{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:34:11Z","timestamp":1789605251523,"version":"build-2803163510"},"reference-count":48,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T00:00:00Z","timestamp":1669939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>This study evaluated the treatments, mortality rate and patient-related factors associated with mortality. This is a retrospective study involving hospitalised patients with infections caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) in a tertiary hospital in Malaysia from January 2018 to June 2020. A clinical pharmacist reviewed patients\u2019 electronic records and collected the data according to a pre-designed form. Data were analysed using both descriptive and inferential tests. The study included 145 patients with CR-GNB infections including 77, 40 and 28 Acinetobacter baumannii, enterobacteriaceae and Pseudomonas aeruginosa, respectively. The mean age was 57.9 \u00b1 15.8 years. Pneumonia (40.7%) and bacteremia (25.5%) were the most common infections. Meropenem (24.7%) and piperacillin-tazobactam (20.4%) were the most commonly used empiric antibiotics while colistin (63.3%) and amikacin (8.3%) were the most common definitive antibiotics. The mean duration before active antibiotics was 4.6 \u00b1 3.3 days. Overall, the in-hospital mortality rate was 41.4%. Multivariate logistic regression analysis showed that intensive care unit (ICU) admission (adjusted odds ratio (AOR): 5.201; 95% confidence interval (CI): 1.603\u201316.872; p = 0.006), sepsis\/septic shock (AOR: 3.430; 95% CI: 1.021\u201311.522; p = 0.049) and elevated serum creatinine (AOR: 2.752; 95% CI: 1.005\u20137.536; p = 0.049) were independently associated with mortality. The mortality rate among patients with CR-GNB infection is high. A high rate of inappropriate antibiotic use was observed, including combination antibiotic therapy and delays in starting active antibiotics. Mortality was significantly associated with ICU admission, sepsis\/septic shock and elevated serum creatinine.<\/jats:p>","DOI":"10.3390\/tropicalmed7120415","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T04:40:09Z","timestamp":1670215209000},"page":"415","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Treatments and Predictors of Mortality for Carbapenem-Resistant Gram-Negative Bacilli Infections in Malaysia: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7549-2877","authenticated-orcid":false,"given":"Usman","family":"Abubakar","sequence":"first","affiliation":[{"name":"Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town 11800, Penang, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amni Izzati","family":"Zulkarnain","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6732-9001","authenticated-orcid":false,"given":"Jes\u00fas","family":"Rodr\u00edguez-Ba\u00f1o","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen Macarena, Department of Medicine, Biomedicines Institute of Seville, University of Seville, 41009 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norhidayah","family":"Kamarudin","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Kulliyah of Medicine, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0026-5514","authenticated-orcid":false,"given":"Mahmoud E.","family":"Elrggal","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0873-6541","authenticated-orcid":false,"given":"Mohamed Hassan","family":"Elnaem","sequence":"additional","affiliation":[{"name":"Quality Use of Medicines Research Group, Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8476-7425","authenticated-orcid":false,"given":"Sabariah Noor","family":"Harun","sequence":"additional","affiliation":[{"name":"Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town 11800, Penang, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,2]]},"reference":[{"key":"ref_1","first-page":"345","article-title":"Treatment options for carbapenem-resistant gram-negative infections","volume":"115","author":"Fritzenwanker","year":"2018","journal-title":"Dtsch. \u00c4rzteblatt Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.3947\/ic.2014.46.3.149","article-title":"Therapy of infections due to carbapenem-resistant gram-negative pathogens","volume":"46","author":"Lee","year":"2014","journal-title":"Infect. 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