279. Surveillance of Antimicrobial Resistance in Bacteria Associated with Central Line-Associated Bloodstream Infections, as Reported by California Hospitals from 2011-2014
Session: Poster Abstract Session: HAI: Device Associated Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Rizzo_AR-CLABSI_IDWEEK2015.pdf (688.0 kB)
  • Background:

    Approximately 400 California hospitals report healthcare-associated infection data to the California Department of Public Health via the National Healthcare Safety Network. When reporting central line-associated bloodstream infections (CLABSIs), hospitals are required to indicate the associated pathogen(s) and select antimicrobial susceptibility test results.   

    Methods:

    CLABSI pathogens reported by California hospitals during the reporting years of 2011-2014 were analyzed. Annual and 4-year, pooled non-susceptibility percentages were calculated for select bacterial species with clinically relevant antimicrobial resistance potential. Four-year trends were assessed with log binomial regression. All analyses were completed with SAS, version 9.3.

    Results:

    The pooled non-susceptibility percentage to oxacillin/methicillin among S. aureus isolates was 44.9% (95% CI: 42.4%, 47.4%); four-year trend analyses revealed a decrease (-9.4%, 95% CI:  -15.4%, -2.9%) in non-susceptibility to oxacillin/methicillin over this period. The pooled non-susceptibility percentage of Klebsiella pneumoniae/oxytoca isolates to carbapenems was 14.3% (95% CI: 11.8%, 16.9%), with an increase in non-susceptibility to carbapenems over this time period (13.3%, 95% CI: -2.9%, 32.2%). The pooled non-susceptibility percentage for E. coli isolates to a combination of at least 3 antimicrobial agents from 5 classes (cephalosporins, fluoroquinolones, aminoglycosides, carbapenems, piperacillin/tazobactam) was 18.8% (95% CI: 16.3%, 21.4%), with an increasing trend (12.9%, 95% CI: -0.2%, 27.9%) of non-susceptibility over this period.

    Conclusion:

    A significant decrease in oxacillin/methicillin non-susceptible S. aureus isolates was observed during 2011-2014. Although not statistically significant, increases in non-susceptible Klebsiella spp. isolates and E. coli isolates were also observed during this period. Monitoring antimicrobial susceptibility trends among pathogens associated with CLABSIs provides a surrogate measure of antimicrobial resistance in California hospitals. These data can be used to inform state-wide prevention efforts targeting antimicrobial use and resistance.

    Kyle Rizzo, MPH, California Epidemiologic Investigation Service (Cal-EIS), Healthcare-Associated Infections Program, Center for Healthcare Quality, California Department of Public Health, Richmond, CA and Erin Epson, MD, Healthcare-Associated Infections Program, California Department of Public Health, Richmond, CA

    Disclosures:

    K. Rizzo, None

    E. Epson, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.