378. National Prevalence of Multidrug-Resistance (MDR) in Enterobacteriaceae (ENT) 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
  • MDR ENT 378 10-24-16.pdf (362.8 kB)
  • Background:Infections caused by resistant Gram-negative bacteria are a serious global public health concern. The purpose of this study was to estimate the national prevalence of MDR ENT 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, P. mirabilis, E. aerogenes, E. cloacae, S. marcescens, C. freundii, & M. morganii and were identified from 346 hospitals nationwide. ENT isolates were characterized as MDR per NHSN definitions. Organisms were classified into ambulatory, admission, and hospital-onset (HO) setting 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 904,446 isolates tested, 41,457 were MDR ENT. The national projected MDR ENT events were 379,163 in the HO, ambulatory and acute care settings (table below). The MDR ENT rates were highest in the HO, followed by admission and ambulatory setting. National Projections for MDR ENT for each region were: ambulatory (3.1, 3.3, 4.6 & 3.3%), admission (5.8, 6.4, 6.2 & 6.2%) and HO (7.6, 10.2, 9.2 & 9.0%) for the Midwest, Northeast (NE), South, and West regions, respectively. 

     

    Observed Events (346 hospitals)

    National Projection

    Period Tested

    Isolates tested

    Confirmed MDR EB

    % MDR ENT

    Isolates tested

    MDR EB

    Events

    % MDR ENT

    Ambulatory

    683,143

    25,305

    3.7

    6,538,605

    241,058

    3.7

    Admission

    119,842

    7,225

    6.0

    1,025,088

    62,465

    6.1

    Hospital-onset

    101,461

    8,927

    8.8

    853,616

    75,641

    8.9

    Total

    904,446

    41,457

    4.6

    8,417,309

    379,163

    4.5

    Regions

    Midwest

    244,752

    9,060

    3.7

    2,636,407

    102,174

    3.9

    NE

    138,490

    6,180

    4.5

    1,331,936

    59,703

    4.5

    South

    381,550

    19,898

    5.2

    2,968,073

    156,355

    5.3

    West

    139,654

    6,319

    4.5

    1,480,893

    60,932

    4.1

    Total

    904,446

    41,457

    4.6

    8,417,309

    379,163

    4.5


    Conclusion: Although the highest prevalence for MDR ENT events was in the HO setting, over 90% of MDR ENT events occurred in the ambulatory and admission settings. Overall prevalence of MDR ENT was highest in the South region, but the NE has the highest projected prevalence for the admission and HO periods.

    Hina Patel, PharmD1, Holly Hoffman-Roberts, 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. Patel, Tetraphase Pharmaceuticals: Employee , Salary

    H. Hoffman-Roberts, 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.