ArticlePloS one2026
Laboratory-based surveillance of antimicrobial non-susceptibility in Enterobacter species over 12 years at a tertiary-care hospital in Saudi Arabia.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnterobacter species are increasingly associated with antimicrobial non-susceptibility, but long-term surveillance of temporal trends across antibiotic classes is limited in southern Saudi Arabia.
methodsWe retrospectively studied non-duplicate Enterobacter isolates from adults at a tertiary-care hospital in southern Saudi Arabia (August 2012-August 2024), interpreted by contemporaneous CLSI criteria. Temporal trends were modelled by logistic regression as the annual percent change (APC) in the odds of non-susceptibility, adjusted for care setting, specimen source, age, and sex. Carbapenem-resistant Enterobacterales (CRE) and difficult-to-treat resistance (DTR; Kadri criteria) were analysed over time; sensitivity analyses excluded partial years and used breakpoint-comparable periods.
resultsOf 1,319 Enterobacter isolates, 91.8% belonged to the Enterobacter cloacae complex. Adjusted trends declined for amikacin (APC -6.1%), gentamicin (-9.4%) and cefepime (-9.1%) and rose for carbapenems (+13.1% to +15.8%), levofloxacin (+6.3%) and piperacillin-tazobactam (+7.0%), with ciprofloxacin stable. The levofloxacin and piperacillin-tazobactam increases did not persist in breakpoint-comparable analyses and are not unequivocal biological increases. Inpatient isolates were more non-susceptible than outpatient isolates by approximately 16-39 percentage points (gentamicin 31.7% vs 14.8%; piperacillin-tazobactam 38.7% vs 23.1%; cefotaxime 63.9% vs 41.5%; cefepime 45.7% vs 28.8%; ceftazidime 61.4% vs 35.3%; ceftriaxone 57.4% vs 18.8%; all p ≤ 0.003). CRE rose early and remained common (APC + 22.8%; 28.7% overall), whereas DTR rose later and stayed infrequent (7.5% of eligible isolates; APC + 16.4%; highest annual value 20.2% in 2023); this difference in timing and overall frequency, not the partially sampled year 2024, indicates dissociation between carbapenem non-susceptibility and loss of all first-line agents.
conclusionNon-susceptibility among Enterobacter species was heterogeneous and antibiotic-specific. The dissociation between CRE and DTR in timing and overall frequency supports using clinically meaningful phenotypes alongside antibiotic-specific trend analysis for stewardship and reporting; the levofloxacin and piperacillin-tazobactam increases warrant caution, as they did not persist in breakpoint-comparable analyses.
Indexed as
Identifiers
What OpenQuestion holds
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.