Lama Hefni

King Faisal Specialist Hospital & Research Centre

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Abeer N. Alshukairi

Alfaisal University

Mohammed F. Saeedi

King Faisal Specialist Hospital & Research Centre

Basem Alraddadi

King Faisal Specialist Hospital & Research Centre

Ashraf Dada

King Faisal Specialist Hospital & Research Centre

Mohammed Qutub

King Faisal Specialist Hospital & Research Centre

Mohammad K. Al Hroub

King Faisal Specialist Hospital & Research Centre

Ayman Kharaba

King Fahad Hospital Jeddah

Yaseen M. Arabi

National Guard Health Affairs

Imran Khalid

King Faisal Specialist Hospital & Research Centre

Ghadeer E. Albishi

King Faisal Specialist Hospital & Research Centre

Cooperative Institutions

King Faisal Specialist Hospital & Research Centre

King Saud bin Abdulaziz University for Health Sciences

King Abdulaziz Medical City

King Abdullah International Medical Research Center

National Guard Health Affairs

King Abdulaziz University

Chinese Academy of Medical Sciences & Peking Union Medical College

Alfaisal University

National University Health System

Peking University

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Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings

Critical Care (2024)

Andrew Li Lowell Ling Hanyu Qin Yaseen M. Arabi Sheila Nainan Myatra

Abstract Background There is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions. Methods This was a secondary analysis of the MOSAICS II study, an international prospective observational study on sepsis epidemiology in Asian ICUs. Associations between qSOFA at ICU admission and mortality were separately assessed in LLMIC, UMIC and HIC countries/regions. Modified Poisson regression was used to determine the adjusted relative risk (RR) of qSOFA score on mortality at 28 days with adjustments for confounders identified in the MOSAICS II study. Results Among the MOSAICS II study cohort of 4980 patients, 4826 patients from 343 ICUs and 22 countries were included in this secondary analysis. Higher qSOFA was associated with increasing 28-day mortality, but this was only observed in LLMIC ( p < 0.001) and UMIC ( p < 0.001) and not HIC ( p = 0.220) countries/regions. Similarly, higher 90-day mortality was associated with increased qSOFA in LLMIC ( p < 0.001) and UMIC ( p < 0.001) only. In contrast, higher 3-day mortality with increasing qSOFA score was observed across all income countries/regions ( p < 0.001). Multivariate analysis showed that qSOFA remained associated with 28-day mortality (adjusted RR 1.09 (1.00–1.18), p = 0.038) even after adjustments for covariates including APACHE II, SOFA, income country/region and administration of antibiotics within 3 h. Conclusions qSOFA was independently associated with 28-day mortality in ICU patients admitted for sepsis. In LLMIC and UMIC countries/regions, qSOFA was associated with early to late mortality but only early mortality in HIC countries/regions. Graphical Abstract

10.1186/s13054-024-04804-7

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Molecular epidemiology and outcome of carbapenem-resistant Enterobacterales in Saudi Arabia

BMC Infectious Diseases (2022)

Basem Alraddadi Emily Heaphy Yamama Aljishi Waleed Ahmed Khalid Eljaaly

Abstract Background The burden of carbapenem resistance is not well studied in the Middle East. We aimed to describe the molecular epidemiology and outcome of carbapenem-resistant Enterobacterales (CRE) infections from several Saudi Arabian Centers. Methods This is a multicenter prospective cohort study conducted over a 28-month period. Patients older than 14 years of age with a positive CRE Escherichia coli or Klebsiella pneumoniae culture and a clinically established infection were included in this study. Univariate and multivariable logistic models were constructed to assess the relationship between the outcome of 30-day all-cause mortality and possible continuous and categorical predictor variables. Results A total of 189 patients were included. The median patient age was 62.8 years and 54.0% were male. The most common CRE infections were nosocomial pneumonia (23.8%) and complicated urinary tract infection (23.8%) and 77 patients (40.7%) had CRE bacteremia. OXA-48 was the most prevalent gene (69.3%). While 100 patients (52.9%) had a clinical cure, 57 patients (30.2%) had died within 30 days and 23 patients (12.2%) relapsed. Univariate analysis to predict 30-day mortality revealed that the following variables are associated with mortality: older age, high Charlson comorbidity index, increased Pitt bacteremia score, nosocomial pneumonia, CRE bacteremia and diabetes mellitus. In multivariable analysis, CRE bacteremia remained as an independent predictor of 30 day all-cause mortality [AOR and 95% CI = 2.81(1.26–6.24), p = 0.01]. Conclusions These data highlight the molecular epidemiology and outcomes of CRE infection in Saudi Arabia and will inform future studies to address preventive and management interventions.

Bacteremia

Univariate analysis

Carbapenem

10.1186/s12879-022-07507-y

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De-isolation of vaccinated COVID-19 health care workers using rapid antigen detection test

Journal of Infection and Public Health (2022)

Abeer N. Alshukairi Awad Al‐Omari Mohammad K. Al Hroub Jaffar A. Al‐Tawfiq Mohammed Qutub

COVID-19 de-isolation guidelines of health care workers (HCW) were formulated based on evidence describing the duration of infectious viral shedding of the wild SARS-CoV-2 virus. During the periods of COVID-19 vaccination and variants, a test-based approach was recommended to end isolation of HCW, based on emerging data describing the viral kinetics of COVID-19 variants. While Rapid antigen detection tests (RADT) are increasingly used in the diagnosis of COVID-19, their use is limited in de-isolation.We described the use of RADT in the de-isolation of COVID-19 vaccinated HCW with mild infection who were asymptomatic on day 7 post diagnosis in a single center retrospective cohort study during the Omicron surge.Of the 480 HCWs, 173 (36%) had positive RADT. The positivity rate of RADT was not different in HCW who received two doses versus three doses of vaccine (34.4% versus 40.3%, p = 0.239).A symptom based, test-based approach using RADT is a useful tool in the de-isolation of HCW, with mild disease, in the era of Omicron. Further studies are required to evaluate the role of RADT in de-isolation of patients with severe COVID-19 disease.

Isolation

Virus isolation

10.1016/j.jiph.2022.06.020

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Statistical analysis plan for the replacing protein via enteral nutrition in a stepwise approach in critically ill patients (REPLENISH) randomized clinical trial

Trials (2024)

Yaseen M. Arabi Hasan M. Al‐Dorzi Omar Aldibaasi Musharaf Sadat Jesna Jose

The optimal amount and timing of protein intake in critically ill patients are unknown. REPLENISH (Replacing Protein via Enteral Nutrition in a Stepwise Approach in Critically Ill Patients) trial evaluates whether supplemental enteral protein added to standard enteral nutrition to achieve a high amount of enteral protein given from ICU day five until ICU discharge or ICU day 90 as compared to no supplemental enteral protein to achieve a moderate amount of enteral protein would reduce all-cause 90-day mortality in adult critically ill mechanically ventilated patients.

Enteral administration

10.1186/s13063-024-08105-w

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SARS-COV-2 Triggers the Development of Class I and Class II HLA Antibodies in Recovered Convalescent Plasma Donors

Intervirology (2022)

Ashraf Dada Khalid Elhassan Rayan Bawayan Ghadeer E. Albishi Lama Hefni

Various studies have shown that SARS-CoV-2 is a highly immunogenic virus. It is known that different types of immunogenic viral pathogens could trigger the formation of HLA antibodies. Therefore, there is a concern that the SARS-CoV-2 could also induce the development of HLA antibodies in volunteers, who donate convalescent plasma after their recovery from COVID-19. HLA antibodies have been identified as the main cause for transfusion-related acute lung injury (TRALI), a well-documented life-threatening complication of transfusions. The TRALI risk could be high in COVID-19 patients who need convalescent plasma, as such patients usually have already an impaired respiratory system affected by the SARS-CoV-2 infection. In this study, we screened 34 convalescent plasma donors on the presence of antibodies against HLA class I and II antigens. All included donors have no any history of sensitization events such as blood transfusions, pregnancy, or previous transplants. We found a high rate of HLA antibody formation in convalescent plasma donors. The frequency of positivity for HLA antibodies for class I, class II, class I and II, and the overall reactivity was 23%, 31%, 46%, and 76%, respectively. The presented data suggest a closed correlation between SARS-CoV-2 virus infection and the development of HLA antibodies in recovered convalescent plasma donors. This finding might have the potential to reduce the risk of TRALI and mortality rate in COVID-19 patients by implementing HLA diagnostic strategies before the administration of convalescent plasma.

Convalescent plasma

10.1159/000524016

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Citations (1)

Test-based De-isolation in COVID-19 Immunocompromised patients: Ct value versus SARS-CoV-2 viral cultures

Author eBooks (2021)

Abeer N. Alshukairi Ahmed M. Tolah Ashraf Dada Jaffar A. Al‐Tawfiq Reem S. Almagharbi

2019-20 coronavirus outbreak

Isolation

Pandemic

Sars virus

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Outcome of COVID19 in Patients With Osteogenesis Imperfecta: A Retrospective Multicenter Study in Saudi Arabia

Frontiers in Endocrinology (2022)

Abeer N. Alshukairi Hazem Doar Afaf Alsagheir Mona Bahasan Anas A. Sultan

Background Although genetic diseases are rare, children with such conditions who get infected with COVID-19 tend to have a severe illness requiring hospitalization. Osteogenesis imperfecta (OI) is a rare genetic disorder of collagen resulting in fractures and skeletal deformities. Kyphoscoliosis, restrictive lung disease, and pneumonia worsen the prognosis of patients with OI. The use of bisphosphonate improves bone mineral density (BMD) and reduces fractures in OI. There is no literature describing the impact of COVID-19 in patients with OI. Methodology A retrospective multi-center study was performed in three hospitals in Jeddah and Riyadh, Saudi Arabia, from March 1st, 2020, until August 31st, 2021, aiming to evaluate the outcome of COVID-19 in patients with OI. Demographics, vaccination status, underlying kyphoscoliosis, functional status, use of bisphosphonate, BMD, and COVID-19 severity, and course were recorded for all patients. Results Twelve cases of confirmed COVID-19 were identified among 146 patients with OI. 9 (75%) of patients were less than 18 years, 6 (50%) were male, 5 (41%) had kyphoscoliosis, and 5 (41%) were wheelchair-bound. 6 (50%) received bisphosphonate, and 7(58%) had normal BMD. All patients had mild disease and did not require hospitalization. None of OI the patients with COVID-19 were fully vaccinated before the infection, and some were ineligible for vaccination. Conclusion Patients with OI and COVID-19 in our study recovered without complications, unlike patients with other genetic diseases. Young age and mild illness contributed to the favorable outcome. Half of the patients received bisphosphonate and had normal BMD.

Kyphoscoliosis

10.3389/fendo.2021.800376

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Citations (4)

Limitation of life-sustaining treatments in Asian ICUs: theory versus practice

Critical Care (2025)

Lowell Ling Andrew Li Jason Phua Uzzal Kumar Mallick Motiul Islam

10.1186/s13054-024-05241-2

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Association Between Carbapenem-Resistant Enterobacterales (CRE) Colonization Status at Time of Hospital Admission and the Subsequent Development of CRE Infection and Mortality in High-Risk Patients

Infection and Drug Resistance (2024)

Basem Alraddadi Emily Heaphy Manar Alzahrani Mohammad Alqadi Moayad Sami Qashqari

The study aimed to determine the impact of Carbapenem-resistant Enterobacterales (CRE) colonization status on development of CRE infection and 30-day mortality outcomes in high-risk patients.

Carbapenem-resistant enterobacteriaceae

10.2147/idr.s479487

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Test-based de-isolation in COVID-19 immunocompromised patients: Cycle threshold value versus SARS-CoV-2 viral culture

International Journal of Infectious Diseases (2021)

Abeer N. Alshukairi Ahmed M. Tolah Ashraf Dada Jaffar A. Al‐Tawfiq Reem S. Almagharbi

2019-20 coronavirus outbreak

Isolation

Viral culture

10.1016/j.ijid.2021.05.027

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Citations (10)