Colistin resistance in CRE infections: Analysis of MIC patterns and associated risk factors in a tertiary care hospital in Saudi Arabia
Keywords:
Colistin resistance; Carbapenem-resistant; Enterobacterales; risk factors, Broth microdilutionAbstract
Background
Gram-negative bacteria represent a significant challenge to the public health as a result of their elevated resistance rates and the associated risk of mortality. The inappropriate use of antibiotics has driven the rise of multidrug-resistant (MDR) bacterial strains. The objectives of this work are to investigate the colistin susceptibility among carbapenem-resistant Enterobacterales (CRE) clinical isolates and to analyze associated risk factors.
Methods
A retrospective evaluation was carried out on 37 patients with their first episode of CRE infection. Clinical isolates obtained from different body sites were identified using the VITEK MS system. Colistin minimum inhibitory concentrations (MICs) were measured using the reference broth microdilution (BMD) method. Demographic, clinical, and microbiological data were interpreted using descriptive statistics.
Results
The mean age of patients was 61.3 years, with 62.2% males and Klebsiella pneumoniae represented the large majority of strains (89.2%), followed by Escherichia coli (10.8%). Colistin resistance was identified in 17% of isolates, and the highest resistance rates were observed for Amoxicillin-Clavulanate (100%), Meropenem (100%), and Ciprofloxacin (89.2%). The colistin MIC50 and MIC90 were 0.25 µg/mL and 4.0 µg/mL, respectively. Mortality was significantly associated with ICU admission and within patients with history of antibiotics consumption.
Conclusion
This study underscores the emerging issue of colistin resistance among CRE strains in Saudi Arabia. The findings suggest that patient acuity and underlying comorbidities are critical determinants of mortality. The study emphasizes the need for coordinated efforts to address this public health issue and improve patient outcomes through effective therapies and infection control strategies.
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