Abstract

Background

Delays in appropriate therapy of infections affect clinical outcomes. The aim of this study was to compare the clinical and economic outcomes of patients with cUTI and cIAI due to cephalosporin- and carbapenem-resistant GNOs to similar infections caused by nonresistant GNOs.

Methods

A retrospective cohort study of patients admitted to two tertiary care hospitals in Lima-Callao, Peru between January and December 2017. Patients with resistant strains were compared with those with nonresistant strains for the failure of initial antibiotic regimen (defined as worsened clinical status, change of initial antibiotic treatment, or in-hospital mortality), median length of stay (LOS), hospitalization ward cost and total hospitalization cost.

Results

A sample of 500 consecutive culture-positive patients were included: 429 (86%) with cUTI and 71 (14%) with cIAI (table).

Conclusion

cUTI caused by GNOs resistant to cephalosporins or carbapenems are associated with an incremental clinical and economic burden. The proportion of inappropriate therapy in patients with resistant infections is high. The cost of care for carbapenem-resistant cUTI was highest. The appropriate initial antibiotic choice may minimize the impact of GNO resistance on outcomes of patients with cIAI and cUTI.

Disclosures

All authors: No reported disclosures.

Details

Title
2035. Clinical and Economic Outcomes in Patients with Complicated Urinary Tract Infection (cUTI) and Complicated Intra-Abdominal Infection (cIAI) in Perú: Impact of Gram-Negative Organisms (GNO) Resistant to Antibiotics
Author
Hercilla, Luis 1 ; Perez, Giancarlo 2 ; Illescas, Ricardo 2 ; Hidalgo, Jose 2 ; Ramirez, Eresvita 1 ; Moreno, Vanesa 1 ; Galdos-Cardenas, Gerson 3 ; Gutierrez-Rodriguez, Raul 4 ; Rodriguez, Lourdes 4 ; Orengo, Juan Carlos 4 ; Monsanto, Homero 4 

1  Sabogal Hospital, Callao, Essalud, Peru; Sabogal Hospital, Lima, Callao, Peru 
2  Almenara Hospital, Lima, Essalud, Peru; Almenara Hospital, Lima, Peru, Peruvian Clinical Research, Lima, Peru 
3  Merck Sharp and Dohme- Medical Affairs, Lima, Peru 
4  Center for Observational and Real-world Evidence (CORE) MSD-Latin America, Puerto Rico, New Jersey 
First page
S684
Publication year
2019
Publication date
Oct 2019
Publisher
Oxford University Press
e-ISSN
23288957
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1093/ofid/ofz360.1715
ProQuest document ID
3171068587
Copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.