A 3-Year Evaluation of Antibiotic Resistance Patterns in Gram-Negative Genitourinary Tract Infections Treated in Outpatient Infusion Centers (POICs)
SUGAR LAND, TX – (February 16, 2022) Resistant Gram-negative pathogens (GNP) are a primary cause of many infections, particularly genitourinary tract infections (GUI). High recurrence rates and increasing antibiotic resistance often require intravenous antibiotics for treatment, commonly provided in the outpatient setting. A study evaluated the distribution and resistance patterns of the GNP isolated from genitourinary patients treated in physician outpatient infusion centers (POICs) over a 3-year period.
In this study, the authors collected data from 18 POICs for GUI patients receiving outpatient antimicrobial therapy (OPAT) from 2018 to 2020. Resistant GNP were evaluated and categorized as extended-spectrum beta-lactamase (ESBL), multi-drug resistant (MDR), or carbapenem-resistant. The data was stratified by the patient location prior to OPAT, either the hospital or the community, and by the year.
E. coli was the most predominant pathogen isolated, followed by Pseudomonas species. Resistance was observed in 52% of pathogens with ESBL-producers 43%, MDR 36% and CPR 3%. In addition, the authors found a significantly higher rate of ESBL with GNP from hospital discharged patients compared to community-acquired infections (53% vs. 36%) and an increase in the overall incidence of ESBL over time.
The year-by-year analysis in the study indicated a comparable distribution of overall GNP in patients between years. Of note, the frequency of ESBLs increased significantly from 37% in 2018 to 49% in 2020 due to a higher incidence of ESBLs in hospitalized patients. The incidence of MDR pathogens appeared consistent over time and did not differ significantly by referral source.
The study concluded that over half of the Gram-negative pathogens isolated in genitourinary patients receiving outpatient antimicrobial therapy had antibiotic resistance. ESBLs had a 1.5-fold higher incidence in hospital-associated infections compared to community-acquired infections and increased year-over-year. Management of Gram-negative GUIs in the outpatient setting requires close monitoring of emerging resistance patterns to ensure effective therapy and outcomes.
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IDWeek is the joint annual meeting of the Infectious Diseases Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), the HIV Medical Association (HIVMA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP). Celebrating its 10th anniversary, IDWeek 2021 was a virtual conference that took place from September 29 to October 3, 2021.
Richard L Hengel, MD, Brian S Metzger, MD, MPH, H Barry Baker, MD, FACP, John S Adams, MD, Ramesh V Nathan, MD, FIDSA, Rishi Bhattacharyya, MD, Richard M Mandel, MD, FIDSA, Kimberly A Couch, PharmD, MA, FIDSA, FASHP, Claudia P Schroeder, PharmD, PhD, Lucinda J Van Anglen, PharmD, 598. A 3-Year Evaluation of Antibiotic Resistance Patterns in Gram-Negative Genitourinary Tract Infections Treated in Outpatient Infusion Centers (POICs), Open Forum Infectious Diseases, Volume 8, Issue Supplement_1, November 2021, Pages S402–S403, https://doi.org/10.1093/ofid/ofab466.796