Program Schedule

1802
Prevalence of KPC-possessing Klebsiella pneumoniae in New York City: Have We Turned the Corner?

Session: Oral Abstract Session: New Insights into the Prevention and Control of MDR GNR
Saturday, October 11, 2014: 2:30 PM
Room: The Pennsylvania Convention Center: 109-AB
Background: Klebsiella pneumoniae carrying the carbapenemase KPC have become established in medical centers in New York City. At the height of the problem in 2006, over one third of K. pneumoniae isolates were found to be carrying this beta-lactamase.

Methods: A three month surveillance study was conducted from November 2013-January 2014 involving 11 hospitals in New York City. All unique patient isolates of K. pneumoniae were gathered from hospital microbiology laboratories. Susceptibility testing was performed by the agar dilution method according to CLSI methods. Cephalosporin-resistant isolates were screened by PCR for the presence of blaKPC. Rates of K. pneumoniae positive for blaKPC were compared to similar surveillance studies conducted in 2006 and 2009 for nine hospitals in Brooklyn, NY. Rates of KPC-possessing isolates from 2006 and 2013-2014 were compared by Fishers’ exact test.

Results: A total of 944 isolates of K. pneumoniae were collected in the 2013-2014 surveillance study. Overall susceptibility rates include: 68% to ceftazidime, 80% to piperacillin-tazobactam, and 86% to meropenem. Of the 944 isolates, 125 (13%) were found to be carrying blaKPC.

Nine hospitals participated in similar surveillance studies conducted in 2006 and 2009. The percentages of KPC-possessing isolates for the nine hospitals during the three surveillance studies are given in the Table.

 

 

2006

2009

2013-2014

P value (2006 vs. 2013-2014)

 

blaKPC positive/ total number of isolates (%)

 

Hospital A

21/76 (28%)

24/97 (25%)

10/99 (10%)

P=0.002

Hospital B

17/42 (40%)

21/55 (38%)

2/42 (4.8%)

P<0.001

Hospital C

39/108 (36%)

5/84 (6.0%)

4/53 (7.5%)

P<0.001

Hospital D

7/17 (41%)

13/29 (45%)

17/35 (49%)

P=NS

Hospital E

31/92 (34%)

52/114 (46%)

15/42 (36%)

P=NS

Hospital F

21/86 (24%)

11/97 (11%)

10/158 (6.3%)

P<0.001

Hospital G

70/142 (49%)

39/133 (29%)

22/126 (17%)

P<0.001

Hospital H

44/119 (37%)

28/124 (23%)

13/129 (10%)

P<0.001

Hospital I

15/54 (28%)

7/55 (13%)

2/60 (3.3%)

P<0.001

Total

265/737 (36%)

200/788 (25%)

95/744 (13%)

P<0.001

Conclusion: Since the height of the problem in 2006, steady and significant progress has been made in reducing the rates of blaKPC-carrying K. pneumoniae in most hospitals in Brooklyn, NY. However, some hospitals continue to struggle with this pathogen.

Marie Abdallah, MD1, Olawole Olafisoye, MD1, Christopher Cortes, MD2, Clayton Charles, MD3, Carl Urban, PhD4, David Landman, MD3 and John Quale, MD3, (1)Infectious Diseases, SUNY Downstate Medical Center, Brooklyn, NY, (2)Infectious Diseases, New York Hospital Queens, Flushing, NY, (3)Medicine, SUNY Downstate Medical Center, Brooklyn, NY, (4)Infectious Disease, New York Hospital Queens, Flushing, NY

Disclosures:

M. Abdallah, None

O. Olafisoye, None

C. Cortes, None

C. Charles, None

C. Urban, Pfizer: Speaker's Bureau, Speaker honorarium
Cubist: Speaker's Bureau, Speaker honorarium

D. Landman, Tetraphase: Research Contractor, Research grant
Achaogen: Research Contractor, Research grant

J. Quale, Tetraphase: Research Contractor, Research grant
Achaogen: Research Contractor, Research grant

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