Infections in G6PD-Deficient Hospitalized Patients—Prevalence, Risk Factors, and Related Mortality

• Published in: Antibiotics (Basel) 2022-07, Vol.11 (7), p.934
• Main Authors: Alrahmany, Diaa, Omar, Ahmed F., Al-Maqbali, Salima R. S., Harb, Gehan, Ghazi, Islam M.
• Format: Article
• Language: English
• Subjects: Antibiotics; Antiinfectives and antibacterials; Antimicrobial agents; Bacteria; Bacterial diseases; Bacterial infections; Blood; Blood transfusion; Chronic illnesses; Comorbidity; Demographics; Enzymes; Fungal infections; G6PD deficiency; Genetic disorders; Glucosephosphate dehydrogenase; Gram-positive bacteria; Health risks; Health services; hospital-acquired infections; Hospitalization; Hospitals; Immune system; Infections; Infectious diseases; Intubation; Laboratories; Males; Medical records; Mortality; Multidrug resistance; Neutrophils; Nosocomial infections; Oxidative stress; Patients; Population studies; prevalence; Risk analysis; Risk factors; Severe acute respiratory syndrome coronavirus 2; Staphylococcus infections; Transfusion
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics11070934

G6PD deficiency is a genetic disease that weakens the immune system and renders affected individuals susceptible to infections. In the Sultanate of Oman resides a high number of recorded G6PD cases due to widespread consanguineous marriage, which may reach 25% of the population. We studied the infection patterns and risk factors for mortality to provide antimicrobial stewardship recommendations for these patients. After obtaining ethical approval, a registry of recorded cases was consulted retrospectively to include G6PD-deficient adult patients admitted to Suhar hospital over 5 years with microbiologically confirmed infections. Patient demographics, health-related information, infection causes, treatment, and clinical outcomes were studied. Data were analyzed to describe infection patterns and risk factors. Several variables, including underlying comorbidities and hospitalization details, such as length of stay, admission to critical care unit, blood transfusion, or exposure to an invasive procedure, were statistically associated with the acquisition of multidrug-resistant and hospital-acquired infections. Meanwhile, these infections were associated with a high mortality rate (28%), significantly associated with the patient’s health status and earlier exposure to antimicrobial treatment due to previous bacterial infection. The high prevalence of G6PD deficiency among the Omani population should alert practitioners to take early action when dealing with such cases during infection that requires hospitalization. Strict infection control measures, Gram-negative empiric coverage, hospital discharge as early as possible, and potent targeted antimicrobial therapy in this patient population can ameliorate the treatment outcomes and should be emphasized by the antimicrobial stewardship team.