352. National Prevalence of Carbapenem-Resistant Enterobacteriaceae (CRE) 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 CRE 352 10-21-16.pdf (208.4 kB)
  • Background: In 2013 the CDC classified infections caused by CRE organisms as an urgent threat. The purpose of this study was to estimate the national prevalence of CRE events in the acute care and ambulatory settings based on a large database from Becton Dickinson & Company.

    Methods: Susceptibility data from non-duplicate E. coli, K. pneumoniae, and P. mirabilis from all sources were identified from 346 hospitals nationwide. Organisms were classified into ambulatory, admission, and hospital-onset periods based on collection time. CRE isolates were identified per NHSN definitions. 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, 5,743 were CRE and the national projected CRE events were 56,464 (see Table). The CRE rates were highest in the hospital onset period, followed by admission and ambulatory. Approximately 75% of all CRE events occurred in the ambulatory or admission settings. Overall CRE rates between the regions ranged from 0.6 to 0.9%, but there was more variability between the regions with admission (range 0.6 -1.9%) and hospital onset periods (range 1.4-3.3%).

    Observed Events (346 hospitals)

    National Projection

    Period Tested

    Isolates tested

    Confirmed CRE

    % CRE

    Isolates tested

    CRE Events

    % CRE

    Ambulatory

    631,846

    2,957

    0.5

    6,058,591

    31,479

    0.5

    Admission

    105,846

    1,133

    1.1

    907,674

    10,572

    1.2

    Hospital-onset

    82,325

    1,653

    2.0

    697,570

    14,413

    2.1

    Total

    820,017

    5,743

    0.7

    7,663,836

    56,464

    0.7

    Regions

    Midwest

    222,311

    1,528

    0.7

    2,401,980

    17,025

    0.7

    Northeast

    125,175

    1,165

    0.9

    1,208,894

    11,095

    0.9

    South

    344,377

    1,990

    0.6

    2,689,175

    15,932

    0.6

    West

    128,154

    1,060

    0.8

    1,363,786

    12,412

    0.9

    Total

    820,017

    5,743

    0.7

    7,663,836

    56,464

    0.7

    Conclusion: These data estimate that national hospital onset CRE rates in 2015 were higher than previously reported. Additionally, a large percent of CRE events occurred in the ambulatory and admission period. CRE rates are quadrupled among hospitalized patients compared with those in ambulatory period.

    Holly Hoffman-Roberts, PharmD1, Melanie Olesky, PhD2, Ying P. Tabak, PhD3, John Mohr, PharmD1, Richard S Johannes, MD, MS3,4 and Vikas Gupta, Pharm.D., BCPS3, (1)Former Employee Tetraphase Pharmaceuticals, Watertown, MA, (2)Tetraphase Pharmaceuticals, Inc., Watertown, MA, (3)Becton, Dickinson and Company, Franklin Lakes, NJ, (4)Harvard Medical School, Boston, MA

    Disclosures:

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

    M. Olesky, 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.