325. Prevalence of Multi-Drug Resistant Organisms (MDROs) Using an Antibiotic Resistant Gene Assay at a Tertiary Care Center
Session: Poster Abstract Session: HAI: Multi Drug Resistant Gram Negatives
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Timpone Poster 10 17 2016 (2).pdf (966.8 kB)
  • Background: Multi-Drug Resistant Organisms (MDROs) are an important cause of healthcare acquired infections. Screening for colonizing MDROs is frequently limited to MRSA and VRE. Active surveillance for MDROs using molecular approaches could improve identification of additional pathogens implicated in health care associated infections.

    Methods: We performed a cross-sectional MDRO prevalence study over 3 days in 2016 at a tertiary care center alongside the city-wide Healthcare Antibiotic Resistance Prevalence—DC Study (HARP DC). Peri-anal swabs were collected from consenting adults. The Acuitas® MDRO Gene Test (OpGen), a RT-PCR assay, was used to identify the presence of 10 antibiotic resistance associated genes (CTX-M-1; CTX-M-2; IMP; KPC; NDM; VIM; OXA-23; OXA-48; OXA-51; vanA ) from each of the collected specimens.

    Results: 179/277 (64.6%) patients participated of whom 39.6% were in the ICU, 49.2% male/ 50.8% female, 46.7% African American, 37.9% Caucasian, and 33.7% had surgery or an invasive procedure. 72.2% had antibiotic exposure within 6 months. We identified that 34.1% (61/179) patients had one or more MDRO genes using the MDRO gene test. We observed a 25.1% (45/179) prevalence of VRE gene (45 vanA), 9.5% (17/179) non-CRE ESBL genes (9 CTXM-2, 6 CTXM- 1, 2 OXA -51), and 4.5% (8/179) CRE genes (6 KPC alone, 1 KPC/OXA-23, 1KPC/OXA-48). 87.5% (7/8) of the CRE group had concurrent detection of the vanA gene whereas 17.6% (3/17) of the non-CRE ESBL group also had the vanA gene.

    Conclusion: We detected genes associated with MDROs among one third of patients in our tertiary care center. This observation raises concern that more active molecular surveillance may be needed to decrease MDRO transmission within health facilities and reinforces the importance of hand hygiene as a central tenet of infection prevention strategies.

    Joseph Timpone, M.D.1, Rebecca Kumar, M.D.2, Deepa Lazarous, M.D.3, Seble Kassaye, MD, MS4, Puneet Agarwal, M.D.2, Roshni Biswas, MBBS, MPH2, Amanda Finnell, BS4, Mary Mcfadden, R.N., MHA5 and Princy Kumar, M.D.1, (1)Division of Infectious Diseases and Travel Medicine, Medstar Georgetown University Hospital, Washington, DC, (2)Medstar Georgetown University Hospital, Washington, DC, (3)Division of Pulmonary, Critical Care, and Sleep Medicine, Medstar Georgetown University Hospital, Washington, DC, (4)Georgetown University, Washington, DC, (5)Infection Prevention, Medstar Georgetown University Hospital, Washington, DC

    Disclosures:

    J. Timpone, None

    R. Kumar, None

    D. Lazarous, None

    S. Kassaye, None

    P. Agarwal, None

    R. Biswas, None

    A. Finnell, None

    M. Mcfadden, None

    P. Kumar, None

    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.