2452. Prevalence of Antimicrobial ReSistanCE iN BloodStream Infections in HOspitalized (BSI) PatieNts in BRazil (ASCENSION-BR): Preliminary Results of a Multicenter Study

Abstract

Abstract Background Carbapenem-resistant Enterobacterales (CRE), P. aeruginosa (CRPA), A. baumannii (CRAB), methicillin-resistant S. aureus (MRSA) and vancomycin-resistant E. faecium (VRE) are major multidrug-resistant (MDR) bacteria causing healthcare-associated infections. There is no multicenter study addressing the prevalence of these MDR bacteria in Brazil. We report the preliminary results of the ongoing ASCENSION-BR study evaluating the prevalence of these microorganisms in BSI in hospitalized patients in this country. Methods This prospective multicenter study has been conducted in 13 hospitals distributed in 4 of 5 Brazilian regions. From 15th August to 31st April (to be finished on 14th August 2023), each hospital recruited patients for a period of up to 6 months. Adult patients hospitalized for at least 48h, with positive blood cultures with Enterobacterales, P. aeruginosa, A. baumannii, S. aureus and Enterococcus spp. were eligible. More than one BSI of the same patients were included if caused by a distinct bacteria. MDR isolates were sent to a central laboratory where isolates were re-identified by MALDI-TOF-MS. Results A total of 10 hospitals recruited patients for 6 months(m), 1 for 5m, and 2 for 1m. 1231 bacterias were isolated from 1091 BSI episodes (118 were polymicrobial), and 442 (35.9%) were MDR. Enterobacterales were the most common isolates in BSIs (659, 75.3%), followed by S. aureus (221, 18.0%), A. baumannii (113, 12.9%), Enterococcus spp. (135, 11.0%: 48 [35.6%] E. faecium and 84 [62.2%] E. faecalis) and P. aeruginosa (103, 8.4%). Among Enterobacterales, the most frequent species were K. pneumoniae (275, 41.7%), E. coli (126, 19.1) and Enterobacter spp. (69, 10.5%). A total of 224 (34.0% of Enterobacterales) BSIs were caused by CRE (155 [69.2%] K. pneumoniae, 27 [12.1%] Serratia marcescens, 15 [6,7%] Enterobacter spp., and 27 [12.1%] other 11 species. A total of 100 (88.5% of A. baumannii) isolates recovered in BSIs were CRAB and 38 (36.9% of P. aeruginosa) were CRPA. Among Gram positives, 50 (22.6% of SA) were MRSA, and VRE represented 93.3% of E. faecium and 3.3% of E. faecalis isolates. Conclusion High prevalence of MDR in BSI, notably in A. baumannii, were found among hospitalized patients in Brazil. Disclosures João Telles, MD, PhD, MSD: Advisor/Consultant|MSD: Speaker|Pfizer: Advisor/Consultant|Pfizer: Speaker|União Química: Advisor/Consultant|União Química: Speaker Alexandre Zavascki, MD, PhD, Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support