Microbiology of Ventilator–Associated Pneumonia Compared With That of Hospital-Acquired Pneumonia

2007 ◽  
Vol 28 (7) ◽  
pp. 825-831 ◽  
Author(s):  
David J. Weber ◽  
William A. Rutala ◽  
Emily E. Sickbert-Bennett ◽  
Gregory P. Samsa ◽  
Vickie Brown ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Empirical Therapy ◽  
Ventilator Associated Pneumonia ◽  
Gram Positive ◽  
Similar Frequency ◽  
Gram Negative ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Gram Positive Cocci ◽  
Ventilated Patients

Objective.Nosocomial pneumonia is the leading cause of mortality attributed to nosocomial infection. Appropriate empirical therapy has been associated with improved survival, but data are limited regarding the etiologic agents of hospital-acquired pneumonia in non-ventilated patients (HAP). This evaluation assessed whether the currently recommended empirical therapy is appropriate for both ventilator-associated pneumonia (VAP) and HAP by evaluating the infecting flora.Design.Prospectively collected hospitalwide surveillance data was obtained by infection control professionals using standard Centers for Disease Control and Prevention definitions.Setting.A tertiary care academic hospital.Patients.All patients admitted from 2000 through 2003.Results.A total of 588 episodes of pneumonia were reported in 556 patients: 327 episodes of VAP in 309 patients, and 261 episodes of HAP in 247 Patients. The infecting flora in ventilated patients included gram-positive cocci (32.0% [oxacillin-susceptible Staphylococcus aureus {OSSA}, 9.25%; oxacillin-resistant Staphylococcus aureus {ORSA}, 17.75%]), gram-negative bacilli (59.0% {Pseudomonas aeruginosa, 17.50%; Stenotrophomonas maltophilia, 6.75%; Acinetobacter species, 7.75%), and miscellaneous pathogens (9.0%). The infecting flora in nonventilated patients included gram-positive cocci (42.59% [OSSA, 13.33%; ORSA, 20.37%]), gram-negative bacilli (39.63% [P. aeruginosa, 9.26%; S. maltophilia, 1.11%; Acinetobacter species, 3.33%), and miscellaneous pathogens (17.78%).Conclusions.Our data demonstrated that patients with HAP, compared with those with VAP, had a similar frequency of infection with ORSA but less commonly had infections due to P. aeruginosa, Acinetobacter species, and S. maltophilia. However, the overall frequency of infection with these pathogens was sufficiently high to warrant the use of empirical therapy likely to be active against them. Our data supports using the currently recommended empirical therapy for both HAP and VAP.

scholarly journals In Vitro Activity of Doripenem, a Carbapenem for the Treatment of Challenging Infections Caused by Gram-Negative Bacteria, against Recent Clinical Isolates from the United States

2008 ◽  
Vol 52 (12) ◽  
pp. 4388-4399 ◽  
Author(s):  
Chris M. Pillar ◽  
Mohana K. Torres ◽  
Nina P. Brown ◽  
Dineshchandra Shah ◽  
Daniel F. Sahm
Keyword(s):  
The United States ◽  
Clinical Isolates ◽  
Gram Negative Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Coagulase Negative Staphylococci ◽  
Hospital Acquired Pneumonia ◽  
Abdominal Infections ◽  
Hospital Acquired ◽  
Gram Positive Cocci

ABSTRACT Doripenem, a 1β-methylcarbapenem, is a broad-spectrum antibiotic approved for the treatment of complicated urinary tract and complicated intra-abdominal infections. An indication for hospital-acquired pneumonia including ventilator-associated pneumonia is pending. The current study examined the activity of doripenem against recent clinical isolates for the purposes of its ongoing clinical development and future longitudinal analysis. Doripenem and comparators were tested against 12,581 U.S. clinical isolates collected between 2005 and 2006 including isolates of Staphylococcus aureus, coagulase-negative staphylococci, Streptococcus pneumoniae, Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter spp. MICs (μg/ml) were established by broth microdilution. By MIC90, doripenem was comparable to imipenem and meropenem in activity against S. aureus (methicillin susceptible, 0.06; resistant, 8) and S. pneumoniae (penicillin susceptible, ≤0.015; resistant, 1). Against ceftazidime-susceptible Enterobacteriaceae, the MIC90 of doripenem (0.12) was comparable to that of meropenem (0.12) and superior to that of imipenem (2), though susceptibility of isolates exceeded 99% for all evaluated carbapenems. The activity of doripenem was not notably altered against ceftazidime-nonsusceptible or extended-spectrum β-lactamase screen-positive Enterobacteriaceae. Doripenem was the most potent carbapenem tested against P. aeruginosa (MIC90/% susceptibility [%S]: ceftazidime susceptible = 2/92%S, nonsusceptible = 16/61%S; imipenem susceptible = 1/98.5%S, nonsusceptible = 8/56%S). Against imipenem-susceptible Acinetobacter spp., doripenem (MIC90 = 2, 89.1%S) was twice as active by MIC90 as were imipenem and meropenem. Overall, doripenem potency was comparable to those of meropenem and imipenem against gram-positive cocci and doripenem was equal or superior in activity to meropenem and imipenem against Enterobacteriaceae, including β-lactam-nonsusceptible isolates. Doripenem was the most active carbapenem tested against P. aeruginosa regardless of β-lactam resistance.

scholarly journals Microbiological Profile of Uropathogens and their Antibiotic Susceptibility Pattern in Pediatric Population from A Tertiary Care Hospital in Amritsar, Punjab

2021 ◽  
Vol 10 (11) ◽  
pp. 306-312
Author(s):  
Manpreet Kaur Bhatha Loveena Oberoi ◽  
Sapna Soneja Anuradha Malhotra ◽  
Kamaldeep Singh
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Pediatric Population ◽  
Age Group ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Antibiotic Susceptibility Pattern ◽  
Gram Negative ◽  
Gram Negative Organisms ◽  
Gram Positive Cocci

Urinary tract infection(UTI) is one of the most commonest bacterial infection encountered in the pediatric age group. Early diagnosis is of utmost importance to preserve renal function and reduce long term complications such as renal scarring. The objective of this study was to determine the prevalence of UTI in pediatric population, identify the common uropathogens and study the antibiotic susceptibility pattern of bacterial isolates. Materials and Methods: A retrospective study was carried out in Department of Microbiology, GMC Amritsar for a period of 6 months from 1 Jan 2021 till 30 June 2021 amongst the pediatric patients (1 month-12 years age group) with clinically suspected UTI including both indoor and outdoor patients. Clean catch midstream urine samples received in the laboratory were processed as per the standard microbiological guidelines. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: A total of 549 samples were received and processed during study period from which 164(29.87%) were culture positive. Culture positivity was more prevalent in females (61.58%) than males (38.41%). Gram negative organisms were predominant (74.4%) followed by gram positive cocci (22.56%) and Candida (3.05%). Among gram negative organisms Escherichia coli was most predominant followed by Klebsiella spp., Pseudomonas spp., Acinetobacter spp., Proteus spp. and Citrobacter spp. Among gram positive cocci Staphylococcus aureus was most predominant followed by Coagulase negative Staphylococci and Enterococcus spp. Majority of gram negative bacilli were resistant to fluroquinolones, 3rd generation cephalosporins and co-trimoxazole while nitrofurantoin, piperacillin-tazobactam and gentamicin were most sensitive drugs. Among Staphylococcus aureus, methicillin resistance was seen in 17% isolates. High sensitivity was seen to linezolid and vancomycin in gram positive cocci. Conclusion: This study highlights increased prevalence of MDR uropathogens in pediatric population which indicates that antibiotic selection should be based on knowledge of local prevalence of bacterial organisms and their antibiotic sensitivities with rational use of antibiotics.

scholarly journals POLA BAKTERI DAN USIA PASIEN TERHADAP PROKALSITONIN DI PNEUMONIA KOMUNITAS DAN NOSOKOMIAL

2018 ◽  
Vol 21 (2) ◽  
pp. 153
Author(s):  
Coriejati Coriejati ◽  
Mohammad Iqbal ◽  
Emmy Hermyanti Pranggono
Keyword(s):  
Infectious Disease ◽  
Mortality Rate ◽  
Bacterial Infection ◽  
Community Acquired Pneumonia ◽  
Sectional Study ◽  
Gram Positive ◽  
Gram Negative ◽  
Hospital Acquired Pneumonia ◽  
The Difference ◽  
Hospital Acquired

Pneumonia is one of an infectious disease with high mortality rate. In the last decade procalcitonin (PCT) was found as a biomarkerthat can predict a kind of infection. The aim of the study was to know the difference of PCT level between community acquired pneumonia(CAP) and hospital acquired pneumonia (HAP) by analyzing it, and the difference between <60 years old and older age patients. Across-sectional study was conducted on the CAP and HAP patients in RSHS, in August–October 2009. The level difference were analyzedwith Mann-Whitney test, with a significancy of p<0.05. In this study 40 (forty) patients (66%) CAP and 21 patients (34%) HAP wereincluded. The median of PCT levels in CAP was 0.88 ng/dL and HAP 8.32 ng/dL (p=0.002), where as in the in Gram negative bacterialinfection (GNBI) level in CAP was 4.76 ng/dL and in Gram positive was 0.61 ng/dL. The median PCT level in HAP with Gram negativewas 19.02 ng/dL and in the Gram positive was 4.63 ng/dL (p=0.201). The median of PCT level in CAP group <60 yo was 1.42 ng/dLand in ≥60 yo was 0.65 ng/dL (p=0.207). The median of PCT level in HAP <60 yo was 8.32 ng/dL, where as in ≥60 yo was 9.93ng/dL (p=0.178). Based in this study can be concluded that the PCT level in HAP group was higher than in the CAP group. The PCTlevel in HAP with Gram negative bacterial infection was higher than in the CAP, where as in the CAP group was lower in ≥60 yo.

DISTRIBUTION OF HEAT-LABILE AND HEAT-STABLE INORGANIC PYROPHOSPHATASES AMONG SOME BACTERIA

1967 ◽  
Vol 13 (12) ◽  
pp. 1695-1699 ◽  
Author(s):  
Bernard I. Blumenthal ◽  
Mary K. Johnson ◽  
Emmett J. Johnson
Keyword(s):  
Staphylococcus Aureus ◽  
Gram Positive ◽  
Gram Negative ◽  
Heat Stable ◽  
Mycobacterium Phlei ◽  
Heat Labile ◽  
Micrococcus Lysodeikticus ◽  
Gram Positive Cocci

Significant biochemical differences were found in the inorganic pyrophosphatases from different bacteria. All of the Gram-positive sporeforming rods tested possessed a constitutive, heat-labile enzyme, and all of the Gram-negative rods tested possessed a constitutive, heat-stable enzyme. Of the enzymes from the Gram-positive cocci studied, the enzymes from two species of the genus Streptococcus were constitutive and heat labile, the enzyme from Micrococcus lysodeikticus was inducible and heat stable, and that from Staphylococcus aureus was inducible and heat labile. The enzyme from Mycobacterium phlei, the only acid-fast organism studied, was constitutive and heat labile.

scholarly journals Study of Aerobic Bacterial Etiology and Their Antibiogram from Pus Samples in a Tertiary Care Hospital

2021 ◽  
Vol 8 (4) ◽  
pp. 358-362
Author(s):  
T. Kanakadurgamba ◽  
Rama Lakshmi Koripella ◽  
B. Gowtham
Keyword(s):  
Staphylococcus Aureus ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Klebsiella Pneumonia ◽  
Microbiological Analysis ◽  
Gram Positive ◽  
Gram Negative ◽  
Culture Positive ◽  
Gram Positive Cocci

Introduction: The spread of multidrug resistant bacteria has added a new angel to the problem of wound infections which are a major cause of morbidity. To avoid difficulty in treatment of such infections it is mandatory for every pus sample to undergo Culture and sensitivity. Aim: To isolate and study the antibiogram of the aerobic bacteria from pus samples. Materials and Methods: A total of 426 pus samples received from various wards in the Microbiology department. Andhra Medical College, Visakhapatnam were processed as per standard guidelines in the laboratory. All the aerobic bacterial isolates obtained were kept for antibiogram by Kirby Bauer’s disc diffusion method as per CLSI Guidelines. Results: Out of 426 samples 394 (92.4%) were culture positive. Among culture positive samples 90.6% were pure cultures and 9.4% were mixed isolates. Gram negative bacilli were 72.8% of the total isolates and 27.2% were Gram positive cocci. Escherichia coli and Klebsiella pneumonia were the predominant isolates (30.3% and 28.9%) followed by Pseudomonas aeruginosa (24%), Proteus species (9.7%) and Acinetobacter species (6.9%). Among Gram positive cocci Staphylococcus aureus (62.6%), Enterococci (20.5%) and Coagulase Negative Staphylococcus (11.2%) and Streptococci (3.7%). GNB were more sensitive to Colistin (92%), Amikacin (86%), Imipenem and Meropenem (86% and 84.4%), Piperacillin Tazobactam (84%), Gentamycin (78%), Cefaperazone Sulbactam (76.2%) and Ciprofloxacin (56%). Gram positive cocci were sensitive to Linezolid and Teicoplanin (98% each), Vancomycin (96.2%), Clindamycin (84%), Gentamycin (79%), Azithromycin (76.4%), Ciprofloxacin (66%) and Amoxiclav (54%) out of 62.6% Staphylococcus aureus isolates 31.4% were MRSA and out of 72.8% of Gram negative bacilli 38.2% were ESBLS. Conclusion: As multidrug resistant bacterial strains are emerging in various infectious and pyogenic wound infection is most important cause of morbidity, it is important for a clinician to send all pus samples for microbiological analysis and their antibiogram before putting cases on antibiotics. Keywords: Pus samples, Multidrug resistance, Gram negative bacilli, Gram positive cocci, Antimicrobial sensitivity.

scholarly journals Assessment of the Bacterial Pollution and Detection of Antibiotic Resistance Genes in Benin: Case of the Hydrographic Channel Complex Cotonou-Nokoué Lake

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Oloufemi Daniel Ichola ◽  
Victorien Tamegnon Dougnon ◽  
Charles Hornel Koudokpon ◽  
Alidehou Jerrold Agbankpe ◽  
Esther Deguenon ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Water Samples ◽  
Bacterial Species ◽  
Resistant Bacteria ◽  
Biochemical Tests ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Cocci

The study aims to document the level of contamination of the aquatic ecosystem of the Cotonou-Lake Nokoué canal hydrographic complex by multidrug-resistant bacteria and their resistance genes. For this purpose, water samples were taken from several points of the complex and from the sediments at the depth of the lake. Samples of several species of freshly caught fish products from the lake were also collected. Bacteriological analyses were carried out according to the AFNOR standard (NF U: 47–100). The identification of the different bacterial species isolated was then carried out using the API 20E gallery and specific biochemical tests. The antibiogram of the strains was performed according to the recommendations of the EUCAST. Molecular characterization of the identified strains was carried out by searching for resistance and virulence genes. The results obtained revealed the presence of several bacterial species in water samples and in sediment and intestine samples of fishery products with a predominance of Gram-negative bacilli. The resistance profile of Gram-negative bacilli showed a total resistance to metronidazole (100%). 23% of the strains were also resistant to ciprofloxacin, 41% to amoxicillin, and 60% to aztreonam. Of the Gram-positive cocci identified, 66% was resistant to vancomycin, 7.5% to ciprofloxacin, 71% to erythromycin, and 22% to tetracycline. Regarding the genes sought, blaTEM (46%), blaSHV (24%), and blaCTX-M-15 (31%) were present in the genome of Gram-negative bacilli as resistance genes and fimH (41%) as virulence gene. As for Gram-positive cocci, the van B gene was completely absent. The van A was present at 6.25% in Staphylococcus aureus and mecA at 21.88 and 33.33%, respectively, in Staphylococcus aureus and coagulase-negative staphylococci strains. The high resistance of isolated bacterial strains is a matter of concern and calls for a rational use of antibiotics in order to avoid the transmission of antibiotic resistance from the environment to humans.

scholarly journals 1477. Impact Of Resistance Thresholds On Mortality In Hospital-Acquired And Ventilator-Associated Pneumonia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S739-S740
Author(s):  
Patrick B Mazi ◽  
M Cristina Vazquez Guillamet ◽  
Scott Micek ◽  
Marin Kollef
Keyword(s):  
Staphylococcus Aureus ◽  
Broad Spectrum ◽  
Methicillin Resistance ◽  
Empiric Therapy ◽  
Risk Difference ◽  
Excess Risk ◽  
Model Parameters ◽  
Ventilator Associated Pneumonia ◽  
Gram Negative ◽  
Hospital Acquired

Abstract Background Hospital-acquired (HAP) and ventilator-associated pneumonia (VAP) represent a significant source of morbidity and mortality in hospitalized patients. Numerous studies demonstrate mortality benefit with appropriate empiric therapy. Choosing the right empiric coverage is paramount; however, this decision becomes more challenging as rates of antibiotic resistance rise. Most recent HAP/VAP guidelines use an arbitrary population resistance rate of 20% to recommended methicillin-resistant Staphylococcus aureus (MRSA) coverage and double-coverage of resistant gram negative bacilli (GNB). Using this threshold has led to overuse of broad spectrum antimicrobials. The goal of this study is to mathematically explore the impact of this threshold on patient outcomes and link population resistance rates to individual mortality risk. Methods We used the concept of excess morality risk (EMR) to develop a theoretical simulation model based for HAP/VAP caused by GNB and MRSA empirically treated with piperacillin-tazobactam and vancomycin. EMR is the product of the proportion of HAP/VAP caused by GNB/MRSA, the rate of antibiotic (piperacillin-tazobactam/ methicillin) resistance in GNB and Staphylococcus aureus isolates and the difference in mortality between discordant and appropriate antibiotic therapy. Model parameters were obtained from large surveillance networks and published clinical trials. Results At the HAP/VAP guideline threshold of 20% methicillin resistance in SA isolates, the EMR was 0.3%; when the model included only culture positive patients, EMR was 0.6%. At a threshold of 20% resistance to piperacillin-tazobactam in GNB isolates, EMR was 1.9% and 3.1% when culture-negative patients were excluded. EMR increased as baseline risk of failure with discordant therapy increased (e.g. critically ill patients, ventilated HAP). Risk Difference of Death for Staphylococcus aureus Isolates Risk Difference of Death for Gram Negative Bacilli Conclusion This model offers a mathematical exploration of the individual excess risk for death in patients with HAP/VAP caused by GNB/MRSA because of discordant therapy. The objectivity of the model would better allow clinicians, guideline authors, and health policy makers to weigh excess risk versus possible harms of broad-spectrum therapy when developing population resistance thresholds cutoffs for empiric therapy recommendations. Disclosures All Authors: No reported disclosures

scholarly journals Bacteriological Profile of Diabetic Foot Infection and Its Effect on Limb Salvation

2020 ◽  
Vol 24 (1) ◽  
pp. 21-25
Author(s):  
Mahbub Murshed
Keyword(s):  
Staphylococcus Aureus ◽  
Data Collection ◽  
Diabetic Foot ◽  
Treatment Modalities ◽  
Gram Positive ◽  
Foot Ulceration ◽  
Gram Negative ◽  
Bacteriological Profile ◽  
Data Collection Sheet ◽  
Gram Positive Cocci

Background: Foot ulceration has been reported as the leading cause of hospital admission and amputation in individuals with diabetes. Diabetes-related foot ulcers require multidisciplinary management and care, including debridement, offloading, dressings, management of infection, modified footwear and management of extrinsic factors. Objective: To identify the bacterial pathogens responsible for diabetic foot infections and its effect on limb salvation. Methods: This prospective observational and cross sectional study was conducted among 100 diabetic foot ulceration patients in Mainamati Medical College Hospital, Cumilla between the period of January, 2017 to December, 2018. The patients with diabetic foot ulcer Wagner Grade (2-5) irrespective of age and sex were included in the study. They were thoroughly examined and swab from ulcer base was collected by sterile swab stick and container supplied by the microbiology department. A pre-structured, peer reviewed, interview and observation based data collection sheet was prepared that was used as a research tool. Data regarding clinical, hematological and bacteriological profile were recorded by data collection sheet. Data were entered, managed and analyzed. Results: Diabetic foot was very common in the elderly age group (51-60yrs) 38% and male predominant (78%). Staphylococcus aureus (35%) is the commonest pathogens affecting as the gram positive cocci whereas pseudomonas (23%) is the commonest among the gram negative bacilli. Chloramphenicol, Amikacin, Vancomycin were the most sensitive drugs against gram positive cocci whereas, Cefuroxin, Co-trimoxazole and Gentamycin found the most sensitive drugs against gram negative bacilli. Incision, drainage and dressing (31%) found the commonest treatment modality. The other treatment modalities were debridement, dressing and reconstruction conservative dressing, above and below knee amputation, toe disarticulation etc. Conclusion: Diabetic foot is usually affected by Staphylococcus aureus and streptococcus among the gram positive cocci and pseudomonas whereas Chlamydia and E. coli among the gram negative bacilli. For the limb salvage incision & drainage as well as debridement, excision and reconstruction are the mostly chosen procedure. Journal of Surgical Sciences (2020) Vol. 24 (1) : 21-25

scholarly journals Isolation, Enumeration, and Identification of Gram-Positive Cocci from Frozen Crabmeat

1995 ◽  
Vol 58 (8) ◽  
pp. 853-857 ◽  
Author(s):  
RUDOLPH D. ELLENDER ◽  
LIEPIN HUANG ◽  
SANDRA L. SHARP ◽  
ROBERT P. TETTLETON
Keyword(s):  
Staphylococcus Aureus ◽  
Species Identification ◽  
Incubation Temperature ◽  
Identification Procedure ◽  
Gram Positive ◽  
Gram Negative ◽  
Plate Counts ◽  
Isolation Media ◽  
Bacterial Type ◽  
Gram Positive Cocci

Bacterial levels in frozen crabmeat samples were determined by plate counts using four staphylococcal isolation media incubated for 24, 48, and 72 h at 26 and 35°C. Staphylococcal counts determined by the spread-plate Food and Drug Administration Baird-Parker protocol incubated at 35°C for 48 h (FDABP48-35) served as the standard for comparison. When FDABP48-35 counts were compared to counts from 29 combinations of media, time of incubation, and incubation temperature, only FDABP and Borrego, Florido, Mrocek, and Romero (BFMR) counts, representing 11 combinations, were statistically comparable to FDABP48-35 counts. Cocci (91.5%) were the dominant bacterial type; gram-positive rods (8.3%) and gram-negative isolates (0.2%) were also detected. Isolates tested by the coagulase reaction were predominantly coagulase negative (CN) (97.7%). Of 100 isolates analyzed by the BIOLOG identification procedure, 62% were classified as Staphylococcus lentus, S. hominis, and S. epidermidis. Three isolates were identified as Staphylococcus aureus. These data indicate that species identification of staphylococci from crabmeat can assist in determining the source of contamination, and that staphylococcal isolates from crabmeat are more likely to be coagulase negative.

scholarly journals 1554. Epidemiology of Adult Bacterial Hand Infections at Two Urban Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S777-S778
Author(s):  
Arsheena Yassin ◽  
Christine Stavropoulos ◽  
Krystina L Woods ◽  
Jiashan Xu ◽  
Justin Carale ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
Antibiotic Regimen ◽  
Gram Positive ◽  
Gram Negative ◽  
Streptococcus Species ◽  
Urban Hospitals ◽  
Haemophilus Parainfluenzae ◽  
Empiric Antibiotic ◽  
Gram Negative Organisms

Abstract Background Hand infections represent a major source of morbidity, which can result in hand stiffness and amputation. Early appropriate empiric antibiotic regimen may reduce the associated morbidity, hence the importance to examine local epidemiology. The aim of this study was to define the current epidemiology of adult hand infections at two urban hospitals in New York City. Methods We performed a double center, retrospective study of adult patients hospitalized from March 2018 to May 2020. Patients with positive cultures associated with the hand infections were included. Retrospectively, 100 patients were reviewed. Data on baseline demographic, clinical, surgical, microbiology, and treatment parameters were collected. Results Of the 100 patients, 76% were male, with median age of 47.5 years (35, 58.25) and average C-reactive protein (CRP) of 50.66 mg/L (± 64.64) on admission (see Table 1). Previous hospitalization within 1 year (38%), previous surgical procedures (39%) and recent IV medication use (26%) were common. 130 bacterial isolates were identified (see Table 2). The most frequent organisms were Gram-positive, with Methicillin susceptible Staphylococcus aureus (MSSA, 25.38%), Streptococcus species (20.08%), and Methicillin resistant Staphylococcus aureus (MRSA, 15.38%) being the most common. Gram-negative organisms were infrequent, with Haemophilus parainfluenzae (3.85%), Enterobacter cloacae (3.85) and Pseudomonas aeruginosa (3.08%) being the most prevalent. Of the 100 patients, 27% had polymicrobial infections, associated with trauma (6%), illicit IV use (6%) and unknown (7%) etiologies. Table 1: Baseline demographics and co-morbid conditions Table 2: Types and numbers of organisms in relation to etiologies Conclusion Within our population, the most common organisms associated with hand infections were Gram-positive, with Staphylococcus aureus and Streptococcus species being the most prevalent. Gram-negative pathogens were infrequently isolated. The results within this study can provide guidance to clinicians on assessing the appropriate empiric antibiotic regimen in patients with hand infections, and can serve as a basis for further studies identifying risk factors associated with isolation of organisms associated with hand infections. Disclosures All Authors: No reported disclosures

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