5PSQ-089 Impact of antimicrobial resistance on hospital mortality, length of hospital stay and length of ICU stay in patients with bacterial pneumonia admitted to ICU

<h3>Background and Importance</h3> The rise of antimicrobial resistance (AMR) jeopardises the effectiveness of antimicrobial drugs. <h3>Aim and Objectives</h3> To determine the impact on hospital mortality and length of hospital stay and Intensive Care Unit (ICU) stay of patients with pneumonia due to AMR bacteria who required admission to the ICU. <h3>Material and Methods</h3> Retrospective case-control study including hospitalisation episodes of patients aged 17 years and older with a diagnosis of bacterial pneumonia who required ICU admission during the period 2017 to 2022, using the Clinical Administrative National Dataset. Episodes with a diagnosis of pneumonia in which the causative agent could not be identified were excluded. Cases were defined as any hospitalisation labelled as AMR in terms of ICD-10. Controls were the remaining episodes of bacterial pneumonia free of these resistance label. Using Stata v.17, three multivariate models based on Poisson regression were constructed to study AMR impact, adjusted for confounding covariates: age, sex, van Walraven comorbidity index, sepsis, non-COVID viral pneumonia, COVID19 and severity level and risk mortality according to the international APR system. <h3>Results</h3> Included 26,567 hospitalisation episodes, 24,050 (90.53%) were caused by bacteria sensitive to standard antimicrobial drugs (controls), while 2,517 (9.47%) were caused by AMR bacteria (cases). Male patients accounted for 69.94% of hospitalisation episodes versus 30.06% of females. The median age at hospital admission was 64 years (IQR 53–73). Patients with AMR bacterial pneumonia had a median hospital length of stay of 34 days (IQR 19–60) versus 21 days (IQR 11–39) in the control group, p&lt;0.0000. The length of ICU stay was 16 days (IQR 7–35) versus 9 days (IQR 4–11), respectively. Patients with AMR pneumonia also had a higher incidence of sepsis, COVID-19 infection, non-COVID-19 viral co-infection, and a higher mortality rate: 33.69% vs. 27.67%. Mortality increased by 11.8% in patients with pneumonia due to AMR bacteria compared to the control group: IRR=1.118 (95%IC 1.056–1.184), p&gt;|z|&lt;0.000. Patients with AMR pneumonia had an increase in their hospital stay of 36.01% (IRR=1.361 (95%IC 1,309–1,414), p&gt;|z|&lt;0.000) and of 37.6% in their ICU stay (IRR=1.376 (95%IC 1,312–1,443), p&gt;|z|&lt;0.000). <h3>Conclusion and Relevance</h3> AMR bacteria pneumonia due requiring admission to the ICU increases &gt;10% the incidence of mortality and &gt;35% length of ICU and hospital stay. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest