TY - JOUR
T1 - Prevalence and 30-day all-cause mortality of carbapenem-and colistin-resistant bacteraemia caused by Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae
T2 - Description of a decade-long trend
AU - Balkhair, A.
AU - Al-Muharrmi, Z.
AU - Al'Adawi, B.
AU - Al Busaidi, I.
AU - Taher, H. B.
AU - Al-Siyabi, T.
AU - Al Amin, M.
AU - Hassan, K. S.
N1 - Publisher Copyright:
© 2019 The Author(s)
PY - 2019/8
Y1 - 2019/8
N2 - Background: Bacteraemia due to carbapenem-resistant gram-negative bacteria is challenging. This study examined the burden of carbapenem and colistin resistance in Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii bacteraemia in Oman. Methods: Adult patients admitted to Sultan Qaboos University Hospital between January 1, 2007 and December 31, 2016 with positive blood cultures for P. aeruginosa, A. baumannii, or K. pneumoniae were identified. Rates of carbapenem resistance, trends in prevalence, and 30-day all-cause mortality were examined. Results: Two hundred and twenty-seven (29.8%) of 761 bacteraemia cases due to these three isolates were carbapenem-resistant, with 87.2% being healthcare-associated. A. baumannii caused 52% of all carbapenem-resistant bacteraemia, K. pneumoniae caused 30%, and P. aeruginosa caused 18%. Rates of carbapenem resistance in P. aeruginosa, A. baumannii, and K. pneumoniae bacteraemia increased from 20%, 67%, and 0%, respectively, in 2007 to 25%, 86%, and 35%, respectively, in 2016. Seventeen (7.9%) carbapenem-resistant bacteraemia cases were also colistin-resistant. Thirty-day all-cause mortality was 62% in patients with carbapenem-resistant bacteraemia and 22% in patients with carbapenem-sensitive bacteraemia. Conclusions: The prevalence of carbapenem-resistant K. pneumoniae, A. baumannii, and P. aeruginosa bacteraemia is increasing alarmingly in Oman, with a large proportion of K. pneumoniae and P. aeruginosa demonstrating additional resistance to colistin. Patients with carbapenem-resistant bacteraemia had higher 30-day all-cause mortality.
AB - Background: Bacteraemia due to carbapenem-resistant gram-negative bacteria is challenging. This study examined the burden of carbapenem and colistin resistance in Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii bacteraemia in Oman. Methods: Adult patients admitted to Sultan Qaboos University Hospital between January 1, 2007 and December 31, 2016 with positive blood cultures for P. aeruginosa, A. baumannii, or K. pneumoniae were identified. Rates of carbapenem resistance, trends in prevalence, and 30-day all-cause mortality were examined. Results: Two hundred and twenty-seven (29.8%) of 761 bacteraemia cases due to these three isolates were carbapenem-resistant, with 87.2% being healthcare-associated. A. baumannii caused 52% of all carbapenem-resistant bacteraemia, K. pneumoniae caused 30%, and P. aeruginosa caused 18%. Rates of carbapenem resistance in P. aeruginosa, A. baumannii, and K. pneumoniae bacteraemia increased from 20%, 67%, and 0%, respectively, in 2007 to 25%, 86%, and 35%, respectively, in 2016. Seventeen (7.9%) carbapenem-resistant bacteraemia cases were also colistin-resistant. Thirty-day all-cause mortality was 62% in patients with carbapenem-resistant bacteraemia and 22% in patients with carbapenem-sensitive bacteraemia. Conclusions: The prevalence of carbapenem-resistant K. pneumoniae, A. baumannii, and P. aeruginosa bacteraemia is increasing alarmingly in Oman, with a large proportion of K. pneumoniae and P. aeruginosa demonstrating additional resistance to colistin. Patients with carbapenem-resistant bacteraemia had higher 30-day all-cause mortality.
KW - Acinetobacter baumannii
KW - Bacteraemia
KW - Carbapenem resistance
KW - Colistin resistance
KW - Klebsiella pneumoniae
KW - Mortality
KW - Oman
KW - Pseudomonas aeruginosa
UR - http://www.scopus.com/inward/record.url?scp=85066761866&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85066761866&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2019.05.004
DO - 10.1016/j.ijid.2019.05.004
M3 - Article
C2 - 31100418
AN - SCOPUS:85066761866
SN - 1201-9712
VL - 85
SP - 10
EP - 15
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -