ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2026
Clinical outcomes and treatment effectiveness in patients with carbapenem-resistant Enterobacterales infections: a multicenter retrospective cohort study.
Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Carbapenem-resistant Enterobacterales (CRE) infections carry high mortality and limited treatment options. We evaluated outcomes among adults with CRE infections at Ministry of National Guard-Health Affairs facilities in Saudi Arabia, comparing monotherapy with combination therapy. Methods: This multicenter retrospective cohort study included adults (≥18 years) with CRE infections during 2020-2024 at King Abdulaziz Medical City (Jeddah and Riyadh). CRE was defined phenotypically per CLSI criteria (first isolate per patient). Bivariate analyses, multivariate logistic regression, and Kaplan-Meier survival analysis compared monotherapy and combination therapy. Results: Among 224 patients (median age 70 years; 62.5% male), overall mortality was 43.3%, and Klebsiella pneumoniae accounted for 96.0% of isolates. Combination therapy was associated with higher mortality than monotherapy (44.5% vs. 26.7%; Conclusions: CRE infections carry a high mortality burden among adults in Saudi Arabia. The higher mortality with combination therapy may, in part, reflect confounding by indication, with broader-spectrum regimens prescribed for sicker patients whose severity was not captured. Prospective studies with disease-severity scoring and individualized treatment are needed, particularly for immunocompromised patients.
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