2045. Clinical and Economic Burden of Multi-drug Resistant Pseudomonas sp. (MDRP) Among Patients with Serious Infections in US Hospitals
Session: Poster Abstract Session: Antimicrobial Resistant Infections: Treatment
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • MDR Pseudomonas(AVY16084.3004).pdf (1.1 MB)
  • Background: To quantify the clinical and economic burden of multi-drug resistant Pseudomonas sp. (MDRP) among hospitalized adult patients with serious infections.

    Methods: Using a large hospital database, we identified admissions of adults (aged ≥18 y) between July 1, 2011 and September 30, 2014 with evidence of serious infection (eg, complicated intra-abdominal infections, hospital-acquired pneumonia, bloodstream infections). The date of the earliest positive culture for Gram-negative bacteria was deemed the “index date”, and attention was focused on patients with evidence of Pseudomonas sp. on this date. MDRP was defined as “nonsusceptible” Pseudomonas sp. to ≥3 antibiotic classes. We propensity matched MDRP patients to those with Pseudomonas sp. that were not designated MDRP (“non-MDRP”) and compared duration of antibiotic therapy, length of stay (LOS) (days), total costs to the hospital to render care and total in-hospital charges.

    Results: A total of 7217 patients met selection criteria, of whom 960 (13.3%) had MDRP. In propensity-matched analyses, MDRP patients averaged 1.0 more days of antibiotic therapy, 1.2 greater LOS days, $4,045 more in total in-hospital costs, and $7,395 more in total in-hospital charges (all P≤0.01). Antibiotics represented between 3% and 4% of total in-hospital costs; room and board, between 50% and 54% (Figure 1). Discharge status/destination differed significantly between the two groups (P for overall comparison <0.01; Figure 2).

    Conclusion: In a well-matched cohort, and relative to susceptible isolates, infections due to MDRP are associated with longer treatment duration, increased LOS, and higher total in-hospital costs and charges. Earlier identification of patients at risk of infection with MDRP may decrease the burden of serious infections due to Pseudomonas sp.

    Table. In-hospital outcomes and costs among propensity-matched patients with MDRP*

     

    MDRP

    (N=518)

    Non-MDRP

    (N=518)

     

    P-Value

    Therapy duration, d

    10.8 (9.6)

    9.8 (10.3)

    <0.01

    LOS, d

    11.5 (11.1)

    10.3 (11.2)

    <0.01

    Total cost, $

    27,966 (47,041)

    23,921 (33,520)

    0.01

    Total charges, $

    93,309 (116,003)

    85,914 (135,187)

    <0.01

    *Unless otherwise noted, values are mean (SD); P-values based on Wilcoxon signed-rank tests

    Thomas P. Lodise, PharmD, PhD1, Rosa Wang, MHA2, Tarun Bhagnani, MS2, Qi Zhao, MD, MPH3, Michael Ye, MS3 and Ariel Berger, MPH2, (1)Albany College of Pharmacy and Health Sciences, Albany, NY, (2)Evidera, Lexington, MA, (3)Allergan plc, Jersey City, NJ

    Disclosures:

    T. P. Lodise, Allergan, Inc: Consultant , Speaker's Bureau and Travel fees , Consulting fee , Speaker honorarium and Travel fees
    Merck: Consultant , Consulting fee
    The Medicines company: Consultant , Consulting fee

    R. Wang, Evidera: Employee , Salary

    T. Bhagnani, Evidera: Employee , Salary

    Q. Zhao, Allergan plc: Employee , Salary

    M. Ye, Allergan plc: Employee , Salary

    A. Berger, Evidera: 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.