P2432 - Multi-Drug Resistant Organisms (MDRO) Account for Majority of Resistant Microbiology Cultures in Admitted Patients With Cirrhosis in Newfoundland and Labrador

Scott D. Bray, MD, MSc, BSc¹, Mark Borgaonkar, MD, MSc, FRCPC, FACG^2
1Memorial University of Newfoundland, St. John's, NF, Canada; ²Memorial University of Newfoundland, St. John's, NF, Canada

Introduction: Patients with decompensated cirrhosis have increased hospitalizations causing a higher risk of acquiring infections caused by multi-drug resistant organisms (MDRO). MDRO lead to delayed appropriate treatment causing increased morbidity, and mortality in the cirrhotic population. We aimed to determine the prevalence of MDRO and extrapolate the implication this may have on empiric antimicrobial treatment in cirrhotic patients hospitalized in Newfoundland and Labrador (NL).

Methods: Patients with a history of cirrhosis and antimicrobial resistant cultures admitted to an acute care facility in the Eastern Health Region of NL between 2016-2021 were included in this study (n=142). Cirrhosis was defined as evidence of advanced liver fibrosis seen on ultrasound, CT-scan or MRI. Each patient was then grouped into non-MDRO or MDRO based on their microbiology culture report. Non-MDRO group was defined as patients with positive microbiology cultures showing resistance to 1 or 2 antimicrobials. Whereas the MDRO group was defined as patients with positive microbiology cultures showing resistance to 3 or more antimicrobials. Microbiology cultures included in this study were, ascitic fluid, blood, pleural fluid, sputum, urine, and wound cultures. Microbiology culture collection date was then cross-referenced with date of admission to determine if their infection was diagnosed upon presentation to hospital or a hospital-acquired infection (HAI).

Results: On review of 142 cirrhotic patients with resistant microbiology cultures, MDRO accounted for 54.7% of all resistant organisms in the cirrhotic patient population through 2016-2021 with the most common MDRO being Escherichia Coli (32.1%) and Enterococcus Faecium (23.5%). Urine cultures were found to be the most common source of MDRO (32.4%), followed by blood cultures (10.8%) and ascitic fluid cultures (4.1%). HAI associated MDRO accounted for 31.0% of all resistant organisms throughout this study time period.

Discussion: These data indicate that in hospitalized cirrhotic patients with drug resistant infections, over 50% have MDRO. These findings could have implications for initial antibiotic choice in this patient population.


Disclosures:


Scott D. Bray, MD, MSc, BSc¹, Mark Borgaonkar, MD, MSc, FRCPC, FACG². P2432 - Multi-Drug Resistant Organisms (MDRO) Account for Majority of Resistant Microbiology Cultures in Admitted Patients With Cirrhosis in Newfoundland and Labrador, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.