1790. Differential Degree of Air and Environmental Surfaces Contamination by KPC-producing Gram-negative Rods Based on the Body Source
Session: Poster Abstract Session: Resistant Gram-Negative Infections: CRE Epidemiology
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • Poster_KPC_092915.pdf (1.0 MB)
  • Background:

    We aim to determine the differential degree of contamination from air and room surfaces among patients (pts) colonized and infected with KPC-producing Gram-negative rods (KPC+). We also evaluated the impact of the anatomic source of KPC (e.g. rectum, respiratory) on the degree of contamination.

    Methods:

    This study was performed at a large hospital in Miami in all consecutive adult ICU pts detected to have KPC+ on clinical and active surveillance cultures (rectal cultures, and if intubated-tracheal cultures). Among KPC+ pts, air and environmental samples were obtained daily for 10 consecutive days or until discharged from hospital. Air was sampled using open blood agar plates (exchanged daily) placed above their headboards (2-ft from roof-tiles). Environmental surfaces sampled included bed rails, bedside tables, ventilator panels, and intravenous pumps.  Sterile Q-tips were used to swab both, blood agar plates and environmental surfaces, immediately placed in 2mL TSB, incubated overnight, and then plated on MaConkey. Organisms were identified based on colony color, and morphology. Final identification was done by Vitek II. KPC+ was determined using Hodge test.

    Results:

    During 5-months, 17 KPC+ pts were identified: 8 rectal, 4 respiratory, and 5 from other sources (2 ascites, 2 wound and 1 urine). Air samples grew KPC+ in 4.3% of ambient air tested among pts colonized in the rectum, 4.3% for those colonized in the respiratory tract, and in 9.5% for those colonized in other sources.  Regarding environmental samples, the percentages of positive samples were 4.8% for pts colonized in the rectum compared to 0.99% for those colonized in the respiratory tract (p=0.04) and 3% for those colonized in other sources.

    Conclusion:

    Environmental contamination with KPC+ seems to be higher among pts colonized in the rectum than among patients colonized in the respiratory tract or from other sources.  In contrast, ambient air contamination seems to be similar between all 3 groups.

    Luis Shimose, M.D.1, Eriko Masuda, MD2, Ana Berbel Caban, M.D.1, Maroun Sfeir, MD1, Maria X. Bueno, MD1, Dennise Depascale, MT3, Timothy Cleary, PhD4, Yohei Doi, MD, PhD5 and L. Silvia Munoz-Price, MD, PhD6, (1)Department of Medicine, University of Miami/ Jackson Memorial Hospital, Miami, FL, (2)Department of Medicine, LAC+USC Medical Center, Los Angeles, CA, (3)Infection Control, Jackson Memorial Hospital, Miami, FL, (4)Department of Pathology, University of Miami/ Jackson Memorial Hospital, Miami, FL, (5)University of Pittsburgh Medical Center, Pittsburgh, PA, (6)Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI

    Disclosures:

    L. Shimose, None

    E. Masuda, None

    A. Berbel Caban, None

    M. Sfeir, None

    M. X. Bueno, None

    D. Depascale, None

    T. Cleary, None

    Y. Doi, Shionogi: Scientific Advisor , Consulting fee
    Merck: Investigator , Research grant
    Melinta: Consultant , Consulting fee

    L. S. Munoz-Price, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.