1783. Results from a Carbapenem-Resistant Enterobacteriaceae (CRE) Point Prevalence Study Conducted at a University Hospital
Session: Poster Abstract Session: Resistant Gram-Negative Infections: CRE Epidemiology
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • IDSA_2015_CRE_UofL9-30-15-1345.pdf (575.7 kB)
  • Background: Multi-drug resistant (MDR) Gram-negative pathogens account for hospital-associated infections, increased morbidity, mortality and outbreaks.  Some patients are colonized asymptomatically.  These patients serve as carriers for potential transmission of highly-resistant pathogens to the environment, healthcare workers, and other patients resulting in poor outcomes.  The objective of this point-prevalence study was to determine how many patients harbored genes coding for MDR pathogens in the institution.

    Methods: The Infection Prevention & Control Department and the Division of Infectious Diseases at the University of Louisville organized a performance improvement activity from November 17-20, 2014.  Patients were informed of the need for the hospital to know how many patients had a “resistant germ”.  They were offered a peri-anal swab while clarifying that their declination would not influence their care.  Swab collection was performed by designated personnel.  The in-patient psychiatry and neonatal units were excluded.  The swab was used to check for carbapenem-resistant Enterobacteriaceae (CRE)-associated genes (KPC, NDM, IMP, VIM, and OXA-48), carbapenemase producer-associated genes (OXA-23 and OXA-51), an extended spectrum β-lactamase (ESBL)-associated gene (CTX-M) and a vancomycin-resistant Enterococci-associated  gene (vanA) using the Acuitas® MDRO Gene Test (OpGen).

    Results: Among 250 eligible patients, 214 (89%) agreed to be swabbed while 26 declined, and 10 were unavailable.  We found 24 patients with a vanA gene and nine patients with a resistant Gram-negative gene (an IMP, an OXA-51, seven CTX-M).  Three patients were identified to carry CRE that were gene test negative (two Enterobacter cloacae complex and one Klebsiella pneumoniae).

    Conclusion: MDR pathogens were identified among patients who were swabbed.  Admission surveillance should be considered moving forward because contact isolation could be instituted to prevent spread among hospitalized patients as soon as patients are found to be positive.

    Forest Arnold, DO, MSc, FIDSA, Infectious Diseases/Medicine, Univ. of Louisville, Louisville, KY, James Snyder, PhD, Microbiology, Univ. of Louisville, Louisville, KY, Crystal Heishman, MSN, RN, CIC, ONC, Infection Prevention and Control, University of Louisville Hospital, Louisville, KY and Trevor Wagner, PhD, OpGen, Gaithersburg, MD

    Disclosures:

    F. Arnold, None

    J. Snyder, Opgen: Board Member , Consulting fee
    Proxy Board Biofire Defense: Board Member , Consulting fee

    C. Heishman, None

    T. Wagner, OpGen Inc.: Employee , Salary

    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.