Epidemiology, clinical outcomes, and antimicrobial resistance of bloodstream infections: a 13-year nationwide multicenter study from the United Arab Emirates

Bloodstream infections (BSIs) remain a major cause of hospital admission and death worldwide. We describe the epidemiology, outcomes, and resistance patterns of BSIs across the United Arab Emirates over 13 years, filling a critical data gap in the Gulf region. We analyzed 50,457 unique BSI isolates collected between 2010 and 2022 from hospitals, centers, and clinics across all seven Emirates. We assessed pathogen distribution, acquisition source, AMR, multidrug resistance (MDR), and clinical outcomes. Multivariable logistic regression examined associations between pathogens and severe outcomes. We identified a dual burden of severe BSI concentrated at the extremes of age. Adults aged ≥ 55 years accounted for 39.7% of cases and had frequent hospital acquisition (52.4%) and the highest mortality (31.7%). Among children under 1 year old, we observed the highest ICU admission rate (43.6%), compared to 25.3% overall, and a high proportion of hospital-acquired infection (56.7%). Although overall BSI incidence remained stable, candidemia increased significantly over time, and Candida species showed the strongest association with ICU admission and death. Carbapenem resistance was high in Acinetobacter baumannii (54.2%) and Pseudomonas aeruginosa (27.8%), and present in 17.2% of K. pneumoniae . Third-generation cephalosporin resistance affected nearly half of E. coli (47.3%) and 41.2% of K. pneumoniae. MDR infection was associated with significantly longer hospital stay and was concentrated in hospital-acquired cases and critical care settings. We provide the first population-level epidemiological benchmark for BSI in the UAE. Despite relatively stable BSI incidence, the UAE faces a growing burden of candidemia and antimicrobial resistance, with severe outcomes concentrated among neonates and older adults.

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Journal
Antimicrobial Resistance and Infection Control
Published
2026-10-15
DOI
https://doi.org/10.1186/s13756-026-01830-8
Primary Topic
Antibiotic Use and Resistance
Type
article
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article

Epidemiology, clinical outcomes, and antimicrobial resistance of bloodstream infections: a 13-year nationwide multicenter study from the United Arab Emirates

Emmanuel Fru Nsutebu, Hafiz Ahmad, Hazim O. Khalifa, Seema Oommen et al.
Antimicrobial Resistance and Infection Control
Antibiotic Use and Resistance
article

Epidemiology, clinical outcomes, and antimicrobial resistance of bloodstream infections: a 13-year nationwide multicenter study from the United Arab Emirates

Emmanuel Fru Nsutebu, Hafiz Ahmad, Hazim O. Khalifa, Seema Oommen, Kavita Diddi, Maya Habous, Rajeshwari T. A. Patil, Fatima A. Al Dhaheri, John M. Stelling, Adam Clark, Saeed Hussein, Ghada Abdel Wahab, Jens Thomsen, Evelyn Kaambo, Adnan A. Alatoom, Arun Kumar Jha, Savitha Mudalagiriyappa, Pramod Rochaldas Chhabrani, Godfred Antony Menezes, Carole Ayoub Moubareck, Ahmed F. Yousef, Madikay Senghore, Najiba Mohamed Abdulrazzaq, Fouzia Jabeen, Simantini Jog, Sameh S. M. Soliman, Mubarak Saif Alfaresi, Farah Al‐Marzooq, Hari Pankaj Vanam, Duckjin Hong, Wei Chen, Laila Al Dabal, Farida Ismail Al Hosani, Anju Nabi, Timothy A. Collyns, Somansu Basu, Nehad Shirawi, Robert Lodu Serafino Wani Swaka, Ayesha Abdulla Al Marzooqi, Dean B Everett, Dean Everett, Faisal Al Ahbabi, Ratna A. Kurahatti, Ahmed Shibl, Francis Amirtharaj Selvaraj, Shaikha Ghannam Alkaabi, Anup Shashikant Poddar, Deeba Jafri, Nesrin Helmy Mahmoud Ismail, Ahmed Elhag Ahmed, Syed Irfan Hussein Rizvi, Imene Lazreg, Hala Ahmed Fouad Ismail, Stefan Weber, Yassir Mohammed Eltahir Ali, Krishnaprasad Ramabhadran, Hadayatullah Ghulam Muhammad, Zahir Osman Babiker, Kaltham Ali Kayaf, Ibrahim Alsayed Mustafa Alhashmi, Husein Alzabi, Mushtaq Khan, Godfred A. Menezes, Ahmed Abdulkareem Al Hammadi, Siobhan O‘Sullivan, Gitanjali Avishkar Patil, Abiola Senok, Ghalia Abdul Khader Khoder, Alaa MM Enshasy, Peter Nyasulu, Irfaan Akthar, Manal Abdel Fattah Ahmed, Amna AlBlooshi
article en

Abstract

Bloodstream infections (BSIs) remain a major cause of hospital admission and death worldwide. We describe the epidemiology, outcomes, and resistance patterns of BSIs across the United Arab Emirates over 13 years, filling a critical data gap in the Gulf region. We analyzed 50,457 unique BSI isolates collected between 2010 and 2022 from hospitals, centers, and clinics across all seven Emirates. We assessed pathogen distribution, acquisition source, AMR, multidrug resistance (MDR), and clinical outcomes. Multivariable logistic regression examined associations between pathogens and severe outcomes. We identified a dual burden of severe BSI concentrated at the extremes of age. Adults aged ≥ 55 years accounted for 39.7% of cases and had frequent hospital acquisition (52.4%) and the highest mortality (31.7%). Among children under 1 year old, we observed the highest ICU admission rate (43.6%), compared to 25.3% overall, and a high proportion of hospital-acquired infection (56.7%). Although overall BSI incidence remained stable, candidemia increased significantly over time, and Candida species showed the strongest association with ICU admission and death. Carbapenem resistance was high in Acinetobacter baumannii (54.2%) and Pseudomonas aeruginosa (27.8%), and present in 17.2% of K. pneumoniae . Third-generation cephalosporin resistance affected nearly half of E. coli (47.3%) and 41.2% of K. pneumoniae. MDR infection was associated with significantly longer hospital stay and was concentrated in hospital-acquired cases and critical care settings. We provide the first population-level epidemiological benchmark for BSI in the UAE. Despite relatively stable BSI incidence, the UAE faces a growing burden of candidemia and antimicrobial resistance, with severe outcomes concentrated among neonates and older adults.

Antimicrobial Resistance and Infection Control
New York University Abu Dhabi (AE), Brigham and Women's Hospital (US), Dubai Health Authority (AE), Kafrelsheikh University (EG), Khalifa University of Science and Technology (AE), United Arab Emirates University (AE), Stellenbosch University (ZA), Oasis Hospital (AE), Trinity School of Medicine (VC), Rashid Hospital (AE), Emirates Foundation (AE), Shaikh Khalifa Medical City (AE), Dubai Hospital (AE), University of Sharjah (AE), Ittihad University (AE), Tawam Hospital (AE), Al Ain Hospital (AE), Sheikh Shakhbout Medical City (AE), Abu Dhabi Health Services (AE), Mohammed Bin Rashid University of Medicine and Health Sciences (AE), Danat Al Emarat Women & Children’s Hospital (AE), Laboratoire National de Référence (MA), Mediclinic City Hospital (AE), Ministry of Health (AE), American University of Ras Al Khaimah (AE), Abu Dhabi Agriculture and Food Safety Authority (AE), Cardiff University (GB), Ras al-Khaimah Medical and Health Sciences University (AE), Zayed University (AE), Abu Dhabi National Oil (United Arab Emirates) (AE)
Good health and well-being
Openalex Percentile: Top 11%
Antibiotic Use and Resistance
DOIOpen Access PDFOpenAlex
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