262. Evaluation of Clinically Important Gram-negative and Gram-positive Isolates in Alabama: Electronically Captured 2007-2010 State-Wide Antibiogram
Session: Poster Abstract Session: Antimicrobial Susceptibility and Resistance
Friday, October 21, 2011
Room: Poster Hall B1
Background:  Regional differences in multi-drug resistant organisms (MDRO) have been noted in the literature.  We report on trends in gram-positive and gram-negative MDROs from state-wide antibiogram data in the state of Alabama for admission and hospital-associated time period for urine and non-urine non-duplicate isolates.

Methods: Using electronically available microbiology results and census data from hospitals in Alabama for calendar years 2007-2010 (MedMined™ Services, CareFusion) we evaluated for trends in resistance (R) for non-duplicate urine and non-urine isolates during the admission [AD] and hospital-associated [HA] time period for: S. aureus (n=194,736)resistant to oxacillin (MRSA), E. faecium (n=7,053) R to vancomycin, K. pneumoniae (n=38,270) R to ceftriaxone, E. coli (n=160,775) R to quinolone, P. aeruginosa (n=39,922) R to carbapenem and pip/tazo.  Non duplicate isolates were defined as first isolate for a species per patient per 30 days.

Results: MRSA was fairly stable and higher (2010) for urine HA (70%) than urine AD (55%) and similar for non-urine HA (63%) and non-urine AD (62%). For gram-negative pathogens, resistance was stable but higher (2010) for urine HA and non-urine HA vs. AD urine and non-urine isolates for K. pneumoniae R to ceftriaxone (12% and 15% vs. 5% and 7%), E. coli R to quinolone (45% and 44% vs. 26% and 33%), P. aeruginoa R to carbapenem (25% and 26% vs. 12% and 11%), P. aeruginosa R to pip/tazo (14% and 16% vs. 10% and 9%).  Most notably, E. faecium R to vancomycin increased across all categories from 2007-2010; urine AD (49% to 63%), non-urine AD (52% to 62%), urine HA (74% to 81%) and non-urine HA (71% to 82%). 

Conclusion: In the state of Alabama, differences in gram-negative and gram positive resistance is stable but higher for HA urine and non-urine non-duplicate isolates.  Increases are seen in E. faecium R to vancomycin across HA and AD categories evaluated.  Such state-wide antibiogram data may be helpful in managing local antimicrobial stewardship efforts.


Subject Category: A. Antimicrobial agents and Resistance

Andrew Madon, Pharm D1, Vikas Gupta, Pharm.D., BCPS1, Olivia Peeden, MPH1, Hollace Whitlock, MPH1, Phillip Francis, MD, MS1 and RS Johannes, MD, MS2, (1)CareFusion, MedMined Services, Birmingham, AL, (2)MedMined Services, Clinical Research, CareFusion and Harvard Medical School, Marlborough, MA

Disclosures:

A. Madon, None

V. Gupta, None

O. Peeden, None

H. Whitlock, None

P. Francis, CareFusion: Employee, Salary

R. Johannes, CareFusion: Employee, Salary

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