Background Resistance profile analysis in Pseudomonas aeruginosa isolates is extremely important to prevent its transmission and to detect outbreaks. Broadly resistant strains (BR) have a high mortality rate in invasive infections. By analyzing the clinical and microbiological characteristics of these infections, one can define more effective actions in a nosocomial outbreak setting in a university hospital in Brazil. Methods From January to September 2019, 13 patients from the oncohematology services and intensive care unit (ICU) followed by the stewardship program of a public university hospital in Brazil had Pseudomonas aeruginosa (PsA) BR infection. Resistant multidrug (MDR) was defined as resistant to three or more antimicrobial classes. Extensively resistant (XDR) was sensitive to a maximum of two antimicrobial classes. Resistant pandrug (PDR) has been defined as resistant to all antimicrobial classes. Bacterial samples were identified by the automated VITEK®2 system (BioMérieux). The resistance pattern was defined based on the CLSI-M100 2019 criteria. Colistin sensitivity was assessed by the colistin drop test (Pasteran et al., 2018). The modified carbapenemic inactivation method (mCIM) was performed by disk diffusion. Results The 13 strains of PsA were isolated from 84.6% (11/13) blood cultures and 15.4% (2/13) tracheal aspirates, being 76.9% (10/13) from the oncohematology unit and 23.1% (3/13) of the ICU. The resistance profile was 23.1% (3/13) strains PsA MDR, 61.5% (8/13) PsA XDR and 15.4% (2/13) strains resistant to all classes (PsA PDR). 69.2% (9/13) of the strains were mCIM positive, in which the therapeutic option was ceftazidime/avibactam in combination with polymyxin. Regarding the sites of infection and use of devices, 53.8% (7/13) of the patients developed the infection after the use of central venous catheter and/or mechanical ventilation. The mortality rate was 76.9% (10/13). Conclusion The investigation of the outbreak of Pseudomonas aeruginosa highlights the importance of infectious surveillance of this pathogen with this resistance profile, to better understand the causalities, minimize its damage and reduce potential recurrence of new outbreaks. Disclosures All Authors: No reported disclosures

Background Enterobacteria and multidrug-resistant non-fermenting Gram-negative bacilli present a challenge in the management of invasive infections, leading to mortality rates due to their limited therapeutic arsenal. The objective of this work was to analyze risk factors that may be associated with these infections, for a better situational mapping and assertive decision-making in a university hospital in Brazil. Methods The study was conducted between January and September 2019, with 167 patients in contact isolation at a university hospital in Brazil. Potential outcome-related variables for wide-resistance Gram-negative bacteria (BGN) infections were evaluated. Risk factors were identified from univariate statistical analysis using Fisher’s test. Results 51 (30.5%) out of 167 patients in contact isolation evolved with wide-resistance BGN infection. Risk factors in univariate analysis were age, hospital unit and previous use of invasive devices. Patients aged up to 59 years were more likely to progress to infection than those aged over 60 years (p 0.0274, OR 2.2, 95% CI 1.1-4.5). Those admitted to the oncohematology (p < 0.001, OR 32.5, Cl 9.1-116.3) and intensive care unit (p < 0.001, OR 28.0, Cl 3.5-225.9) units were more likely to develop this type of infection. The least likely were those admitted to a kidney transplant unit (p 0.0034, OR 15.33, Cl 1.8-131.0). Prior use of mechanical ventilation (p 0.0058, OR 12.2, Cl 2.0-76.1) and delayed bladder catheter (p 0.0266, OR 5.0, Cl 1.2-20.1) in patients with respiratory and urinary tract infection, respectively, were also reported as risk factors related to these infections. The gender of the patients was not significant for the study. Conclusion This study determined that variables such as age, hospitalization unit, use of mechanical ventilation and delayed bladder catheter could be considered important risk factors in triggering the infectious process by wide-resistant gram-negative bacteria. Thus, the analysis of these factors becomes a great foundation to prevent the development of multiresistant pathogens through prevention strategies, prophylaxis management and more targeted empirical therapies. Disclosures All Authors: No reported disclosures

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