898. Development of Risk Score to Guide Therapy for Carbapenem-resistant Pathogens

Abstract Background Carbapenem resistance is a major concern of the World Health Organization (WHO) and Centers for Disease Control (CDC). The mortality in carbapenem-resistant infection ranges from 26-44%. Delays appropriate antibiotic therapy can lead to increased longer hospital stay. Studies have identified several risk factors associated with carbapenem including mechanical ventilation, indwelling devices, recent invasive surgery, severity illness, hospitalization, prior exposure. However, most these studies include Enterobacterales not Acinetobacter baumannii or Psuedomonas aeruginosa. Therefore, we aimed identify all pathogen types develop scoring tool. Methods This was an observational nested case-control study hospitalized patients January 2016-2022. Risk were compared culture-confirmed gram-negative (GN) organisms (CRO) vs carbapenem-susceptible GN (CSO). Using accumulated data logistic regression backwards-stepwise analysis, tool created c-statistic validation performed on 75% subsample. Results There 1,020 CRO 51,157 CSO identified. Patients primarily female (70.6%) mean age 61 years. common site respiratory (47.1%) followed by urine (29.0%). pathogens included Pseudomonas (66.6%), (18.9%), (14.5%). Included final 46-79 years, male sex, admission, procedure, use, admission unit, APACHE II score, chronic diseases (cardiovascular, liver, renal, respiratory), site, nosocomial (c-statistic, 0.879). A separate type, once identified, improving accuracy 0.941). Conclusion Utilizing obtainable factors, straightforward be used predict to, provide guidance treatment decisions. Further warranted. Disclosures All Authors: No reported disclosures.