Clinical and Drug Resistance Characteristics of Providencia Infections

<b>Background:</b><i>Providencia</i> is a G ram-negative bacillus that most frequently colonizes the urinary tract and is often resistant to many antimicrobials. This study aimed to evaluate the resistance patterns of <i>Providencia</i> spp. and clinical outcomes due to the paucity of data. <b>Methods:</b> A multi-center, descriptive, retrospective chart review of adult patients with <i>Providencia</i> spp. infections was conducted from 1 January 2020 to 31 May 2022. The primary outcome was to describe the drug resistance patterns of <i>Providencia</i> spp. isolates. This study's secondary outcome was to evaluate the clinical outcomes of patients with <i>Providencia</i> spp. infections. <b>Results:</b> Of the 312 patients screened, 244 were excluded primarily for polymicrobial infections. The mean age was 70 years, and 39 (56.5%) were males. Of the 68 included cases, 46 (67.6%) were <i>P. stuartii</i>, 20 (29.4%) were <i>P. rettgeri</i>, and 2 (2.9%) were <i>P. alcalifaciens</i>. The most common infections were bacteremia 38 (55.8%), followed by 27 (39.7%) urinary tract infections and 3 (4.4%) wound infections. In this study, 45 patients (65.2%) had urinary catheters. The primary antibiotics used for treatment consisted of ceftriaxone (25 (36.2%)), cefepime (20 (29%)), and meropenem (10 (14.5%)). Only 5 of 68 (7.2%) cases were multidrug- resistant and required meropenem. In total, 19 patients (27.1%) died during their admission, but none were related to Providencia infections. A total of 10 of the 68 patients (14.5%) were readmitted within 30 days for reasons unrelated to the progression or recurrence of Providencia infections. <b>Conclusions:</b><i>Providencia</i> bacteremia is predominantly seen in elderly patients. Third- generation cephalosporins remain an appropriate choice of antibiotics for <i>Providencia</i> spp. <i>Providencia stuartii</i> was the only species with multidrug resistance.