P-883. Descriptive single center study on hospital acquired gram negative bloodstream infection: epidemiology, susceptibilities and outcomes in a six-year period
Bibliographic record
Abstract
Abstract Background Hospital acquired (HA)gram negative bacteremia contribute to substantial mortality and morbidity. Understanding the epidemiology of this entity including susceptibility patterns can inform appropriate antimicrobial therapy. Objective: To describe the epidemiology, antimicrobial susceptibilities and outcomes of hospital acquired gram negative blood stream infection over six-year period in a quaternary care hospital. Methods We used the Infection Prevention Control data base to identify all cases of hospital acquired -gram negative bacteremia from Jan 1 2014 to Dec 31 2019. Charts and susceptibilities were reviewed retrospectively. Results 440 HA-gram negative bacteremia cases with 469 gram negative bacterial isolates were included in the study after the exclusion of repeat positives within the first 2 weeks of first positive culture. 65% were male. The mean patient age was 62. Mortality was 23% at 30 days. 90% were monomicrobial infection. The majority had secondary blood stream infection accounting for 80% while 20% had primary blood stream infections. The most common source of secondary blood stream infections was UTI at38%. E. coli was the most common organism isolated during this period followed by K. pneumoniae and P aeruginosa, 44%, 16% and 11% respectively. 14% of isolates were ESBL/AMPC organisms with increasing rates over time. Only 77% of P. aeruginosa was susceptible to meropenem. 42%(n=22/52) of Pseudomonas isolates were multidrug resistant and 12%(n=6/52) were identified as difficult to treat resistance. Enterobacterales group organisms (n=372) were susceptible to ceftriaxone 82%, meropenem 99%, piperacillin-tazobactam 80%, ciprofloxacin 77% and TMP-SMX 74%. Overall, vast majority of gram-negative isolates were susceptible to meropenem (97%). Conclusion Over the six-year period there was a slight increase in ESBL/AMPC organisms but resistance of non ESBL organisms remained stable. The majority were susceptible to meropenem (97). A significant percentage of P. aeruginosa was resistant to meropenem (23%). Disclosures All Authors: No reported disclosures
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".