Open Forum Infect DisOpen Forum Infect DisofidOpen Forum Infectious Diseases2328-8957Oxford University PressUS681119510.1093/ofid/ofz360.559ofz360.559AbstractsPoster Abstracts486. Epidemiology of Carbapenem-Resistant Pseudomonas aeruginosa Identified through the Emerging Infections Program (EIP), United States, 2016–2018GrassJulian EMPH1BulensSandra NMPH1BambergWendy MMD2JanelleSarah JMPH2SchutzKyleMS2JacobJesse TMD, MSc3BowerChris WMPH4BlakneyRebekahMS4WilsonLucy EMD, ScM5VaethElisabethMPH6LiLindaMPH6LynfieldRuthMD7Snippes VagnonePaulaMT(ASCP)8DobbinsGinetteMPH7PhippsErin CDVM, MPH9HancockEmily BMS9DumyatiGhinwaMD10TsayRebeccaMPH10CassidyP MaureenMPH11WestNicoleMPH11KainerMarion AMBBS, MPH, FRACP, FSHEA12MounseyJacquelynRN12StantonRichard APhD1McAllisterGillian ABS13CampbellDavinaMS1LutgringJoseph DMD1KarlssonMariaPhD13WaltersMaroya SPhD1 Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia Colorado Department of Public Health and Environment, Denver, Colorado Emory University, Atlanta, Georgia Georgia Emerging Infections Program, Decatur, Georgia University of Maryland Baltimore County, Baltimore, Maryland Maryland Department of Health, Baltimore, Maryland Minnesota Department of Health, Saint Paul, Minnesota Minnesota Department of Health Laboratory, St. Paul, Minnesota University of New Mexico, Albuquerque, New Mexico New York Rochester Emerging Infections Program at the University of Rochester Medical Center, Rochester, New York Oregon Health Authority, Portland, Oregon Tennessee Department of Health, Nashville, Tennessee Centers for Disease Control and Prevention, Atlanta, Georgia10201923102019231020196Suppl 2IDWeek 2019 AbstractsS238S238© The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America.2019This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.comAbstractBackground

Pseudomonas aeruginosa is intrinsically resistant to many commonly used antimicrobials, and carbapenems are often required to treat infections. We describe the crude incidence, epidemiology, and molecular characteristics of carbapenem-resistant P. aeruginosa (CRPA) in the EIP catchment area.

Methods

From August 1, 2016 through July 31, 2018, we conducted laboratory- and population-based surveillance for CRPA in selected areas in eight sites. We defined a case as the first isolate of P. aeruginosa resistant to imipenem, meropenem, or doripenem from the lower respiratory tract, urine, wounds, or normally sterile sites identified from a resident of the EIP catchment area in a 30-day period. Patient charts were reviewed. Analysis excluded cystic fibrosis patients. A random sample of isolates was collected. Real-time PCR to detect carbapenemase genes and whole-genome sequencing are in progress.

Results

We identified 4,209 cases in 3373 patients. The annual incidence was 14.50 (95% CI, 14.07–14.94) per 100,000 persons and varied among sites from 4.89 in OR to 25.21 in NY. The median age of patients was 66 years (range: < 1–101), 42.1% were female, and nearly all (97.5%) had an underlying condition. Most cases were identified from urine (42.8%) and lower respiratory tract (35.7%) cultures. Nearly all (93.3%) occurred in patients with inpatient healthcare facility stay, surgery, chronic dialysis, or indwelling devices in the prior year; death occurred in 7.2%. Among 937 isolates tested, 847 (90.4%) underwent PCR; six (0.7%) harbored a carbapenemase, from four sites (CO, MD, NY, and OR): blaVIM (3), blaKPC (2), and blaIMP (1). Of 612 (65.3%) isolates sequenced, the most common ST types were ST235 (9.2%) and ST298 (4.9%).

Conclusion

Carbapenemases were rarely the cause of carbapenem resistance but were found at EIP sites with high and low CRPA incidence. The emergence of mobile carbapenemases in P. aeruginosa has the potential to increase the incidence of CRPA. Increased detection and early response to carbapenemase-producing CRPA is key to prevent further emergence.

Disclosures

All authors: No reported disclosures.

Session: 53. HAI: MDRO – GNR Epidemiology, Other

Thursday, October 3, 2019: 12:15 PM