TOUBES E, SINGH K, YIN D, LYU R, GLICK N, RUSSELL L, MOHAPATRA S, SAHGAL N, TRENHOLME G; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. K-1189.

Rush Medical College, Chicago, IL

BACKGROUND: A prospective observational study was conducted of LTCF patients admitted with microbiologically documented infections to determine risk factors for antibiotic resistant bacteria (ARB), treatment outcomes and resource use. ARB were defined as cefotaxime (CTAX) or levofloxacin (LV) resistant gram-negative bacilli (GNB), methicillin-resistant Staphylococci (MRS), or vancomycin-resistant Enterococci (VRE). RESULTS: 164 patients were included from 2/99 to 3/01. 126 patients had UTIs, 38 had LRTIs, 39 had bacteremia, and 32 had skin, soft tissue, or bone infections. The isolates included 65 E.coli, 48 Proteus species, 10 Klebsiella species, 13 P.aeruginosa, 13 Staphylococci, 18 Enterococci and 6 Streptococci. 20 patients had GNB resistant to CTAX, 69 to LV; 24 had MRS, and 3 had VRE. By univariate analysis, ARB were significantly associated with non-ambulatory status, indwelling urinary catheter, feeding tube, and prior use of antibiotics (< 14 days to admission). Multivariate logistic regression found that ARB were independently associated with feeding tube use and polymicrobial infection. The ARB group had changes in the initial antibiotic regimen more often (64% vs. 45%, p<0.05) than the non-ARB group. Patients with ARB whose initial antibiotic regimens were changed had longer mean hospital LOS (14.1 vs. 10.1 days, p<0.05), longer mean antibiotic days (10.5 vs. 8.4 days, p<0.05), higher mean hospitalization cost ($21,205 vs. $12,132, p<0.05) and were more likely to resolve their primary infection (p<0.05) than patients with no change in initial regimens. CONCLUSIONS: LTCF patients with feeding tubes and polymicrobial infections were more likely to have ARB. The choice of initial antibiotic therapy for patients with ARB could significantly affect treatment outcomes and use of healthcare resources.

Publication Types:

• Meeting Abstracts

Keywords:

• Anti-Bacterial Agents
• Cefotaxime
• Drug Resistance
• Enterococcus
• Gram-Negative Bacteria
• Hospitalization
• Humans
• Logistic Models
• Prospective Studies
• Risk Factors
• Staphylococcus
• Staphylococcus aureus
• Treatment Outcome

Other ID:

• GWAIDS0029201

UI: 102268833

From Meeting Abstracts