390. Epidemiology and risk factors of patients with infection or colonization secondary to ESBL-producing E. coli and Klebsiella sp. in Central China
Session: Poster Abstract Session: Gram Negative Infection - Epidemiology and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Background: Extended spectrum B-lactamase (ESBL)-producing gram-negative rods (GNRs) are growing in prevalence throughout the world and have been found to be an important cause of hospital and community-acquired infections. The impact of ESBL-+ bacteria is being increasingly studied; epidemiology and risk factors for infection and colonization with ESBL-producing GNRs have not been well studied in China.

Methods: Retrospective chart review was performed for 107 patients chosen at random, with cultures positive for E. coli and Klebsiella sp. over a 9-month time period (Oct 2009-June 2010) at two teaching hospitals in central China.  Antibiotic susceptibility and ESBL testing was performed using Kirby Bauer Disk Diffusion according to CLSI guidelines. Categorical and continuous variables were compared using the chi-square test and t-test. Risk factors for ESBL+ colonization or infection were analyzed using logistic regression.

Results: 107 patients (51 male, 56 female, average age 58.7±20.3) had positive cultures for E. coli (75) and Klebsiella sp. (32). 70% (75/107) of isolates were ESBL+, including 31 (29%) urine, 29 (27%) respiratory tract, 21 (20%) blood, and 26 (24%) from other sources. The majority of ESBL+ isolates grew from patients w/o history of ICU admission 49 (65%), on medical services 40 (53%), and without prior of hospitalization in the last 60 days 53 (71%). 13/21 (62%) of ESBL + are blood isolates and 3/13 (23%) were community-acquired.  The presence of any invasive device (p=.01), and surgery in past 60d (p=.05) were significantly associated with infection or colonization with ESBL-producing isolates. After multivariate analysis, the presence of any invasive device/catheter alone remained an independent risk factor of infection or colonization with ESBL + isolates.

Conclusion: ESBL + E. coli and Klebsiella sp. are prevalent in central China. The removal of non-essential invasive devices, along with transmission control measures, may help to decrease the spread of these organisms in the hospital environment. Community-acquired infection potentially plays an important role.  More work is needed to study the contribution of community-acquired ESBL+ bacteria to colonization, infection, and subsequent morbidity and mortality.


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Xiaobei Chen, PH.D., Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, China, Jennifer M. Christoff, MD, University of Chicago Medical Center, Chicago, IL, Mingqi Luo, master degree, Infectious Diseases, Zhongnan hospital of Wuhan university, Wuhan, China, Qinglian Guo, PH.D., clinical laboratory, Zhongnan hospital of Wuhan university, Wuhan, China, Xuan Cai, master degree, clinical laboratory, Renmin Hospital of Wuhan University, Wuhan, China and David Pitrak, MD, University of Chicago, Chicago, IL

Disclosures:

X. Chen, None

J. M. Christoff, None

M. Luo, None

Q. Guo, None

X. Cai, None

D. Pitrak, None

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