1191. Prevalence and Microbiology of Carbapenem Resistance Among Six Gram-Negative Pathogens in Bloodstream Infections in US Hospitals, 2010-2015
Session: Poster Abstract Session: Healthcare Epidemiology: MDR-Gram Negative Infections
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • 1191_IDWPOSTER_2018_Premier-Prev-CRpathogens_ECHOLS_R7.pdf (334.7 kB)
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    Prevalence and Microbiology of Carbapenem Resistance Among Six Gram-Negative Pathogens in Bloodstream Infections in US Hospitals, 2010-2015  A. Shorr1, T. Lodise2, R. Echols3, W.Wang4, F. A. Corvino4, B. Cai5, M. Zilberberg6; 1Washington Hospital Center, Washington, DC, USA; 2Albany College of Pharmacy and Health Sciences, Albany, NY, USA; 3ID3C LLC, Easton, CT, USA; 4Genesis Research, Inc., Hoboken, NJ, USA; 5Shionogi Inc., Florham Park, NJ, USA; 6EviMed Research Group, LLC, Goshen, MA, USA.

    Background: Carbapenem resistance (CR) is a growing threat in hospitals in the US and worldwide. We evaluated the prevalence and geographic distribution of CR among 6 most common Gram-negative (GN) bloodstream infection (BSI) pathogens in US hospitals.

    Methods:  We analyzed microbiology data in a cohort of adults (≥18 years) hospitalized in 181 US hospitals contributing microbiology data to the Premier Healthcare Database (Oct 2010–Sep 2015) with blood cultures positive for 6 most common GN pathogens (S. maltophilia assumed 100% CR). We report CR prevalence by pathogen, hospital ward (ICU vs floor), and census region.

    Results: Of the 43,095 GN BSIs included, 1,513 (3.5%) were caused by the 6 most common CR pathogens (Figure 1). CR was more frequently isolated from patients with an ICU stay (4.7%) vs those without (2.7%). Nearly 75% (n=1,100) of CR occurred in nonfermenters (S. maltophilia, P. aeruginosa and A. baumannii). Among individual organisms, the prevalence of CR—outside of S. maltophilia—was highest among A. baumannii, 35.1%, and lowest among E. coli, 0.2% (Figure 2). Geographically, CR prevalence ranged from highest in the Mountain region (7.1%) to lowest in the West North Central (2.3%) [Figure 3]. The maximum CR prevalence occurred in A. baumannii from the East North Central (55.7%), and the minimum in E. coli from the West North Central (0.05%) regions.

    Conclusion: Among six most frequently isolated pathogens in BSI, the overall CR prevalence is 3.5%. The wide variations in prevalence based on organism, location in the hospital, and geography emphasize the clinical importance of knowing local pathogen and resistance patterns in order to optimize empiric treatment.

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Thomas P. Lodise Jr., PharmD, PhD, Albany College of Pharmacy and Health Sciences, Albany, NY, Roger Echols, MD, FIDSA, ID3C, Easton, CT, Weiying Wang, MPH, Genesis Research, Hoboken, NJ, Frank Corvino, PhD, Genesis Research LLC, Hoboken, NJ and Bin Cai, MD, PhD, Shionogi Inc., Florham Park, NJ

    Disclosures:

    T. P. Lodise Jr., Motif BioSciences: Board Member , Consulting fee .

    R. Echols, None

    W. Wang, None

    F. Corvino, None

    B. Cai, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.