Volunteer monitoring of E. coli in streams of the upper Midwestern United States: a comparison of methods

Inequality in the promised land: Race, resources, and suburban schooling is a well-written book by L’ Heureux Lewis-McCoy. The book is based on Lewis-McCoy’s doctoral dissertation, that included an ethnographic study in a suburban area named Rolling Acres in the Midwestern United States. Lewis-McCoy studied the relationship between families and those families’ relationships with schools. Through this study, the author explored how invisible inequality and racism in an affluent suburban area became the barrier for racial and economically minority students to grow up academically. Lewis-McCoy also discovered the hope of the minority community for raising their children for a better future.

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1675. Epidemiology of Urinary Tract Infections in the United States, 2009 - 2018

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1853 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S823-S823

Author(s):

Kendra Foster ◽

Linnea A Polgreen ◽

Brett Faine ◽

Philip M Polgreen

Keyword(s):

United States ◽

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Urinary Tract Infections ◽

Proteus Mirabilis ◽

Antibiotic Use ◽

The United States ◽

Drug Resistant ◽

E Coli ◽

Tract Infections

Abstract Background Urinary tract infections (UTIs) are one of the most common bacterial infections. There is a lack of large epidemiologic studies evaluating the etiologies of UTIs in the United States. This study aimed to determine the prevalence of different UTI-causing organisms and their antimicrobial susceptibility profiles among patients being treated in a hospital setting. Methods We used the Premier Healthcare Database. Patients with a primary diagnosis code of cystitis, pyelonephritis, or urinary tract infection and had a urine culture from 2009- 2018 were included in the study. Both inpatients and patients who were only treated in the emergency department (ED) were included. We calculated descriptive statistics for uropathogens and their susceptibilities. Multi-drug-resistant pathogens are defined as pathogens resistant to 3 or more antibiotics. Resistance patterns are also described for specific drug classes, like resistance to fluoroquinolones. We also evaluated antibiotic use in this patient population and how antibiotic use varied during the hospitalization. Results There were 640,285 individuals who met the inclusion criteria. Females make up 82% of the study population and 45% were age 65 or older. The most common uropathogen was Escherichia Coli (64.9%) followed by Klebsiella pneumoniae (8.3%), and Proteus mirabilis (5.7%). 22.2% of patients were infected with a multi-drug-resistant pathogen. We found that E. Coli was multi-drug resistant 23.8% of the time; Klebsiella pneumoniae was multi-drug resistant 7.4%; and Proteus mirabilis was multi-drug resistant 2.8%. The most common antibiotics prescribed were ceftriaxone, levofloxacin, and ciprofloxacin. Among patients that were prescribed ceftriaxone, 31.7% of them switched to a different antibiotic during their hospitalization. Patients that were prescribed levofloxacin and ciprofloxacin switched to a different antibiotic 42.8% and 41.5% of the time, respectively. Conclusion E. Coli showed significant multidrug resistance in this population of UTI patients that were hospitalized or treated within the ED, and antibiotic switching is common. Disclosures All Authors: No reported disclosures

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Epidemiologic and Microbiologic Characteristics of 28 Hospitalized Patients Cocolonized With Multiple Carbapenem-Resistant Enterobacteriaceae (CRE) in the United States

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.547 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s62-s62

Author(s):

Timileyin Adediran ◽

Anthony Harris ◽

J. Kristie Johnson ◽

David Calfee ◽

Loren Miller ◽

...

Keyword(s):

United States ◽

Secondary Analysis ◽

Positive Culture ◽

The United States ◽

Healthcare Personnel ◽

Surveillance Culture ◽

E Coli ◽

Carbapenem Resistant ◽

Multicenter Prospective Cohort Study ◽

Epidemiological Significance

Background: As carbapenem-resistant Enterobacteriaceae (CRE) prevalence increases in the United States, the risk of cocolonization with multiple CRE may also be increasing, with unknown clinical and epidemiological significance. In this study, we aimed to describe the epidemiologic and microbiologic characteristics of inpatients cocolonized with multiple CRE. Methods: We conducted a secondary analysis of a large, multicenter prospective cohort study evaluating risk factors for CRE transmission to healthcare personnel gown and gloves. Patients were identified between January 2016 and June 2019 from 4 states. Patients enrolled in the study had a clinical or surveillance culture positive for CRE within 7 days of enrollment. We collected and cultured samples from the following sites from each CRE-colonized patient: stool, perianal area, and skin. A modified carbapenem inactivation method (mCIM) was used to detect the presence or absence of carbapenemase(s). EDTA-modified CIM (eCIM) was used to differentiate between serine and metal-dependent carbapenemases. Results: Of the 313 CRE-colonized patients enrolled in the study, 28 (8.9%) were cocolonized with at least 2 different CRE. Additionally, 3 patients were cocolonized with >2 different CRE (1.0%). Of the 28 patients, 19 (67.6%) were enrolled with positive clinical cultures. Table 1 summarizes the demographic and clinical characteristics of these patients. The most frequently used antibiotic prior to positive culture was vancomycin (n = 33, 18.3%). Among the 62 isolates from 59 samples from 28 patients cocolonized patients, the most common CRE species were Klebsiella pneumoniae (n = 18, 29.0%), Escherichia coli (n = 10, 16.1%), and Enterobacter cloacae (n = 9, 14.5%). Of the 62 isolates, 38 (61.3%) were mCIM positive and 8 (12.9%) were eCIM positive. Of the 38 mCIM-positive isolates, 33 (86.8%) were KPC positive, 4 (10.5%) were NDM positive, and 1 (2.6%) was negative for both KPC and NDM. Also, 2 E. coli, 1 K. pneumoniae, and 1 E. cloacae were NDM-producing CRE. Conclusion: Cocolonization with multiple CRE occurs frequently in the acute-care setting. Characterizing patients with CRE cocolonization may be important to informing infection control practices and interventions to limit the spread of these organisms, but further study is needed.Funding: NoneDisclosures: None

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