A single-centre retrospective cohort examined 352 adults who developed a gram-negative bloodstream infection at least 48 hours after ICU admission between 2021 and 2025. Carbapenem resistance was present in 50.8% of isolates and colistin resistance in 33.8%, and 30-day mortality was 57.9%. Carbapenem resistance (OR 1.87), a catheter-related source (OR 3.39), older age and prior cerebrovascular event were independently associated with death, while appropriate empirical therapy was associated with lower odds (OR 0.40).
Why it is interesting: It puts a mortality figure on carbapenem resistance in critical care, where resistant gram-negative infection is the sharp end of the resistance burden.