2166. Real-world susceptibilities to newer antibiotics in Enterobacterales and Pseudomonas aeruginosa including carbapenem non-susceptible and multi-drug resistant isolates : A multicenter analysis

BACKGROUND: Infections caused by multi-drug resistant (MDR) Gram-negative pathogens are increasingly problematic in healthcare settings and are associated with worse clinical outcomes in critically ill patients. We conducted a multicenter evaluation of real-world susceptibilities to newer antibiotics. METHODS: Adult patients (≥ 18 years old) with facility reported antibiotic susceptibility from 2018-2022 across 100 facilities in the BD Insights Research Database (Franklin Lakes, NJ) were evaluated for overall and carbapenem non-susceptible (Carb-NS) Enterobacterales (ENT) and Pseudomonas aeruginosa (PSA) across respiratory, blood, urine, intra-abdominal, skin/wound, and other sources. [Figure: see text] RESULTS: A total of 27676 susceptibility results for Gram-negative pathogens were available for one or more of the antibiotics in Table 1 across 100 facilities, of which 79.9% (22101) and 19.6% (5420) were for ENT and PSA, respectively (Table 2). Ninety percent of susceptibility results for newer antibiotics were for E coli (42.9%), P aeruginosa (19.6%), K pneumoniae (14.6%), P mirabilis (8.1%), and E cloacae (4.8%). The top 3 antibiotics tested for ENT were CZA (11,667), TOL-TAZ (10,127), and MEV (211) and for PSA were TOL-TAZ (3172), CZA (1900), and FDC (317). For antibiotics reporting > 30 isolates, susceptibilities were highest for CZA in overall (98.7%), MDR (92.9%) and Carb-NS (85.0%) ENT and for FDC in overall (95.6%) and Carb-NS PSA (93.3%) (Table 3). Susceptibility of Carb-NS ENT to CZA was lower in 2022 (76.7%) than in 2018 (93.5%) but was consistent from 2019-2021 (85.7-87.7%). In Carb-NS ENT, TOZ-TAZ S was lower than CZA each year, ranging from 13.4 to 43.3% (Figure 1). CZA S was higher in 2022 than in 2018-2021 for Carb-NS PSA and was 82.0% compared to 86.4% for TOL-TAZ (Figure 1). [Figure: see text] [Figure: see text] [Figure: see text] CONCLUSION: Real-world susceptibilities of all ENT were > 90% to CZA, TOL-TAZ, and MEV. Susceptibilities of Carb-NS ENT to CZA and MEV were >80%. Real-world susceptibilities of all PSA were > 85% for CZA, TOL-TAZ, and FDC. Susceptibilities of Carb-NS PSA were > 70% to CZA, TOL-TAZ, and FDC. Newer antibiotics remain an important option for management of resistant ENT and PSA. DISCLOSURES: Todd Riccobene, PhD, AbbVie: Employee salary|AbbVie: Stocks/Bonds ChinEn Ai, MPH, Becton, Dickinson and Company: Employee Kalvin Yu, MD, FIDSA, BD: Stocks/Bonds Sara Gregory, PhD, Becton, Dickinson and Company: Employee Brooke Kim, RN, BSN, MSM, AbbVie: Employee|AbbVie: Stocks/Bonds Dmitri Debabov, PhD. Molecular biology, Abbvie Inc.: Employee of Abbvie that participated in design, study conduct, financial support, interpretation of data, review, and approval of the publication Vikas Gupta, PharmD, Becton, Dickinson and Company (BD): Employee of BD|Becton, Dickinson and Company (BD): Stocks/Bonds