Clinical characteristics, causative organisms, and antimicrobial resistance profiles of hospital-acquired invasive gram-negative bacterial infections at a tertiary-care center in Saudi Arabia: a five-year retrospective cohort study (2020-2024)
Abstract
Background: Hospital-acquired gram-negative bacterial (HA-GNB) infections are a leading cause of nosocomial morbidity and mortality, yet local epidemiological data to guide empirical therapy remain limited.
Methods: We conducted a retrospective cohort study of 377 adult patients with culture-confirmed invasive gram-negative infection acquired ≥ 48 h after admission to King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia (2020-2024). Demographics, comorbidities, infection type, microbiology, susceptibility, complications, and outcomes were analyzed using chi-square/Fisher's exact tests and t-tests/Mann-Whitney U tests; multivariable logistic regression was used to identify independent predictors of multidrug-resistant (MDR) infection and in-hospital mortality. Infection types were classified according to U.S. Centers for Disease Control and Prevention / National Healthcare Safety Network (CDC/NHSN) surveillance definitions.
Results: Mean age was 64.6 ± 17.7 years (59.4% male). Hypertension (61.0%), diabetes (54.6%), and cardiovascular disease (40.8%) were the commonest comorbidities. Pneumonia predominated (47.1%), followed by bloodstream infection (33.0%), surgical-site infection (15.7%), and ventilator-associated pneumonia (9.6%). Klebsiella pneumoniae (41.9%), Pseudomonas aeruginosa (34.0%), and Escherichia coli (15.4%) were the predominant pathogens. Resistance was highest for ciprofloxacin (44.4%), ceftazidime (40.2%), and cefepime (39.9%), and 34.3% for meropenem.…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 377 participants or records.
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