Recurrence, Readmission, and Key Mortality Predictors in Patients with Carbapenem-Resistant Enterobacterales...

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Epidemiology

Background:

• Carbapenem-resistant Enterobacterales (CRE) are critical-priority pathogens globally.
• Limited regional data exist for CRE outcomes in the Middle East.
• This study addresses the knowledge gap in Saudi Arabia.

Purpose of the Study:

• To analyze clinical, microbiological, and therapeutic data of CRE infections in Saudi Arabia.
• To determine the incidence of infection recurrence, readmissions, and mortality.
• To identify predictors of recurrence and mortality.

Main Methods:

• Retrospective cohort study of 101 adult patients with CRE infections (2019-2024).
• Analysis of clinical, microbiological, and treatment data.
• Univariate and multivariate Cox regression for predictor assessment.

Main Results:

• Klebsiella pneumoniae (94%) and OXA-48 (70%) predominated; most infections were hospital-acquired (78%).
• Recurrence was 16.8%, with 12.9% readmissions; 90-day mortality was 42.6%.
• Diabetes mellitus predicted recurrence; pneumonia, critical care, and hypotension predicted mortality.

Conclusions:

• CRE infections in Saudi Arabia present a substantial clinical burden with high recurrence and mortality.
• Risk stratification tools like Pitt bacteremia and INCREMENT-CPE scores can identify high-risk patients.
• Findings underscore the need for enhanced surveillance, stewardship, and early recognition for infection control and research.