1317. Prevalence of Pseudomonas aeruginosa as the Causative Organism for Community Acquired Pneumonia

Abstract

BackgroundIDSA/ATS guidelines regarding pneumonia diagnosis and treatment changed in 2019. Guidelines recommend determining local prevalence of MRSA and P. aeruginosa to help guide empiric antibiotic coverage. The aim of our study was to determine the prevalence of P. aeruginosa as the causative organism for adult patients admitted to a large urban academic medical center with community acquired pneumonia (CAP).MethodsA report of urine streptococcus antigen tests collected January 1st-December 31st in 2019 was generated. Six hundred charts were reviewed and two hundred subjects met inclusion criteria (figure 1). Inclusion criteria were age >18, hospital admission, and documented suspicion of pneumonia by a physician.ResultsThe average age was 70 and half of the cases were women. The causative organism was identified in 60/200 cases (table 1). No cases of P. aeruginosa were identified. The most commonly isolated organisms were Influenza A and pneumococcus. 66% of cases had age >65yo, 25% were from long term care facilities, 34% had structural lung disease, 20% had dementia, 15% were hospitalized in the prior 90 days and received IV antibiotics, and 30% of cases met severe CAP criteria (table 2). Figure 1. WorkflowTable 1. Organisms Identified Table 2. Risk Factors ConclusionLimitations include a low prevalence of renal failure in the study population, and lack of a standardized respiratory infection evaluation. Our results suggest that empiric coverage for P. aeruginosa may not be needed at our center in this cohort of older patients with clinical characteristics sometimes thought to be risk factors for P. aeruginosa.Disclosures Wendy Szymczak, PhD, Premier, Inc (Consultant)Qiagen (Consultant, Scientific Research Study Investigator) Gregory Weston, MD MSCR, Allergan (Grant/Research Support)