374. Burden of Carbapenem-resistant Gram-negative Infections in US Hospitals
Session: Poster Abstract Session: HAI: MDRO-GNR/Emerging Resistant Bacterial Pathogens
Thursday, October 5, 2017
Room: Poster Hall CD
Posters
  • IDWeek 2017Poster 374 - final.pdf (607.8 kB)
  • Background: Carbapenem-resistant (CR) Gram-negative infections have received much attention because of the lack of effective treatment. This study explored the burden of CR Gram-negative pathogens on hospital stay and intensive care unit (ICU) stay.

    Methods: Hospitalized patients with laboratory-confirmed infections due to Gram-negative pathogens from specified infection sites between 2010 and 2015 were identified from Premier Healthcare Database. Two cohorts were defined using local hospital carbapenem susceptibility test results [CR cohort and carbapenem susceptible (CS) cohort]. However all patients with S. maltophiliawere considered CR because of its inherited resistance to carbapenem. The length of total hospital stay and length of ICU stay were compared between two cohorts by pathogen and infection site (Blood, Respiratory, Urinary, & Other).

    Results:

    From Oct 2010 to Sept 2015, 23,426 of 260,280 (9%) patients infected with non-fermenters (A. baumannii, P. aeruginosa, S. maltophilia), K. pneumoniae or E. coli had carbapenem-resistant pathogens. About 89% of CR infections had one of 3 non-fermenters. The median number of days of hospitalization by pathogen and infection site is shown in the table below. Length of total hospital stay was longer in CR cohort than CS cohort in each instance, except for A. baumannii in Respiratory.

    Pathogen

    Blood

    Respiratory

    Urinary

    Other

    CR

    CS

    CR

    CS

    CR

    CS

    CR

    CS

    A. baumannii

    13

    9

    14

    16

    11

    7

    11

    8

    P. aeruginosa

    15

    9

    15

    10

    9

    8

    13

    9

    K. pneumoniae

    13

    8

    17

    14

    9

    7

    14

    10

    E. coli

    10

    6

    16

    12

    7

    6

    15

    9

    S. maltophilia

    12

    -

    15

    -

    8

    -

    9

    -

    Compared to patients with CS pathogens, those with CR pathogens were more likely to stay at ICU and had longer days in ICU for each of first four pathogens shown in above table at each infection site, except for patients with A. baumanniiRespiratory infection where the median ICU stay for CS patients was 4 days longer than CR patients.

    Patients with S. maltophilia, especially in Respiratory, had similar hospital stay and ICU stay to other CR cases.

    Conclusion: In general, patients infected with CR Gram-negative pathogens had longer total hospital stay and ICU stay with the exception of A. baumannii infection in Respiratory. These results indicate a heavier disease burden of CR Gram-negative infections, especially from the non-fermenters.

    Bin Cai, MD, PhD1, Roger Echols, MD, FIDSA2, Frank Corvino, PhD3, Gareth Morgan, Ph.D4, David Van Veenhuyzen, MBChB, MPharmMed4, Mari Ariyasu, Ph.D5, Takuko Sawada, BA5 and Tsutae Den Nagata, MD, PhD, FFPM5, (1)Shionogi Inc., Florham Park, NJ, (2)ID3C, Easton, CT, (3)Genesis Research LLC, Hoboken, NJ, (4)SHIONOGI INC., Florham Park, NJ, (5)SHIONOGI & CO., LTD., Osaka, Japan

    Disclosures:

    B. Cai, Shionogi Inc: Employee , Salary

    R. Echols, Shionogi Inc: Consultant , Consulting fee

    F. Corvino, None

    G. Morgan, Shionogi Inc: Employee , Salary

    D. Van Veenhuyzen, Shionogi Inc: Employee , Salary

    M. Ariyasu, Shionogi: Employee , Salary

    T. Sawada, Shinogi: Employee , Salary

    T. D. Nagata, Shionogi: Employee , Salary

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.