1488. National Prevalence of Multidrug-Resistant Acinetobacter baumannii (MDR AB) infections in the Ambulatory and Acute Care Settings, Including Carbapenem-Resistant Acinetobacter Infections, in the United States in 2015
Session: Poster Abstract Session: HAI: Surveillance and Public Reporting
Friday, October 28, 2016
Room: Poster Hall
Posters
  • MDR-AB 58422 v2 10-24-16.pdf (440.7 kB)
  • Background: In 2013 the CDC classified MDR AB infections as a serious threat. The purpose of this study was to estimate the national prevalence of MDR AB events in the acute care and ambulatory settings based on a large database from Becton Dickinson & Company.

    Methods: Susceptibility data from non-duplicate isolates was collected from 346 hospitals nationwide and identified as MDR per NHSN definitions. Organisms were classified into ambulatory, admission, and hospital-onset periods based on collection time. All data were consolidated into CMS National Hospital Data Provider IDs. The raking method was applied per CMS national hospital distribution by location, teaching status, urban/rural status, and bed size to project the national prevalence estimates.

    Results: Of 5,582 isolates tested, 2,124 were MDR AB. The national projected MDR AB events were 18,109 (see Table). The MDR AB rates were highest in the hospital onset period, followed by admission and ambulatory. Eighty percent of MDR AB isolates were also carbapenem resistant. National Projections for MDR AB for each region were: ambulatory (26.5, 21.5, 26.6, & 8.7%), admission (51.2, 45.7, 31.8 & 43.1%) and hospital-onset (63.4, 64.2, 47.4 & 45.7%) for the Midwest, Northeast (NE), South & West regions, respectively.

    Observed Events (346 hospitals)

    National Projection

    Period Tested

    Isolates tested

    Confirmed MDR AB

    % MDR AB

    Isolates tested

    MDR AB Events

    % MDR AB

    Ambulatory

    2,461

    614

    24.9

    20,416

    4,865

    23.8

    Admission

    1,168

    484

    41.4

    9,769

    4,179

    42.8

    Hospital-onset

    1,953

    1,026

    52.5

    16,113

    9,065

    56.2

    Total

    5,582

    2,124

    38.1

    46,318

    18,109

    39.1

    Regions

    Midwest

    1,438

    648

    45.1

    15,597

    7,044

    45.2

    NE

    940

    406

    43.2

    8,553

    3,710

    43.4

    South

    2,664

    882

    33.1

    17,314

    5,956

    34.4

    West

    540

    188

    34.8

    4,854

    1,399

    28.8

    Total

    5,582

    2,124

    38.1

    46,318

    18,109

    39.1

    Conclusion: These data estimate that national hospital onset MDR AB rates in 2015 were higher than previously reported estimates. The highest rates of MDR AB events occur in the hospital-onset period, however 27% of MDR AB events occur in the ambulatory period. The highest rates of MDR AB events were in the hospital-onset period in the Midwest and NE regions.

    Holly Hoffman-Roberts, PharmD1, Patrick Scoble, PharmD1, Ying P. Tabak, PhD2, John Mohr, PharmD1, RS Johannes, MD, MS2,3 and Vikas Gupta, Pharm.D., BCPS2, (1)Former Employee Tetraphase Pharmaceuticals, Watertown, MA, (2)Becton, Dickinson and Company, Franklin Lakes, NJ, (3)Harvard Medical School, Boston, MA

    Disclosures:

    H. Hoffman-Roberts, Tetraphase Pharmaceuticals: Employee , Salary

    P. Scoble, Tetraphase Pharmaceuticals: Employee , Salary

    Y. P. Tabak, Becton Dickinson: Employee , Salary

    J. Mohr, Tetraphase Pharmaceuticals: Employee , Salary

    R. Johannes, Becton Dickinson: Employee , Salary

    V. Gupta, Becton Dickinson: Employee , Salary

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.