P24.05 Time trends and associated factors to antimicrobial resistance of Escherichia coli infections in hospitalized patients. Spain, 1999–2009

s, 7th International Conference of the Hospital Infection Society, 10–13 October 2010, Liverpool, UK / Journal of Hospital Infection 76S1 (2010) S1–S90 S69 3GC increased from 5.5% to 25.3% and from 3.9% to 22% throughout the study period, respectively (p 1yr. (OR 9.7). Resistance to 3GC was associated to nosocomial infection (OR 2.25), and ICU (OR 1.55). Conclusions: Rates of resistance of K. pneumoniae to FQ and 3GC in Spain are high, have increased dramatically in the last years, are highly correlated with FQ consumption, and are associated with several factors. The study was granted by FIS PI07/90255. P24.05 Time trends and associated factors to antimicrobial resistance of Escherichia coli infections in hospitalized patients. Spain, 1999–2009 A. Asensio, T. Alvarez-Espejo, R. Canton, A. Ramos, E. Munez, J. Molina, D. Monge, J. Vaque. Puerta de Hierro University Hospital, Spain; Ramon y Cajal University Hospital, Spain; CU Insular de Canarias, Spain; Hospital Vall d’Hebron, Spain Background: E. coli is the main Gram-negative bacteria causing infections in hospitalized patients. Monitoring national rates and trends associated to antimicrobial resistance (AR) infections can help to prevention. Objectives: To identify rates, time trends and associated factors of antibiotic resistant E. coli infections in hospitalized patients in Spain. Methods: A series or annual prevalence surveys in Spanish hospitals from 1999 through 2009. Resistance to, and consumption of, 3rd gen. cephalosporins (3GC) and fluoroquinolones (FQ) were recorded, as well as patient and infection characteristics. Time trends in AR and antibiotic use and correlation between them were computed. AR associated factors were identified by logistic regression. Results: Up to 266 hospitals participated every year. A total of 17,193 E. coli infections were identified. Most infections were localized in the urinary tract (54%) and in patients older than 65 years (59%). Resistance to FQ and to 3GC increased from 15.9% to 34.2% and from 4.6% to 15.7% respectively (p 15 yrs. (OR 4.57). Resistance to 3GC was associated to nosocomial infection (OR 1.71), ICU (1.81) and respiratory tract infections (OR 2.05). Conclusions: Rates of resistance of E. coli to FQ and 3GC in Spain are high, have increased dramatically in the last years, are highly correlated with FQ consumption, and are associated with several factors. The study was granted by FIS PI07/90255. P24.06 Prevalence of highly resistant Enterobacteriaceae including ESBLs in retail meat J. Bruin, M. van der Aar, I. Overdevest, J. Kluytmans, B. Diederen. The Regional Laboratory of Public Health, Netherlands; St Elisabeth Hospital, Netherlands; VU University Medical Centre and Amphia Hospital, Netherlands Aim: The aim of this study is to determine the prevalence and quantity of highly resistant Enterobacteriaceae (HRE) including ESBLs in retail meat. Methods: The study was performed between April and May 2010. Raw retail meat was collected in sterile containers filled with 5ml of saline. After vortexing, 10ml was inoculated directly on ESBL ID (bioMerieux), non selective media, and into trypticase soy broth (TSB) supplemented with 1mg/l ceftazidime. After incubation for 24h at 35°C, 10ml of broth was streaked on a ESBL ID plate. Plates were incubated for 24h at 35°C. All Enterobacteriaceae were identified and antimicrobial susceptibility testing was performed. The definition for HRE was used according to the Dutch Working Party on Infection Prevention guideline. Susceptibility data and confirmation of ESBL was determined according to CLSI criteria. Results: A total of 85 meat samples were included in this study. The tested samples were chicken (52%), beef (29%), pork (9%), and other sources (9%). From 18% (15/85) of the samples tested, ESBL producing E. coli was recovered. All ESBL positive samples were chicken (34% positive). Six samples were positive after direct inoculation of the agar media. The average quantity in these samples was 300CFU/gram chicken (range: 77–652). In a total of 39 samples (32 chicken, 5 beef, 2 other), 44 (ESBL negative) Enterobacteriacea were isolated. Resistance rates were 98% to ampicillin, 80% to amoxicillin/clavulanic acid, 7% to cotrimoxazole, 5% to gentamicin and 0% to piperacillin/tazobactam, meropenem and ciprofloxacin. None of these isolates fulfilled the criteria for HRE. Conclusion: One third of all chicken samples contained ESBL producing E. coli. We did not isolate HRE other than ESBL producing E. coli. Chicken meat is a potential source of pandemic ESBL producing E. coli in the community and hospitals. Further investigations are needed to elucidate the role of ESBLs in chickens and its possible transmission to humans. P24.07 Time trends and associated factors to antimicrobial resistance of Acinetobacter baumannii infections in hospitalized patients. Spain, 1999–2009 T. Alvarez-Espejo, A. Ramos, R. Canton, J. Vaque, P. Rodriguez, F. Calbo-Torrecillas, V. Pastor, A. Asensio. Puerta de Hierro University Hospital, Spain; Ramon y Cajal University, Spain; Hospital Vall d’Hebron, Spain; Gregorio Maranon University Hospital, Spain; Hospital Carlos Haya, Spain; Princesa University Hospital, Spain Background: A. baumanni is an emergent and resistant pathogen in nosocomial infections. Monitoring national rates and trends of antimicrobial resistant (AR) infections can help to prevent and control infections. Objective: To identify rates, time trends and associated factors of infections due to antibiotic resistant A. baumannii in hospitalized patients in Spain. Methods: A series of annual prevalence surveys in Spanish hospitals from 1999 to 2009. Resistance to, and consumption of carbapenems (CP), were recorded, as well as patient and infection characteristics. A correlation between resistance and antibiotic consume was made. Factors associated to AR were identified by logistic regression. Results: Up to 266 hospitals participated every year. A total of 1865 A. baumannii infections were identified. Most infections were in men (74.5%), older than 65 years (64.9%), nosocomial acquired (84.3%) and located in respiratory tract (42.3%). They were located in ICUs (36.1%) and medical wards (33.4%) Resistance to CP increased from 38.7% to 61% in the last ten years. Correlations between CP resistance and CP consumption were observed (Pearson correlation coefficient 0.88; p < 0.001). Resistance to CP was associated to nosocomial onset, lung chronic disease, mechanic ventilation, tracheotomy and peripheral line. Conclusions: Rates of resistance of A. baumannii to antibiotics in Spain are high, have doubled in the last years, are highly correlated with CP consumption, and are associated with several identifiable factors. The study was granted by FIS PI07/90255.