The epidemiology of gram-negative bacteremia in Lebanon: a study in four hospitals

Gram-negative bacteremia is a life-threatening infection with high morbidity and mortality. Its incidence is rising worldwide, and treatment has become more challenging due to emerging bacterial resistance. Little data is available on the burden and outcome of such infections in Lebanon. We conducte...

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Published in:	Annals of clinical microbiology and antimicrobials Vol. 23; no. 1; pp. 90 - 14
Main Authors:	Nasr, Janane, Abdessamad, Hilal, Mina, Johnathan, Haykal, Tony, Jamil, Yasser, Abboud, Emma, Mahdi, Ahmad, Asmar, Rana, Abi Assaad, Rawad, Alameddine, Dana, Bourji, Alaa, Mahdi, Mahmoud, Abdulaal, Razan, Tomassian, Serge, El Ahmadieh, Hanane, Azzam, Wael, Mokhbat, Jacques E, Moghnieh, Rima, Rodriguez-Morales, Alfonso J, Husni, Rola
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 09-10-2024 BioMed Central BMC
Subjects:	Acinetobacter baumannii - drug effects Acinetobacter baumannii - isolation & purification Adult Aged Aged, 80 and over Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Bacteremia Bacteremia - drug therapy Bacteremia - epidemiology Bacteremia - microbiology Care and treatment Cross Infection - epidemiology Cross Infection - microbiology Drug Resistance, Bacterial Epidemiology Female Gram-negative Gram-negative bacteria Gram-Negative Bacteria - drug effects Gram-Negative Bacteria - isolation & purification Gram-Negative Bacterial Infections - drug therapy Gram-Negative Bacterial Infections - epidemiology Gram-Negative Bacterial Infections - microbiology Hospitals - statistics & numerical data Humans Klebsiella pneumoniae - drug effects Klebsiella pneumoniae - isolation & purification Lebanon Lebanon - epidemiology Male Microbial Sensitivity Tests Middle Aged Mortality Multicentric Patient outcomes Pseudomonas aeruginosa - drug effects Pseudomonas aeruginosa - isolation & purification Retrospective Studies Risk Factors Lebanon Lebanon Gram-negative Mortality Bacteremia Multicentric
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Summary:	Gram-negative bacteremia is a life-threatening infection with high morbidity and mortality. Its incidence is rising worldwide, and treatment has become more challenging due to emerging bacterial resistance. Little data is available on the burden and outcome of such infections in Lebanon. We conducted this retrospective study in four Lebanese hospitals. Data on medical conditions and demographics of 2400 patients diagnosed with a bloodstream infection based on a positive blood culture were collected between January 2014 and December 2020. Most bacteremias were caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, with the more resistant organisms being hospital-acquired. Third-generation cephalosporin and quinolone resistance was steady throughout the study, but carbapenem resistance increased. Mortality with such infections is high, but carbapenem resistance or infection with Pseudomonas or Acinetobacter species were significant risk factors for poor outcomes. This is the first multi-center study from Lebanon on gram-negative bacteremia, resistance patterns, and factors associated with a poor outcome. More surveillance is needed to provide data to guide empirical treatment for bacteremia in Lebanon.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1476-0711 1476-0711
DOI:	10.1186/s12941-024-00740-0