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N10. MDRO-GNR/emerging resistant bacterial pathogens
Oral Abstract Submission
Thelma E. Dangana, MBBS
Coordinator
Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Teppei Shimasaki, MD, MS
Dr.
Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Michael Schoeny, PhD
Associate Professor
Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Yoona Rhee, MD, ScM
Assistant Professor
Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Michelle Ariston, BS
Ms.
Rush University Medical Center
Chicago, IL
Disclosure: Abbott Diagnostics: Employee
Karen Lolans, BS
Lab Research Assistant II
Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Enrique Cornejo Cisneros, MD, MS
Infectious diseases physician
Rush University Medical Center
Lima, Lima, Peru
Disclosure: Nothing to disclose
Khaled Aboushaala, MD
Researcher
Rush University Medical Center
Naperville, IL
Disclosure: Nothing to disclose
Lina Thabit, MBBS, MS
Dr
Rush University Medical Center
Burlington, ON, Canada
Disclosure: Nothing to disclose
Jianrong Sheng, MD, PhD
Dr.
Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Pamela B. Bell, II, BA
Lab Research Tech III
Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Robert A. Weinstein, MD
Professor
Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Michael Y. Lin, MD, MPH
Associate Professor
Rush University Medical Center
Chicago, IL
Disclosure: CareFusion Foundation (BD): Investigator-initiated grant, Other Financial or Material Support
OpGen: Other Financial or Material Support, Research support in the form of contributed product
Sage Products (now part of Stryker): Other Financial or Material Support, Research support in the form of contributed product
Vincent B. Young, MD, PhD
William Henry Fitzbutler Collegiate Professor
University of Michigan
Ann Arbor, MI
Disclosure: Bio-K+ International: Consultant
Pantheryx: Consultant
Vedanta Biosciences: Consultant
Mary K. Hayden, MD
Chief, Division of Infectious Diseases; Director, Division of Clinical Microbiology, Professor of Medicine and Pathology
Rush University Medical Center
Chicago, Illinois
Disclosure: Clorox: Grant/Research Support, Other Financial or Material Support, I am co-investigator on research projects at healthcare facilities where Clorox provides product at no cost. Neither I nor my institution receive product.
Medline: Other Financial or Material Support, I am co-investigator on research projects at healthcare facilities where Medline provides product at no cost. Neither I nor my institution receive product.
Molnlycke: Other Financial or Material Support, I am co-investigator on research projects at healthcare facilities where Molnlycke provides product at no cost. Neither I nor my institution receive product.
OpGen: Other Financial or Material Support, I am co-investigator on research projects at healthcare facilities where Sage provides laboratory services at no cost. Neither I nor my institution receive services.
Sage: Other Financial or Material Support, I am co-investigator on research projects at healthcare facilities where Sage provides product at no cost. Neither I nor my institution receive product.
Background :
Among hospitalized patients, underlying variation in gut microbiota may confer differential risk for gut MDRO acquisition.
Methods :
Rectal swab samples were collected from patients ≤2 days of MICU admission and then daily in the 27-bed MICU of an acute care hospital in Chicago, IL over 1 year. Patients were screened for MDRO colonization by selective culture (see Fig. 1 for MDRO types); those with ≥2 swabs and MICU stays ≥3 days were studied. Bacterial 16S rRNA gene amplicon sequences were used for microbiota analysis. Medical records were reviewed.
Results :
In preliminary analysis, 2,480 samples were collected from 627 patients who acquired 170 MDROs (Fig. 1). Debilitation, co-morbidities, and certain medical devices were associated with MDRO acquisition, though admission MDRO status was not (Table). While no interactions were detected between admission MDRO status and clinical predictors of MDRO acquisition, there were significant differences in gut microbiota composition at the time of MICU admission between patients colonized with an MDRO on admission and those not colonized (P-value < 0.001, using analysis of molecular variance (AMOVA) on distances). Therefore, we stratified our analysis by admission MDRO colonization status.
For patients MDRO-colonized at admission, there were no significant differences in microbiota of patients who later did or did not acquire a new MDRO (AMOVA P-value: 0.32). For patients not MDRO-colonized on admission, there was a significant difference in microbiota of patients who later acquired an MDRO and those who did not (AMOVA P-value: 0.026). Differentially abundant operational taxonomic units (OTUs, based on 3% sequence difference) included OTUs classified as Anaerococcus and as other Clostridiales (higher in patients who remained uncolonized) and as Enterococcus (higher in patients who acquired an MDRO) (Fig. 2). Diversity was also higher in patients who remained uncolonized (Wilcoxon test P-value: 0.035) (Fig. 3).
Conclusion :
Among patients not already colonized with an MDRO on admission, we identified gut microbiota differences associated with MDRO acquisition that could help explain patient-level variation in MDRO colonization resistance.