BACKGROUND: According to CDC, Multi Drug Resistant Organisms (MDRO) is used to describe bacteria that have acquired resistant to one or more classes of antimicrobial agents. Antibiotic resistant bacteria cause more than 2 million illnesses and at least 23,000 deaths each year in United States. MDRO’s are found in many health care settings like acute care hospitals, long term care facilities, nursing homes, rehabilitation facilities and other health care settings. Although MDRO includes more than 70 species, reporting in State of Texas, is limited to Carbapenem-resistant Enterobactericeae (CRE)-Klebsiella species, CRE-Escherichia coli, and Multidrug resistant-Acinetobacter (MDR-A). Objective of this study is to examine demographic as well as clinical data of the MDRO cases in Houston, Texas, in year 2015.
METHODS: Population based surveillance data was abstracted from Houston’s electronic disease surveillance system from January 1, 2015 to December 31, 2015. Descriptive analysis was performed to examine demographic and clinical data across different age groups, gender and race/ethnicity. Houston Health Department has received a total of 740 MDRO reports of unique cases during 2015, out of which 193 (26%) were out of jurisdiction cases and 175 (24%) cases were non-reportable. The remaining 372 (50%) cases were included in this study.
RESULTS: Out of a total of 372 cases, 202 (54%) were females, and 170 (46%) were males. The mean age of the cases was 64 years (age ranges from 1-94). Majority of the cases were in the older age group (70 years and above) 142 (38%) followed by 88 (24%) in age group 60-69 years. Among the different race/ethnic groups, African-Americans were 134 (36%), followed by Whites 84 (26%) and Hispanics 60 (16%). Out of 372 cases, 295 (79%) were hospitalized, and among them, 104 (35%) came to hospital by themselves, followed by 64 (22%) came from long term care facility/nursing home. Out of 295 hospitalized cases, 78 (26%) were in Intensive Care Unit and 155 (53%) had an invasive or indwelling devices. Of all the cases, 60% had CRE Klebsiella pneumoniae, followed by 35% who had MDR-A.
CONCLUSIONS: MDRO cases are found to be more common among older age groups, females and African Americans population. Multi-drug resistance can be a ground for Health Care-Associated Infections and possible reasons may include frequent hospitalization, use of invasive and indwelling devices, advancing age, underlying medical conditions and prolong use of antibiotics. Further studies are needed to explore the occurrence of anti-microbial drug resistance among the specific population groups.