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Background: Acinetobacter is a Gram-negative bacterium that causes nosocomial infections, increasing healthcare costs, patient morbidity, and mortality. The rate of carbapenem resistance among Acinetobacter species is rising in several countries, including Saudi Arabia. Objective: To determine the risk factors and compare the predictors of mortality in patients infected with carbapenem-susceptible and carbapenem-resistant Acinetobacter strains. Materials and Methods: This retrospective study included patients with Acinetobacter infection who were admitted to a community hospital in Madinah, Saudi Arabia, between January 2017 and June 2021. A logistic regression analysis was conducted to assess the risks of acquiring carbapenem-resistant Acinetobacter infections and the mortality risk associated with these infections. Results: This study included 138 Acinetobacter -infected cases, of which 114 (82%) were carbapenem-resistant infections. Between 2017 and 2020, resistance rates increased from 75% to 87%. Patients with carbapenem-resistant Acinetobacter infections had higher 90-day mortality than those with carbapenem-susceptible infection (62% vs. 29%, P = 0.006). The risk factors for carbapenem-resistant Acinetobacter infections were prior antimicrobial therapy (aOR: 8.36 [1.69–41.29]; P = 0.009) and mechanical ventilation (aOR: 6.07 [1.82–20.20]; P = 0.003). Among all patients with Acinetobacter infections, significant predictors of 90-day mortality were carbapenem resistance (aOR: 3.26 [1.19–8.90]; P = 0.021) and Charlson comorbidity score (aOR: 1.19 [1.06–1.34]; P = 0.004). Conclusion: The increase in carbapenem-resistant Acinetobacter cases in this study was consistent with the findings of other studies from Saudi Arabia. This, together with the high associated mortality rates, indicates the urgent need for effective antimicrobials and infection prevention strategies to combat carbapenem-resistant Acinetobacter infections in hospitals. [ABSTRACT FROM AUTHOR]

Background Brucellosis causes a disabling human disease and loss of animals' lives. The clinical significance of Brucella bacteremia is still unclear and Brucella identification in blood culture is suboptimal. Methods This was a retrospective study conducted in Medina in Saudi Arabia from August 2016 to May 2019. We included cases with brucellosis symptoms and a positive culture or serological evidence for brucellosis, comparing bacteremic with non-bacteremic brucellosis cases for the rates of complications, infection relapses and brucellosis development. Also, we estimated blood culture positivity rates and the time to detect Brucella in an automatic blood culture instrument. Results Of the total number of 147 cases, 62 (42%) had a positive blood culture for Brucella , and the blood culture instrument (BACT/ALERT 3D) detected all positive blood cultures within 3 d of incubation. We found higher rates of chronic brucellosis in bacteremia than non-bacteremia cases (OR 7.25, 95% CI 1.41 to 37.23; p=0.018). Patients aged <15 y developed a higher rate of bacteremia than those aged ≥15 yr (OR 11.93 95% CI 1.37 to 103.75; p=0.025). Conclusion Brucella bacteremia is an independent predictor for the development of chronic infection. Brucella bacteremia cases may need long follow-up periods and a more thorough evaluation to exclude deep-seated infection. [ABSTRACT FROM AUTHOR]

Background: Mortality from tuberculosis (TB) remains high despite its declining global incidence. Host risk factors of TB death have not been fully identified. The aim of this study is to explore some of the host risk factors associated with TB mortality. Methods: We conducted a retrospective cross-sectional review of patients with TB admitted to Sultan Qaboos University Hospital in Oman from July 2006 to February 2016. Multivariate logistic regression analyses were used to evaluate the risk factors for TB mortality. Results: Of the 205 TB cases reviewed, we identified 31 (15%) TB deaths during TB treatment. The median time of death from starting TB drugs was 30 days. Fifty-one percent of the TB deaths occurred in the 1st month of TB diagnosis. The main risk factors for TB mortality were advanced age, low body weight, negative sputum TB smear, pulmonary involvement, human immunodeficiency virus infection, and noncitizen status. Conclusion: To improve TB outcome in this high-risk group, abrupt clinical management approaches should be applied when TB is suspected. Public health measures that increase community awareness of TB mortality and reduce barriers to TB care are crucial to reducing TB mortality. [ABSTRACT FROM AUTHOR]