Tamer Saied Osman

Background: Carbapenem-resistant Gram-negative bacteria (CR-GNB) pose major challenges in intensive care units (ICUs) due to limited treatment options and high mortality. Data describing their predictors in Jordan are scarce. This study aimed to identify risk factors associated with CR-GNB infections among ICU patients. Methodology: A retrospective analysis was conducted using national surveillance data from 18 ICUs across 13 public hospitals in Jordan between September 2018 and September 2024. Patients with confirmed Gram-negative infections were included. Laboratory testing followed CLSI M100 standards. Logistic regression was performed to determine independent predictors of carbapenem resistance. Results: Of 1,180 Gram-negative isolates tested, 451 (38%) were carbapenem-resistant. Acinetobacter baumannii and Klebsiella spp. were the predominant resistant pathogens, while E.coli was mainly carbapenem-susceptible. Independent predictors of carbapenem resistance identified by multivariate logistic regression were: ICU-acquired infection (OR: 2.44; 95% CI: 1.31–4.54; p = 0.004), pneumonia (OR: 2.77; 95% CI: 1.48–5.23; p = 0.001), invasive device use (OR: 3.37; 95% CI: 1.28–9.95; p = 0.019), and admission to high-risk ICU units (OR: 3.33; 95% CI: 2.06–5.48; p < 0.001). Mortality was significantly higher among CR-GNB patients (69.8%) compared to carbapenem-susceptible patients (42.0%), with a 3.15-fold increased risk of death (OR: 3.149; 95% CI: 2.392–4.145; p < 0.001). Conclusion: The findings of this study underscore the need for strategies to prevent and control carbapenem-resistant infections, particularly in high-risk populations such as patients with invasive devices and those diagnosed with pneumonia. Enhanced infection control measures, including strict hand hygiene practices, judicious antibiotic stewardship, and proper management of invasive devices, are essential to minimize the transmission of carbapenem-resistant bacteria in healthcare settings.

Candida auris (C. auris) is an opportunistic budding yeast that has been identified across 41 countries, including several countries in the Middle East. The increasing global concern stems from the pathogen’s acquired resistance to antifungal drugs and its ability to form biofilms, which allows it to survive on hospital surfaces and medical devices for up to 14 days, compromising infection prevention measures in hospitals. In this report, we present the first (reported) case of C. auris isolated from a urine sample from a 48-year-old female living in Jordan. The patient succumbed to illness five days following admission to hospital. The isolate was identified retrospectively through the national surveillance system in Jordan and was confirmed by real-time PCR. Antifungal susceptibility was carried out using the microbroth dilution technique and the isolate was found to be susceptible to all tested antifungal drugs. Overall, the report emphasizes the need for active surveillance for the rapid identification of high-risk patients colonized with C. auris. It also stresses the importance of understanding the inter-clade difference in the susceptibility pattern of C. auris to facilitate the development of preventive and therapeutic strategies.