1419. RISK FACTORS FOR INFECTION OR COLONIZATION BY CARBAPENEM-RESISTANT Klebsiella pneumoniae IN A THIRD-LEVEL UNIVERSITY HOSPITAL. BOGOTA 2009-2010
Session: Poster Abstract Session: Epidemiology of Multiple Drug-Resistant Gram Negative Rods
Saturday, October 20, 2012
Room: SDCC Poster Hall F-H
Background: The prevalence of nosocomial infections by Klebsiella pneumoniae (K. pneumoniae) carbapenem-resistant, it has increased in the hospitalized population constituting a problem of great magnitude due to the high morbidity and mortality. It has been shown a significant increase in mortality by infections attributable to carbapenem-resistant Klebsiella vs non-resistant Klebsiella (OR 5.4) and significant differences when comparing Klebsiella KPCwith other etiologic agents of infection in the ICU (OR 6.7 ), with an increased mortality risk of 20 %

General Objective: To identify the risk factors associated with infection or colonization by K. pneumoniae carbapenem-resistant in hospitalized patients

Methods:

case study and matched control by type of microbiological sample from January 2009 to April 2011 (1:2). Cases: patients with a diagnosis of infection or colonization by carbapenem-resistant K. pneumoniae. Controls: patients hospitalized during the same period of the cases with infection or colonization by K. pneumoniae sensitive to carbapenemics. Sample: 99 patients. 33 Cases and 66 controls.

Results: The bivariate analysis demonstrated risk factors associated with the prior use of antibiotics (p 0.004 ), particularly cefepime (p 0,021 ) and carbapenemics (p 0,019 ), the days of mechanical ventilation (p 0.003 ), the days of use of central venous catheter (p 0,016 ), the days of stay in ICU before the isolation (p 0.003 ) and the time of total hospital stay before the isolation (p 0.001 ); in the multivariate analysis a significant association was found in the number of days of prior use of carbapenemics (OR of 2.08) (CI 1.03 4.17 ) (p 0.04). The attributable mortality was 25 %. It was confirmed the presence of an outbreak of infection by K. pneumoniae resistant to type KPC3 carbapenemics

Conclusion: The days of prior use of carbapenemics are associated with the infection or colonization by carbapenem-resistant Klebsiella pneumoniae. For each day of use in excess of carbapenemics there is a risk 50% higher of colonization or infection by Klebsiella pneumoniae KPC in a hospital institution of high-complexity. It highlights the importance of the control measures such as isolation and washing of hands for the restraint of outbreaks of infection.

Claudia Janneth Linares Miranda1, Carlos Gomez Quintero, MD1, Carlos Arturo Alvarez Moreno, Medical infectious diseases1, Aura Lucia Leal, MD2, Fabian Gil, MD1, Sandra Liliana Valderrama Beltran, MD3 and Judy Puerta1, (1)Hospital Universitario San Ignacio, Bogota, Colombia, (2)Universidad Nacional de Colombia, Bogota, Colombia, (3)Hospital Universitarion San Ignacio, Bogota, Colombia

Disclosures:

C. J. Linares Miranda, None

C. Gomez Quintero, None

C. A. Alvarez Moreno, None

A. L. Leal, None

F. Gil, None

S. L. Valderrama Beltran, None

J. Puerta, None

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