Carbapenem-resistant Providencia spp.: the threat at the door.

BACKGROUND

Providencia species are emerging opportunistic pathogens associated with nosocomial infections, particularly in immunocompromised patients and those with prolonged hospital stays. The increasing prevalence of carbapenem-resistant Providencia spp. poses a significant therapeutic challenge due to limited treatment options.

AIM: To evaluate the clinical characteristics, risk factors, and outcomes of patients with carbapenem-resistant and carbapenem-susceptible Providencia spp.

METHODS

A retrospective, observational study was conducted, including hospitalized patients with Providencia spp. isolates between January 1st, 2020 and January 1st, 2024. Patients were stratified based on carbapenem susceptibility. Clinical data, risk factors, and mortality rates were compared between carbapenem-resistant and carbapenem-susceptible cases. Statistical analyses were performed to identify independent risk factors for carbapenem resistance.

FINDINGS: Among 118 Providencia-associated infections, 53 (44.9%) were carbapenem-resistant. Providencia rettgeri was the predominant species (67.8%), with a significantly higher carbapenem resistance rate than P. stuartii (P = 0.003). Carbapenem-resistant infections were most commonly urinary tract infections (58.5%), while carbapenem-susceptible infections were more frequently associated with skin and soft tissue infections (40.0%) (P < 0.001). Carbapenem-resistant cases exhibited longer hospital stays, increased ICU admissions, and higher mortality rates (P < 0.05). Risk factors for carbapenem resistance included prior ICU admission, mechanical ventilation, urinary catheterization, and prior carbapenem use.

CONCLUSION

Carbapenem-resistant Providencia infections are associated with increased morbidity and mortality. Given the limited therapeutic options, infection control measures and antimicrobial stewardship programmes should be strengthened. Further large-scale studies are needed to characterize resistance mechanisms and optimal treatment strategies.