267 - Characteristics and Trends of Serratia Blood Stream Infections

Background: Serratia is an opportunistic pathogen known to cause an array of infectious presentations including UTIs, pneumonia, wound infections, skin and soft tissue infections, surgical site infections and although rare, endocarditis and bacteremia. The aim of the proposed study is to identify the characteristics of patients with community-acquired Serratia blood stream infection over a five-year period within the TriHealth inpatient population within the Cincinnati, Ohio Region. The study will also examine antibiotic resistance patterns among patients with Serratia bloodstream infections.
 

Methods: This is a retrospective cohort study of 107 adult patients admitted to two community hospitals from January 2014 to December 2018 with a positive blood culture for Serratia species. A complete data set of 100 patients was analyzed for complications, antibiotic resistance, in-hospital mortality, 90-day mortality, readmission within 90 days and length of Hospital Stay (LOS). Descriptive statistics was performed using frequencies for discrete variables and median (IQR) for continuous variables.

Results: Patients admitted with a positive Serratia blood culture were 38% female with a median (IQR) age of 54.5 years (40.25-71.75) and predominantly white (85%). Forty percent had hepatitis C (HCV) infection and 42% had a history of IV drug use. Most patients were living at home (77%), 18% in long term care and 91% were infected with Serratia marcescens. The most common complications were endocarditis (12%) and osteomyelitis (10%). Extended spectrum beta-lactamase (ESBL) production was confirmed in 13%. In-hospital mortality was 2%, 90-day mortality 2%, readmission 23% and median (IQR) LOS 7(3.25-14.75).PATIENT CHARACTERISTICS AND OUTCOMES (part 1)
PATIENT CHARACTERISTICS AND OUTCOMES (part 2)
PATIENT CHARACTERISTICS AND OUTCOMES (part 3)


Conclusion: This study demonstrates that a high proportion of patients admitted with Serratia bacteremia are IV drugs users and that they have a high prevalence of coexistent HCV infection. Endocarditis and metastatic foci of infection are relatively common.   Appropriate empiric antibiotic management should take into account the significant incidence of ESBL production resulting in a prolonged LOS and a high readmission rate.