Program Schedule

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Multidrug-Resistant Organisms in Community Hospitals: Initial Trends from the DICON MDRO Biorepository

Session: Poster Abstract Session: Multidrug-resistant Organisms: Epidemiology and Prevention
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • MDRO Bio_Poster_SW_9 30 14 dja final.pdf (178.5 kB)
  • Background: Although the majority of Americans receive their healthcare in community hospitals, almost nothing is known about Multidrug-resistant organisms (MDRO) in that setting. 

    Methods: The DICON MDRO Biorepository is an ongoing resource that prospectively collects clinically well-characterized samples from MDRO-infected patients hospitalized in community hospitals.  For this cohort analysis, we analyzed the first 100 subjects enrolled.  Data collected at enrollment included demographic information, previous medical history, social history, culture data, as well as a 90 day follow-up from the time of hospital discharge.  Patients under the age of 18 and outpatients were excluded.  Data points were collected at the bedside and through a detailed review of each subject’s electronic medical record. Standard descriptive statistics were used.

    Results: The average patient age was 61.7 (± 17.7); 49 (49%) were women.  Seven patients were concurrently infected with more than one MDRO.  The three most common MDROs were C. difficile (n=41, 38%), MRSA (n=41, 38%), and E. coli (n=14, 13%).  Multidrug resistant aerobic bacteria caused similar numbers of soft tissue (n=20, 17%), bloodstream (n=19, 17%) and urinary tract infections (n=18, 16%). Co-morbidities such as diabetes (n=43, 43%), current and previous tobacco use (n=65, 65%), and BMI >30 (n=35, 35%) were common.  61 (61%) patients were categorized as having community-onset, community-associated infections; 28 (28%) were classified as hospital-acquired; and 11 (11%) were community-onset, healthcare-associated.  30 (30%) of patients required assistance with more than one ADL upon admission.  5 (5%) patients died and 10 (10%) required admission to the ICU due to infection.  The average length of hospitalization was 18 days.  For the 66 MDRO-infected patients with complete 90-day follow-up data, 22 (33%) were readmitted to the hospital; 17 (77%) re-admissions were infection related. 

    Conclusion: Similar to tertiary care centers, C. difficile and MRSA were the most common cause of MDRO infections in community hospitals.  Over 75% of patients had community-onset infection.  Consequences of MDRO infections in community hospitals such as death and readmission were both severe and frequent.

    Shera Watson, MPH1,2, Vance Fowler Jr, MD3, Daniel J. Sexton, MD, FIDSA1,2 and Deverick Anderson, MD, MPH1,2, (1)Division of Infectious Diseases, Duke University Medical Center, Durham, NC, (2)Duke Infection Control Outreach Network, Durham, NC, (3)Duke University Medical Center, Durham, NC

    Disclosures:

    S. Watson, None

    V. Fowler Jr, None

    D. J. Sexton, UpToDate: Editor, Royalties
    National Football League: Consultant, Consulting fee and Educational grant
    Cubist: Grant Investigator, Grant recipient
    Johnson and Johnson: Consultant, Consulting fee

    D. Anderson, None

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