AUTHOR=Alraddadi Basem M. , Heaphy Emily L. G. , Almaghrabi Reem , Althawadi Sahar , Alshahrani Ahmad M. , Almosallam Salma , Alraddadi Abdullah , Hefni Lama , Almannaei Mooza S. , Bahabri Ibrahim , Taha Rabab , Alamoudi Ebtihal , Bosaeed Mohammed 

TITLE=Epidemiology and outcomes of Carbapenem-resistant Enterobacterales infection in high-risk patients in Saudi Arabia

JOURNAL=Frontiers in Microbiology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2025.1619611

DOI=10.3389/fmicb.2025.1619611

ISSN=1664-302X

ABSTRACT=IntroductionSolid organ transplant (SOT) recipients, bone marrow transplant (BMT) recipients, and patients with hematological malignancies experience increased morbidity due to infections caused by multidrug-resistant, Carbapenem-resistant Enterobacterales (CRE). The current study aimed to further describe the epidemiology and outcomes associated with CRE infection in high-risk SOT and BMT recipients and in patients with hematological malignancies in Saudi Arabia.MethodsPatients aged 16 years and older admitted to a participating hospital between October 2018 and August 2024 who received an SOT or a BMT or were diagnosed with a hematological malignancy and had a confirmed CRE infection were included in this retrospective cohort study. A total of 155 eligible patients were included in the study population. The primary outcome of interest was all-cause mortality within 90 days of the date of the first CRE culture.ResultsAmong the 155 patients, 118 (76.1%) had received a solid organ transplant, while 37 (23.9%) had either a bone marrow transplant or a hematological malignancy. The BMT recipients and patients with hematological malignancies were 2.84 times more likely to die within 90 days of their first positive culture [adjusted odds ratio (AOR) = 2.84, 95% confidence interval (CI) = 1.01–8.01, p = 0.049]. Compared to the patients with CRE infections carrying the blaNDM gene, after controlling for other predictors, patients with infections harboring the blaOXA-48 gene were 3.97 times more likely to die within 90 days of the first culture (AOR = 3.97, 95%CI = 1.04–15.15, p = 0.044).ConclusionThe BMT recipients and patients with CRE infections harboring the blaOXA-48 gene were at greater risk for 90-day all-cause mortality in Saudi Arabia, confirming previous findings of high mortality rates associated with CRE infections in immunocompromised populations.