268. Carbapenem-Resistant Enterobacteriaceae (CRE) in Hennepin and Ramsey Counties, Minnesota: 30-Day Laboratory Surveillance
Session: Poster Abstract Session: Antimicrobial Susceptibility and Resistance
Friday, October 21, 2011
Room: Poster Hall B1
Background: CRE have been associated with increased mortality, and spread of these resistant organisms has occurred in healthcare settings. Accurate reporting of carbapenem resistance is important for control and prevention of CRE.

Methods: Fourteen labs were identified that serve hospitals, ambulatory centers, long-term care facilities (LTCF) and long-term acute care hospitals (LTACH) in the two most populous counties in MN (Hennepin and Ramsey; population 1,662,490). In November 2010, labs collected the number of unique cultures from all body sites growing Enterobacteriaceae spp. In addition, isolates that were nonsusceptible to imipenem or meropenem by the new Clinical and Laboratory Standards Institute interpretive criteria were submitted to the MN Dept. of Health (MDH). Submissions included an isolate submission form with basic demographic data, culture site, and location of service.

Results: Twelve of 14 labs submitted data. 7,534 cultures grew Enterobacteriaceae spp. during the 30-day surveillance period. Escherichia coli and Klebsiella pneumoniae were most frequently identified with 4,998 and 931 unique isolates, respectively. Forty-three isolates that met criteria for CRE were submitted to MDH (0.6% resistant). The percent resistant E. coli, K. pneumoniae, and Enterobacter cloacae were 0.1%, 1%, and 2%, respectively. Thirty-two (74%) isolates were from urine; eight (19%) from respiratory secretions; and two (5%) from blood. The distribution of the submitted isolates from hospitals, ambulatory centers, LTCF, and LTACH was 17 (40%), 17 (40%), 6 (14%), and 3 (7%), respectively. PCR testing for the blaKPC gene was positive in 1 of 8 isolates tested. Two additional isolates were from subjects known to carry this gene. All 3 isolates were K. pneumoniae.

Conclusion: We report the first estimates of CRE in a metropolitan area in MN, a region not considered to be endemic for CRE. Data from this study included sites across the continuum of healthcare (acute, long-term, and ambulatory), with a majority of isolates coming from non-hospitalized subjects. Ongoing surveillance, even in non-endemic areas, is necessary for identification, control and prevention of this emerging problem.


Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Edwin C Pereira, MD1, Paula M Snippes Vagnone, MT (ASCP)2, Kristin M Shaw, MPH2, Jane Harper, RN2 and Ruth Lynfield, MD2, (1)Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, (2)Minnesota Department of Health, St. Paul, MN

Disclosures:

E. C. Pereira, None

P. M. Snippes Vagnone, None

K. M. Shaw, None

J. Harper, None

R. Lynfield, None

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