1588. Prevalence and Risk Factors for Carbapenem Resistant and Extended Spectrum Beta-lactamase-producing Bacterial Acquisition in a Thai University Hospital Setting
Session: Poster Abstract Session: Multidrug-Resistant Gram Negative Rods
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Poster IDSA_SK.pdf (215.7 kB)
  • Background: Carbapenem resistant (CR) and extended spectrum beta-lactamase (ESBL)-producing bacteria are major emerging pathogens in hospital-acquired infections. Surveillance and monitoring for prevalence of antimicrobial-resistant pathogens are one of important components of infection control efforts.

    Objective:We aimed to determine prevalence and risk factors for CR and ESBL-producing bacterial acquisition among patients who were admitted in medical wards in a university hospital setting.

    Methods:  Perianal swab cultures were performed in all patients who were admitted in the medical intensive care unit (ICU) between November 2010 and April 2011. Additional cultures, such as tracheal suction, urine, and wound were performed in all patients with related medical devices/condition. Factors for CR and ESBL-producing bacterial acquisition were determined by logistic regression analysis.

    Results: A total of 89 patients who were admitted in the ICU for more than 48 hours had surveillance culture performed. Of all, 44 (49.4%) patients were male, mean (SD) age was 60.9 (16.7) years, and 52.8% patients were hospitalization in another ward before ICU admission. Fifty-four (60.7%) patients had positive culture results for CR or ESBL-producing bacteria. The common isolated organisms were ESBL-producing Escherichia coli (66.7%), followed by CR-Acinetobacter baumannii (29.6%). Patients with CR or ESBL-producing bacterial acquisition were more likely to have a longer duration of hospitalization before ICU admission (8.6 days vs. 3.6 days, p=0.010), receive antibiotic previously (51.8% vs. 28.6%, p=0.030), prior expose to chemotherapy (25.9% vs. 2.9%, p=0.005), use devices (40.7% vs. 20%) or mechanical ventilation (25.9% vs. 5.7%, p=0.015). Higher mortality rate at 14 days was found in patients with CR or ESBL-producing bacterial acquisition (42.6% vs. 25.7%, p=0.105). By multivariate analysis, only age (OR 3.03, >60 years vs. <60 years; 95% CI 1.08-8.4, p=0.034) was an independent factor associated with CR or ESBL-producing bacterial acquisition.

    Conclusion: High prevalence of CR and ESBL-producing bacteria acquisition is determined in our hospital setting. Regular surveillance and monitoring system for drug-resistant organisms may be crucial, especially in patients with some particular factors, for controlling drug resistant problem.     

     

    Sasisopin Kiertiburanakul, MD, MHS1, Boossarakum Ninlapun, MD1, Suntareeya Sirichote, MSc2, Somporn Somsakul, BSc2, Pitak Santanirand, PhD3 and Kumthorn Malathum, MD1, (1)Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, (2)Department of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, (3)Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    Disclosures:

    S. Kiertiburanakul, None

    B. Ninlapun, None

    S. Sirichote, None

    S. Somsakul, None

    P. Santanirand, None

    K. Malathum, None

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