Bacteremia in the Gulf Cooperation Council Region: A Review of the Literature 2013–2023

Tariq Al-Musawi,1,2 Rawan Al-Agha,3 Safaa Al-Khiami,4 Hussain Al-Shamari,5 Malak Baghdadi,6 Mohammad Bosaeed,7– 9 Hamad Abdel Hadi,10,11 Ahmed Mady,12,13 Nisrine Sabra14 1Department of Critical Care Medicine, Dallah Hospital, Al-Khobar, Saudi Arabia; 2Department of Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Manama, Bahrain; 3Internal Medicine Department, Salmaniya Medical Complex-Governmental Hospitals, Manama, Kingdom of Bahrain; 4Infectious Disease Department, Ibrahim bin Hamad Obaidullah Hospital, Ras Al-Khaimah, United Arab Emirates; 5Microbiology Unit, Sabah Al-Ahmad Urology Center, Kuwait City, Kuwait; 6Medical Affairs, Pfizer, Jeddah, Saudi Arabia; 7Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; 8Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 9Department of Infectious Diseases Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 10Division of Infectious Diseases, Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar; 11College of Medicine, Qatar University, Doha, Qatar; 12Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia; 13Department of Anesthesiology and ICU, Tanta University Hospitals, Tanta, Egypt; 14Medical Affairs, Pfizer, Dubai Media City, Dubai, United Arab EmiratesCorrespondence: Tariq Al-Musawi, Dallah Hospital, Al-Khobar, Saudi Arabia, Email [email protected]: Bloodstream infections (BSIs) are amongst the leading healthcare-associated infections (HCAIs), and their comprehensive evaluation and management are of global and regional importance. This narrative review examines and reports data on BSIs from the Gulf Cooperation Council (GCC) region covering the period between 2013 and 2023. The reviewed literature demonstrated that BSIs were frequently associated with critical care settings such as the Intensive Care Unit (ICU) and were often associated with invasive lines and devices [such as central-line associated BSI (CLABSI)]. Fever was the main presenting symptom, while diabetes mellitus and hypertension were the common associated comorbidities. High mortality rates were reported for BSIs, particularly when caused by multidrug-resistant (MDR) Gram-negative pathogens. There was a wide range of antimicrobial resistance rates reported across the region; however, carbapenem-resistance rates exceeding 30% were reported for Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae. Few publications included molecular mechanisms of carbapenem resistance; however, when mechanisms were reported they were dominated by OXA-48. In conclusion, the lack of structured surveillance programs and networks to monitor microbiological phenotypic and genotypic patterns as well as clinical outcomes across the region means there is paucity of uniform data on BSIs across the GCC region. To bridge this gap, we recommend timely surveillance programs for the monitoring of resistance and outcomes.Keywords: bacteremia, bloodstream infection, Gulf, review, antimicrobial