Analysis of Infection Types, Pathogens, Antimicrobial Treatment, and Clinical Outcomes Data in Hospitalised Patients: Comprehensive Online Database for Antimicrobial Resistance (CODAR) Retrospective Pilot Study

BACKGROUND: Effective surveillance of prevalent infections, pathogen distribution, and treatment patterns help inform patient management and enhance outcomes. The Comprehensive Online Database for Antimicrobial Resistance (CODAR) pilot study aimed to provide insights into epidemiology, existing treatment strategies, and outcomes. METHODS: This surveillance study (February 2023-2024) across 21 hospitals in India, Mexico, Saudi Arabia, Spain, and the United Kingdom (UK) evaluated pathogen distribution, antimicrobial treatments, and survival rates in hospitalised patients using electronic health records and hospital reports. RESULTS: Among 8060 eligible patient records, 7434 (92.2%) with complete data were included in this analysis. Urinary tract infections (UTI), predominantly occurring in female patients (59.0%), were the most prevalent across countries (29.0%). Comorbidities such as vascular and metabolic and nutritional disorders were most commonly observed across countries included in this study. Meropenem and amoxicillin-clavulanate were most commonly used antimicrobials in India and the UK, respectively, across most infection types. Patients with skin and skin structure infections had the highest survival rates (94.4%) and shortest hospital stay (mean [standard deviation], 20.6 [33.53] days), whereas those with bloodstream infections (BSI, 81.7%), mixed infections (82.1%), and lower respiratory tract infections (LRTI, 83.3%) had relatively lower survival rates. Low proportion of patients alive (≤55.0%) with both monotherapy and combination therapy were observed with Acinetobacter baumannii (LRTI), Klebsiella pneumoniae (LRTI and BSI), and Escherichia coli (UTI) in India and Staphylococcus aureus (SSSI) and Enterococcus faecium (UTI) in the UK. CONCLUSION: Low survival rates associated with infections caused by specific pathogens highlight challenges in managing these infections, necessitating ongoing surveillance for effective infection control with suitable antimicrobial therapies to enhance patient care.