396. Prevalence of Klebsiella pneumoniae carbapenemase-producing Enterobacteriaciae (KPC) among adult patients in intensive care units (ICUs) and long-term acute care hospitals (LTACHs) in the Chicago region
Session: Poster Abstract Session: Gram Negative Infection - Epidemiology and Prevention
Friday, October 21, 2011
Room: Poster Hall B1

Background: The Chicago region had no known KPC until 2007; however, KPC have been increasingly recognized in clinical infections. The prevalence of KPC colonization among patients in the Chicago region is currently unknown.

Methods: Hospitals in the city of Chicago with ≥10 ICU beds were recruited for a 1-day point prevalence survey during July 2010 January 2011. Patients had swab specimens collected from rectal or groin sites using a single rayon-tipped swab for each site. In addition, LTACHs in the Chicago region (Cook County) were recruited for a 1-day point prevalence survey from January to May, 2011. All LTACH patients had rectal swab specimens collected. All swabs were processed in a central laboratory using broth enrichment and direct plating. KPC were screened using an ertapenem disk method and blaKPC was confirmed by PCR.

Results: 24 of 25 eligible hospitals and 5 of 7 eligible LTACHs participated in the point prevalence survey. 17 / 458 adult ICU patients (4%, 95% confidence interval [CI] 2 to 6%) were colonized with KPCs. Among LTACH patients, 101 / 290 patients (35%, CI 29 to 41%) were colonized with KPCs. The overall prevalence rate of KPC colonization among LTACH patients was 9-fold higher than that of hospital ICU patients (prevalence ratio 9, CI 6 to 15, P < 0.001).

11 of 24 hospitals had at least 1 KPC-colonized ICU patient at time of survey. In contrast, 5 of 5 LTACHs had KPC-colonized patients. Individual LTACH prevalence rates varied from 11 to 54%.

Conclusion: Since the first detection of KPC in the Chicago region three years ago, KPC colonization has become epidemic in LTACHs but remains sporadic in acute care hospital ICUs.  Regional control strategies should address KPC across all healthcare facility types, including long-term care facilities.


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

Michael Y. Lin, MD, MPH1, Rosie D. Lyles, MD, MS2, Karen Lolans, BS1, Kavitha Prabaker, MD1,2, David W. Hines, MD3, Joel B. Spear, MD4, Russell Petrak, MD3, William E. Trick, MD1,2, Robert Weinstein, MD, FIDSA1,2 and Mary Hayden, MD1, (1)Rush Univ. Med. Ctr., Chicago, IL, (2)Cook County Health and Hospitals System, Chicago, IL, (3)Metro Infectious Diseases Consultants, LLC, Burr Ridge, IL, (4)Saint Joseph Hosp., Chicago, IL

Disclosures:

M. Y. Lin, None

R. D. Lyles, None

K. Lolans, None

K. Prabaker, None

D. W. Hines, None

J. B. Spear, None

R. Petrak, None

W. E. Trick, None

R. Weinstein, None

M. Hayden, Sage: Grant Investigator, Grant recipient
3M: Grant Investigator, Speaker honorarium
Cardinal Health: Consultant, Speaker honorarium

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.