Background: The use of carbapenems has become increasingly common and there is lack of information of their susceptibilities in long term acute care hospitals (LTACHs). The aim of this study is to analyze the trends in susceptibility of common bacteria including Acinetobacter baumannii (AB), Klebsiella pneumonia (KP) and Pseudomonas aeruginosa (PA) to carbapenems in three long term acute care hospitals in United States.
Methods: Minimum Inhibitory Concentrations (MICs) of carbapenems including imipenem to three MDROs including AB, KP, and PA was retrieved from the microbiology database of three LTACHs in United States from 2008 to 2014. Chi square test was used to calculate the p-value.
There was a decrease in susceptibility to imipenem at all the three LTACHs during the study period. The susceptibility of PA isolates to imipenem decreased from 71% in 2008 to 45% in 2014 (p<.001, O.R=2.94, 95% C.I 1.7, 5.1) at LTACH 1, changed from 40% in 2011 to 44% in 2014 at LTACH 2 and 30% in 2008 to 45% in 2014 at LTACH 3 (Figure 1). The susceptibility of KP isolates to imipenem changed from 56% in 2010 to 71% in 2014 at LTACH 1, decreased from 78% in 2009 to 58% in 2013 at LTACH 2 and 98% in 2008 to 57% in 2014 (p<.001, O.R=1.72, C.I 1.47, 2.01) at LTACH 3 (Figure 2). The susceptibility of AB isolates to imipenem were reportedly low during the study period at all the three LTACHs ranging from 0% to 34% (Figure 3).
Given the dwindling antimicrobial pipeline and slow pace of R & D to develop new drugs, it is pertinent to preserve the limited drugs available for treatment of MDROs. Implementation of antimicrobial stewardship programs at LTACHs and making antibiograms available to infection control personnel is warranted.
E. Goldstein, None
D. W. Hines, None
G. Glenn, None
T. Chopra, None
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