2035. Clinical and Economic Outcomes in Patients with Complicated Urinary Tract Infection (cUTI) and Complicated Intra-Abdominal Infection (cIAI) in Perú: Impact of Gram-Negative Organisms (GNO) Resistant to Antibiotics

Abstract

BackgroundDelays in appropriate therapy of infections affect clinical outcomes. The aim of this study was to compare the clinical and economic outcomes of patients with cUTI and cIAI due to cephalosporin- and carbapenem-resistant GNOs to similar infections caused by nonresistant GNOs.MethodsA retrospective cohort study of patients admitted to two tertiary care hospitals in Lima-Callao, Peru between January and December 2017. Patients with resistant strains were compared with those with nonresistant strains for the failure of initial antibiotic regimen (defined as worsened clinical status, change of initial antibiotic treatment, or in-hospital mortality), median length of stay (LOS), hospitalization ward cost and total hospitalization cost.ResultsA sample of 500 consecutive culture-positive patients were included: 429 (86%) with cUTI and 71 (14%) with cIAI (table).ConclusioncUTI caused by GNOs resistant to cephalosporins or carbapenems are associated with an incremental clinical and economic burden. The proportion of inappropriate therapy in patients with resistant infections is high. The cost of care for carbapenem-resistant cUTI was highest. The appropriate initial antibiotic choice may minimize the impact of GNO resistance on outcomes of patients with cIAI and cUTI. Disclosures All authors: No reported disclosures.