Evidence map›Paper›PMID 42414940›Full record

ArticleBMC infectious diseases2026

Distinct molecular epidemiology and outcomes of carbapenem-resistant gram-negative infections in Lebanon: insights from the MDRO network.

Jean-Francois Jabbour, Hind Kadri, Elio Jabra, Joya-Rita Hindy, Sara F Haddad, Zeina A Kanafani, Nada K Zahreddine, Antoine G Abou Fayad, Lauren Komarow, Yixuan Li and 9 more

Registry-linked trialAbstract read
In one paragraph

Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03646227 (Multi-Drug Resistant Organism Network - MDRO Network), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03646227 completednot on this map

Multi-Drug Resistant Organism Network - MDRO Network

TypeobservationalSponsorDuke UniversityRan2016 to 2020Enrolled6,496ConditionsInfections Resistant to Multiple Drugs, Bacterial InfectionsArmsStandard of Care
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Jean-Francois JabbourDivision of Infectious Diseases, Department of Internal Medicine, Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Riad El Solh 1107 2020, PO -Box 11-0236, Beirut, Lebanon.
Hind KadriDivision of Infectious Diseases, Department of Internal Medicine, Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Riad El Solh 1107 2020, PO -Box 11-0236, Beirut, Lebanon.
Elio JabraDepartment of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Joya-Rita HindyDivision of Infectious Diseases, Department of Internal Medicine, Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Riad El Solh 1107 2020, PO -Box 11-0236, Beirut, Lebanon.
Sara F HaddadDivision of Infectious Diseases, Department of Internal Medicine, Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Riad El Solh 1107 2020, PO -Box 11-0236, Beirut, Lebanon.
Zeina A KanafaniDivision of Infectious Diseases, Department of Internal Medicine, Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Riad El Solh 1107 2020, PO -Box 11-0236, Beirut, Lebanon.
Nada K ZahreddineInfection Control and Prevention Program, American University of Beirut Medical Center, Beirut, Lebanon.
Antoine G Abou FayadDepartment of Experimental Pathology, Immunology and Microbiology, Center for Infectious Diseases Research, WHO Collaborating Center for Reference and Research on Bacterial Pathogens, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Lauren KomarowThe Biostatistics Center, George Washington University, Rockville, MD, USA.
Yixuan LiThe Biostatistics Center, George Washington University, Rockville, MD, USA.
Jianping JiangCenter for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA.
George F ArajDepartment of Pathology and Laboratory Medicine, Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Ghassan M MatarDepartment of Experimental Pathology, Immunology and Microbiology, Center for Infectious Diseases Research, WHO Collaborating Center for Reference and Research on Bacterial Pathogens, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Yohei DoiCenter for Innovative Antimicrobial Therapy, Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Vance G FowlerDivision of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, NC, USA.
David L PatersonSaw Swee Hock School of Public Health, ADVANCE-ID, National University of Singapore, Singapore, Singapore.
Michael J SatlinDivision of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
David van DuinDivision of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Souha S KanjDivision of Infectious Diseases, Department of Internal Medicine, Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Riad El Solh 1107 2020, PO -Box 11-0236, Beirut, Lebanon. sk11@aub.edu.lb.

Funding

Antibacterial Resistance Leadership Group (ARLG)UM1AI104681 · NIAID · DUKE UNIVERSITY · PI Vance G. Fowler, Henry F HENRY CHAMBERS · 2013 to 2026
$180.8M
National Institutes for Allergy and Infectious Diseases at the National Institutes of Health UM1AI104681NIAID NIH HHS UM1 AI104681
6 · The paper itself

Abstract

backgroundThis study provides the first prospective, genomically validated dataset integrated into the global MultiDrug-Resistant Organism (MDRO) Network from the Middle East and North Africa region. To address the substantial gap in antimicrobial resistance (AMR) data, the American University of Beirut Medical Center (AUBMC) investigated carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPA).

methodsConsecutive, hospitalized patients whose clinical cultures were positive for CRE, CRAB, or CRPA were prospectively enrolled between June 2018 and November 2019. Data on demographics, hospitalization, outcomes, and antimicrobial susceptibility were collected. Whole-genome sequencing (WGS) characterized the isolates. The primary outcome was the Desirability of Outcome Ranking (DOOR).

resultsNinety-four patients were included: 35 with CRE, 19 with CRAB, and 40 with CRPA. Overall, 30% of patients survived without adverse events, whereas 33% experienced two or more adverse events. Patients with CRAB had the poorest prognosis, with only 5% surviving without complications, and a significantly different DOOR distribution versus CRE or CRPA (p = 0.023). Adjusted DOOR probabilities confirmed the poorer outcomes associated with CRAB: when compared with CRE or CRPA, a randomly selected CRAB patient had only a 37.7% (95% CI, 24.9-52.6%) and 38.8% (95% CI, 26.5-52.7%) probability of achieving a more desirable outcome, respectively. WGS identified bla

conclusionsMDRO infections in Lebanon have distinct molecular patterns compared to the US, Chinese, South American, and Australian cohorts, as well as poor outcomes, especially with CRAB. Ongoing surveillance, strengthening regional collaboration, and future clinical trials are essential to guide diagnostic and therapeutic strategies in settings with increasing AMR. TRIAL REGISTRY: ClinicalTrials.gov. TRIAL REGISTRATION NUMBER: NCT03646227. DATE OF REGISTRATION: 15-08-2018.

Indexed as

CarbapenemsDrug Resistance, Multiple, BacterialGram-Negative Bacterial InfectionsAcinetobacter baumanniiAdultAgedAnti-Bacterial AgentsFemaleHumansLebanonMaleMicrobial Sensitivity TestsMiddle AgedMolecular EpidemiologyProspective StudiesPseudomonas aeruginosaAnti-Bacterial AgentsCarbapenemsAntimicrobial resistanceCarbapenemase genesGenomic epidemiologyInfection outcomesMolecular surveillanceMultidrug-resistant pathogens

Identifiers

PMID42414940
PMCPMC13628720

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.