.3-109.6), and malignancy (OR 4.2; CI95 1.6-10.5). The mean CRE score was 4.2 ± 2.2 in the CRE group and 2.4 ± 2.4 in the CSE group (p < 0.001). Infection-related mortality was higher among CRE patients (63.6% vs. 20.0%; p = 0.015), and CRE was independently associated with all-cause in-hospital mortality. Conclusions: We developed a scoring system that would allow risk stratification and would guide empiric antibiotic therapy. CRE infections were associated with a worse outcome compared to CSE infections. Copyright © 2025 El Sawda et al. |
| Keywords: | adult; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; major clinical study; case control study; case-control studies; mortality; nonhuman; metastasis; infection; kidney disease; lung disease; risk factors; drug effect; retrospective study; information processing; risk factor; risk assessment; acute kidney failure; hospitalization; antiinfective agent; anti-bacterial agents; escherichia coli; diabetes mellitus; risk stratification; bacteremia; tertiary health care; epidemiology; drug therapy; microbiology; isolation and purification; microbiological examination; cephalosporin; septic shock; demographics; analytical parameters; carbapenem; meropenem; klebsiella pneumoniae; imipenem; carbapenem derivative; escherichia coli infections; escherichia coli infection; disk diffusion; ertapenem; tertiary care centers; very elderly; humans; human; male; female; article; tertiary care center; klebsiella infection; mortality risk; carbapenem-resistant enterobacteriaceae; malignant neoplasm; carbapenem resistance; klebsiella infections; carbapenems; carbapenem resistant klebsiella pneumoniae; enterobacterales; lebanon; carbapenem resistant escherichia coli; carbapenem susceptible enterobacterales |
| Journal Title: | Journal of Infection in Developing Countries |
| Volume: | 19 |
| Issue: | 5 |
| ISSN: | 2036-6590 |
| Publisher: | JIDC |
| Date Published: | 2025-05-01 |
| Start Page: | 683 |
| End Page: | 690 |
| Language: | English |
| DOI: | 10.3855/jidc.20725 |
| PUBMED: | 40452522 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
