Clinical Predispositions, Features, and Outcomes of Infections with Carbapenem-resistant among Critical Care Patients.

BACKGROUND

Carbapenem-resistant (CRE) infections pose a significant global public health threat. We aimed to assess the risk variables, clinical characteristics, and outcomes of CRE-caused infections in criticalcare patients.

PATIENTS AND METHODS

This prospective study enrolled 181 adult patients infected with in the intensive care unit (ICU). Patients underwent clinical assessment and monitoring throughout their ICU stay. Carbapenem resistance was identified through antibiotic susceptibility testing and multiplex molecular detection of carbapenemase-encoding genes.

RESULTS

The mean age of patients was 67.99 ± 12.89 years, with 71.3% being males. Of 181 patients, 111 (61.3%) were found to have CRE infections, including 39 and 31 isolates. The CRE isolates showed the predominance of the (74.8%), followed by the genes (20.7%). The risk factors associated with CRE infection included high sequential organ failure assessment (SOFA) score, prolonged length of stay (LOS) in ICU, prior use of broad-spectrum antimicrobials, hemodialysis, plasma exchange, and prolonged mechanical ventilation. Carbapenem-resistant infections significantly required longer LOS, more need for mechanical ventilation, and exhibited lower rates of bacterial elimination than carbapenem-susceptible (CSE) infections. The type of resistance gene did not significantly influence the mortality rate among CRE patients. The successful treatment of -positive CRE showed a strong correlation with tigecycline and colistin antibiotics.

CONCLUSION

Carbapenem-resistant infection in ICU patients was associated with adverse outcomes. Identification of high-risk patients is essential for early diagnosis and appropriate management. Therefore, it is crucial to improve infection control methods and implement antimicrobial stewardship to avoid spreading infections.

HOW TO CITE THIS ARTICLE

Shoala ARK, Nassar Y, El-Kholy AA, Soliman NS, Abdel-Fattah A, El-Ghawaby H. Clinical Predispositions, Features, and Outcomes of Infections with Carbapenem-resistant among Critical Care Patients. Indian J Crit Care Med 2025;29(1):36-44.