2052. Temporal and Geographical Prevalence of Carbapenem-Resistant Pseudomonas aeruginosa and the In Vitro Activity of Ceftolozane/Tazobactam and Comparators in Taiwan – SMART 2012-2020

Abstract

Abstract Background Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is listed as a critical pathogen by World Health Organization (WHO). Using clinical isolates collected in Taiwan as part of the global SMART surveillance program, we evaluated the trend of CRPA prevalence in recent nine years (2012-2020) as well as in vitro activity of ceftolozane/tazobactam (C/T) and comparators against CRPA collected from ICU vs non-ICU wards from 2016 to 2020. Methods Between 2012-2020, Pseudomonas aeruginosa (PA) isolates were collected from nine sites in Taiwan (2 in Northern, 3 in Central and 4 in Southern Taiwan). MICs were determined and interpreted based on CLSI broth microdilution guidelines and 2021 CLSI breakpoints. PCR screening and β-lactamase gene sequencing were performed for isolates non-susceptible to imipenem or imipenem/relebactam or C/T. Results During the study period, a total of 2639 PA isolates were collected. Among these, 448 isolates were resistant to either imipenem or meropenem (17.0%). Yearly prevalence rate of CRPA increased from 12.3% in 2012 to 22.8% in 2020: 12.3% in 2012 (14/114), 11.5% in 2013 (16/139), 11.5% in 2014 (13/113), 12.2% in 2015 (41/336), 15.5% in 2016 (57/367), 15.9% in 2017 (68/428), 20.4% in 2018 (73/357), 19.4% in 2019 (75/386) and 22.8% (91/399) in 2020. Hospitals in Northern Taiwan had higher CRPA prevalence rate (22.8%, 131/574) compared to those in Central (15.7%, 126/802) and Southern Taiwan (15.1%, 191/1263). Percentage susceptibility of CRPA isolates to C/T from 2016 to 2020 showed 89.47% (51/57) in 2016, 79.41% (54/68) in 2017, 93.2% (68/73) in 2018, 90.7% (68/75) in 2019 and 98.9% (90/91) in 2020. For ICU vs. Non-ICU CRPA isolates, the susceptibility to C/T were 88.3% vs.93.8%, 77.8% vs. 82.5%, 92.3 % vs. 92.9%, 87.1% vs.93.2% and 100% vs. 98.26%, in 2016,2017, 2018, 2019 and 2020, respectively. Conclusion During the period of 2012-2020, the yearly prevalence of CRPA in Taiwan hospitals increased from 12.3% to 22.8%. The high prevalence and increasing trend of CRPA warrant continuous monitoring of evolving antibiotic resistance in Taiwan. Disclosures Tai-Chin Hsieh, MBBS, MSD Taiwan: Advisor/Consultant|MSD Taiwan: Employee of MSD Taiwan|MSD Taiwan: Stocks/Bonds.