212. Carbapenem Resistance Among Nosocomial Infections, a Clinico-Microbiological Profile at a Tertiary Care Center in South India
Session: Poster Abstract Session: Criticare, HAIs: Pneumonia and Chlorhexidine
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Satyesh's-Report---Copy2.png (355.3 kB)
  • Background:

    Carbapenems are the last resort antibiotics for severe, multi drug resistant nosocomial infections. Recently, there has been an alarming rise in resistance to carbapenems.

    Our study aims to find the prognosis, morbidity and mortality in patients with proven nosocomial infections resistant to carbapenems.

    Methods:

    Prospective study done from June 2011 to December 2012. Patients who developed nosocomial infections with isolates exhibiting proven resistance to carbapenems were included in the study. Patients were evaluated for site of infection, specimen collected, organism isolated, prior exposure to broad-spectrum antibiotics, duration of ventilator support, urinary catheterization and invasive lines.

    Results:

    - A total of 173 patients are included in the study.  The average age of the study group is 47.1 years. 123 (73.9%) are males.

    - The following risk factors were identified to be significant in the study group:

    • 125 (72.2%) had previous exposure to broad-spectrum antibiotics with average duration > 5days.
    • 127 (73.4%) were on mechanical ventilation with average duration of 6.8 days. 77 (44.5%) patients had Ventilator associated pneumonia.
    • 118 (68.7%) had central venous/arterial lines inserted with average duration of 10.4 days.
    • 141 (81.5%) had urinary catheters inserted with average duration of catheterization being 14.54 days.
    • 62 (35.8%) had severe sepsis with Multi Organ Dysfunction Syndrome. ARDS was diagnosed in 23 (13.2%) patients, Disseminated Intravascular Coagulation (DIC) in 16 (9.2%) patients.
    • Average duration of ICU stay was 6.3 days.

    - The commonest site of infection is the respiratory system in 91 patients (53%) , 40 (23.4%) had bactermia, 22 (12.84%) skin and soft tissue infections, 7 (4%) urinary tract infections and 5(2.79%) had meningitis.

    - The most common organisms isolated are Acinetobacter species (54.3%), Klebsiella pneumonia (25%), Psuedomonas aureginosa(18%).

    - Type-2 Diabetes Mellitus was found to be the most common premorbidity in 65 patients (37.5%) followed by Ischemic Heart disease and Chronic liver disease.

    - Mortality rate in our study is 63.5% (110 patients).

    Conclusion: Carbapenem resistance was associated with high mortality rate. Avoiding prolonged administration of antibiotics and strict infection control measures can prevent emergence of carbapenem resistant organisms.

    Satyesh Chowdary Muppavarapu, Medical Student, Kasturba Medical College, Manipal University, Manipal, India, Danturulu Muralidhar Varma, MD, Department of Medicine, Kasturba Medical College, Manipal University., Manipal Karnataka, India, Sudha Vidyasagar, MD, Medicine, Kasturba Medical College, Manipal Karnataka, India and Chiranjay Mukhopadhyay, Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, India

    Disclosures:

    S. C. Muppavarapu, None

    D. M. Varma, None

    S. Vidyasagar, None

    C. Mukhopadhyay, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.