2477. Characteristics of patients infected with Carbapenem-resistant Acinetobacter baumannii complex and Carbapenem-resistant Enterobacterales in Tennessee, 2016–2021

BACKGROUND: The spread of Carbapenem-resistant pathogens is a growing global public health concern. Tennessee conducts surveillance of Carbapenem-resistant Enterobacterales (CRE) since 2011 and participates in Multi-site Gram-negative Surveillance Initiative (MuGSI) in Davidson County and seven surrounding counties since 2014. METHODS: We analyzed the CRE and Carbapenem-resistant Acinetobacter baumannii complex (CRAB) incident cases reported to the MuGSI project from 2016–2021. A CRE case is defined as the isolation of Escherichia coli, Enterobacter species and Klebsiella species from normally sterile site or urine, and resistant to ≥1 carbapenem. A CRAB case is defined as the isolation of A.baumannii complex from a normally sterile site or urine (2016-2020). In 2021, cultures from a lower respiratory tract or wound were added. Incident case is defined as a report of the first case in 30 days. Data analysis was performed using SAS Version 9.4. RESULTS: One hundred nine CRAB and 467 CRE cases were reported from 2016–2021. The proportion of males was higher for CRAB (62.39% vs 37.61%, p< 0.0001), while the proportion of females were higher for CRE cases (68.74% vs 31.26%, p< 0.0001). The mean age was 65 and 60 years for CRE and CRAB case respectively. The incidence rate of CRAB was significantly higher in non-white populations (15.90 per 100,000) compared to white populations (4.86 per 100,000) (p< 0.0001). Smoking was more prevalent among CRAB patients (27.52%) than CRE patients (16.49%) (p=0.0076). The prevalence of neurological health conditions was higher in CRAB than CRE (59.63% vs 38.33%; p< 0.0001), as were renal conditions (38.53% vs 26.12%; p=0.0097) and diabetes (48.62% vs 37.69%; p=0.0357). The prevalence of urinary tract infections was higher in CRE than CRAB cases (52.29% vs 77.09%; p< 0.0001). CRAB (95%) and CRE (65%) cases were healthcare-associated infections. CONCLUSION: Patients with CRAB had significantly higher prevalence of neurological, renal, diabetes and smoking history, while UTI was more common in patients with CRE. CRAB incidence was significantly higher in non-whites than whites. More research is needed to explain the disparities and reduce infection burden in vulnerable populations. DISCLOSURES: All Authors: No reported disclosures