369. National Prevalence of Extended Spectrum Beta-lactamase Producing Enterobacteriaceae (ESBL) in the Ambulatory and Acute Care Settings in the United States in 2015
Session: Poster Abstract Session: HAI: Multi Drug Resistant Gram Negatives
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Tetraphase ESBL 369 10-21-16.pdf (211.4 kB)
  • Background: In 2013 the CDC classified infections caused by ESBL organisms as a serious threat. The purpose of this study was to estimate the national prevalence of ESBL events in outpatient and hospitalized patients based on the incidence of ESBL episodes in the Becton Dickinson research database.

    Methods: Susceptibility data from non-duplicate organisms including E. coli, K. pneumoniae, and P. mirabilis were collected from 346 hospitals. ESBL was identified per NHSN definitions. Organisms were classified into ambulatory, admission, and hospital-onset (HO) 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 820,017 isolates tested, 56,718 were ESBL and the national projected ESBL events were 517,384 (see Table). The ESBL rates were highest in the HO period, followed by admission and ambulatory. Approximately 66% of all ESBL events occurred in the ambulatory settings. National Projections for ESBLs for each region were: ambulatory (4.7, 6.3, 6.3 & 5.6%), admission (8.6, 10.7, 9.0 & 8.9%) and HO periods (11.3, 16.6, 13.2 & 13.4%) for the Midwest, Northeast (NE), South and West regions, respectively.

    Observed Events (346 hospitals)

    National Projection

    Period Tested

    Isolates tested

    Confirmed ESBL

    % ESBL

    Isolates tested

    ESBL Events

    % ESBL

    Ambulatory

    631,846

    36,086

    5.7

    6,058,591

    341,955

    5.6

    Admission

    105,846

    9,693

    9.2

    907,674

    82,717

    9.1

    HO

    82,325

    10,939

    13.3

    697,570

    92,712

    13.3

    Total

    820,017

    56,718

    6.9

    7,663,836

    517,384

    6.8

    Regions

    Midwest

    222,311

    12,161

    5.5

    2,401,980

    137,340

    5.7

    NE

    125,175

    9,727

    7.8

    1,208,894

    95,351

    7.9

    South

    344,377

    26,047

    7.6

    2,689,175

    195,007

    7.3

    West

    128,154

    8,783

    6.9

    1,363,786

    89,686

    6.6

    Total

    820,017

    56,718

    6.9

    7,663,836

    517,384

    6.8

    Conclusion: These data estimate that national hospital onset ESBL rates in 2015 were higher than previously reported. Although the highest prevalence of ESBL events occurred in the HO period, ESBL events were highest in frequency in the ambulatory period. The highest rates of ESBL infections were in the NE and South regions among all periods tested.

    Holly Hoffman-Roberts, PharmD1, Katherine Luepke, PharmD1, Ying P. Tabak, PhD2, John Mohr, PharmD1, Richard S 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

    K. Luepke, Tetraphase Pharmaceuticals: Employee , Salary

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

    J. Mohr, Tetraphase Pharmaceuticals: Employee , Salary

    R. S. 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.