360. Pseudomonas aeruginosa Non-susceptibility to Common Antibiotics by Source in USA Hospitals in 2015: A Multicenter Study
Session: Poster Abstract Session: HAI: Multi Drug Resistant Gram Negatives
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Merck PSA NS ID Week Poster v6 FINAL 10-24-16.pdf (320.1 kB)
  • Background: We evaluated the non-susceptibility of commonly used antibiotics used to treat Pseudomonas aeruginosa (PSA) infections by source in the inpatient setting.

    Methods: We analyzed a 2015 inpatient dataset in an electronic research database of Becton Dickinson & Company from 346 USA hospitals. All non-duplicate PSA isolates (first isolate of a species per 30 day period) from respiratory, blood, wound, or urine were identified as non-susceptible if intermediate or resistant to ciprofloxacin or levofloxacin, ceftazidime, cefepime, meropenem, or piperacillin/ tazobactam (PIP/TAZ).

    Results: The non-susceptible rates across all 4 sources were 33.6% (14,169/42,207), 19.4% (5,673/29,310), 19.8% (7,611/38,424), 20.9% (5,759/27,514), and 14.0% (5,385/38,404) for ciprofloxacin/levofloxacin, ceftazidime, cefepime, meropenem, and PIP/TAZ, respectively. Respiratory source had significantly higher non-susceptible rates than other sources for each of the 5 antibiotics, ranging from 19.8% to 39.3% (all P<0.01) (see Table).

    Source

    Non-susceptibility Rate (%, n)

    Ciprofloxacin or Levofloxacin

    Ceftazidime

    Cefepime

    Meropenem

    PIP/TAZ

    Respiratory

    39.3 (5,916/15,071)

    25.6 (2,723/10,649)

    26.3 (3,667/13,926)

    29.4 (3,050/10,377)

    19.8 (2,747/13,862)

    Blood

    23.9

    (472/1,976)

    16.1 (218/1,355)

    15.3 (279/1,827)

    15.5 (205/1,320)

    10.8 (197/1,822)

    Wound

    27.5 (3,036/11,050)

    17.6 (1,339/7,597)

    16.3 (1,639/10,025)

    15.2 (1,097/7,238)

    11.9 (1,190/10,039)

    Urine

    33.6 (4,745/14,110)

    14.3 (1,393/9,709)

    16.0 (2,026/12,646)

    16.4 (1,407/8,579)

    9.9 (1,251/12,681)

    All 4 Sources

    33.6 (14,169/42,207)

    19.4 (5,673/29,310)

    19.8 (7,611/38,424)

    20.9 (5,759/27,514)

    14.0 (5,385/38,404)

    Conclusion: Across all 4 sources in the inpatient population, 1 in 3 PSA isolates was non-susceptible to ciprofloxacin or levofloxacin and 1 in 5 to ceftazidime, cefepime, or meropenem. Respiratory source had the highest rates of non-susceptibility for all of these common antibiotics which are considered the cornerstone of PSA therapy. These findings highlight the importance of antibiotic choice and source of infection when choosing anti-pseudomonal therapy.

    Sanjay Merchant, PhD1, Ying P. Tabak, PhD2, C. Andrew Deryke, PharmD1, Daryl D. Depestel, PharmD, BCPS-ID1, Richard S Johannes, MD, MS2,3, Pamela Moise, PharmD1 and Vikas Gupta, Pharm.D., BCPS2, (1)Merck & Co. Inc., Kenilworth, NJ, (2)Becton, Dickinson and Company, Franklin Lakes, NJ, (3)Harvard Medical School, Boston, MA

    Disclosures:

    S. Merchant, Merck & Co. Inc.: Employee , Salary

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

    C. A. Deryke, Merck & Co. Inc.: Employee , Salary

    D. D. Depestel, Merck & Co. Inc.: Employee , Salary

    R. S. Johannes, Becton Dickinson: Employee , Salary

    P. Moise, Merck & Co. Inc.: 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.