361. Multidrug Resistant Pseudomonas aeruginosa (MDR-PSA) in USA Hospitals by Geographic Region in 2015
Session: Poster Abstract Session: HAI: Multi Drug Resistant Gram Negatives
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • BD MDR PSA ID Week Poster v4 FINAL 10-24-16.pdf (286.3 kB)
  • Background: We examined the prevalence of MDR-PSA in hospitalized patients across different USA geographic regions.

    Methods: Utilizing a 2015 electronic research dataset established by Becton Dickinson & Company from 346 USA hospitals, non-duplicate PSA isolates (first isolate of a species per 30 day period) from all sources were identified as MDR if intermediate/resistant, as defined by NHSN, to > 1 antibiotic in 3 of the 5 drug classes: ceftazidime or cefepime; ciprofloxacin or levofloxacin; aminoglycosides, carbapenems; and piperacillin/tazobactam. Isolates were categorized as either: admission (< 3 days of an inpatient admission and no previous admission within 14 days) or hospital-onset (>3 days post-admission or within 14 days of discharge). Geographic regions were classified into NHSN categories (Sievert, 2013, ICHE), with Region 1, 7, and 8 being grouped into “other” due to small number of hospitals. We conducted pairwise comparison between regions using the region with the lowest MDR-PSA rate as the reference group.

    Results: The overall MDR-PSA rate was 16.1% (7,218/44,844) with admission and hospital-onset settings rates of 13.1% (2,474/18,820) vs 18.2% (4,744/26,024), respectively (P<0.0001). Significant regional differences were noted within admission and hospital-onset settings compared to Region 10 in both settings (see Table).

    Region

    States

    # of Hospitals

    MDR-PSA Rate (%)

    Admission

    Hospital-Onset

    2

    NJ, NY, PR, VI

    30

     13.5*

     21.9*

    6

    AR, LA, NM, OK, TX

    59

     15.0*

     19.7*

    9

    AZ, CA, HI, Pacific Islands

    28

    13.0

     19.0*

    5

    IL, IN, MI, MN, OH, WI

    85

     13.9*

     17.2*

    4

    AL, FL, GA, KY, MS, NC, SC, TN

    98

    12.7

     18.2*

    1, 7, 8

    All Other

    11

    11.1

    16.7*

    3

    DE, DC, MD, PA, VA, WV

    13

    9.6

    12.0

    10

    AK, ID, OR, WA

    22

    9.0

    10.6

    Overall

    346

    13.1

    18.2

    * P < 0.05 compared to Region 10 within admission & hospital-onset settings

    Conclusion: The overall MDR-PSA rate was significantly higher for the hospital-onset setting in the US hospitals, with 1 in 6 PSA isolates being MDR positive. There is a significant regional difference in MDR-PSA rates. Hospitals in different geographic regions need to be aware of their local microbiological epidemiology for MDR-PSA in selecting empiric antibiotics for patients at risk of infection with PSA.

    C. Andrew Deryke, PharmD1, Daryl D. Depestel, PharmD, BCPS-ID1, Ying P. Tabak, PhD2, Sanjay Merchant, PhD1, Richard S Johannes, MD, MS2,3, John Jay Hawkshead III, DrPH1, 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:

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

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

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

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

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

    J. J. Hawkshead III, Merck & Co. Inc.: 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.