1784. Extended Spectrum β-Lactamase-Producing Enterobacteriaceae in Finnish Pediatric Patients: Majority Did not Persist as Carriers
Session: Oral Abstract Session: Children Getting Sick from Healthcare Pediatric HAIs
Saturday, October 29, 2016: 11:45 AM
Room: 275-277
Background: The prevalence of extended spectrum β-lactamase-producing Enterobacteriaceae (ESBL) is increasing in pediatric patients. Long-term carriage of ESBL is often of great concern to the parents of the colonized children, and causes a risk of horizontal transmission in health-care settings. We aimed to assess the proportion of patients who cleared the fecal colonization.

Methods: ESBL-E.coli positive cultures obtained from patients below the age of 18 years were identified from the Helsinki and Uusimaa hospital district laboratory (HUSLAB) database retrospectively. Cultures obtained from patients treated in the Children’s Hospital of the Helsinki University Hospital were selected for review of study criteria: i) at least one clinical or screening sample positive for ESBL in 2008-2012, and ii) at least two fecal follow-up samples obtained on different days after the positive sample. Of the patients who met the study criteria, data on gender, age at the time of the positive culture, underlying conditions, and time between the first positive and the first negative/ last positive screening culture, were collected. A patient with at least two consecutive negative fecal screening samples was considered to have cleared the gastrointestinal ESBL colonization.

Results: A total of 325 ESBL positive cultures were identified, of which 111 could be linked to the Children’s Hospital. Of those, 63 patients met the study criteria, 44% of them were boys. Median age at the time of the first positive culture was 2 years (range, 0-17), and the most common underlying diseases were urinary tract anomalies (24%) and gastrointestinal conditions (14%); only 8% of the patients did not have a chronic underlying disease. Majority (78%) of the patients cleared the colonization; median time for this was 460 days (range, 46-1586 days). Patients with persistently positive screening samples had a median follow-up of 693 days (range, 63-2026 days).

Conclusion: Four in five patients with ESBL positive cultures seemed to clear the colonization over time, sometimes after a long period of positivity. A more systematic study approach is needed to assess the duration of colonization.

Emmi Sarvikivi, M.D., Ph.D.1, Anu Pätäri-Sampo, M.D., Ph.D.2, Leena Simons, RN1 and Harri Saxén, M.D., Ph.D., Prof.1, (1)Children's Hospital, Helsinki University Hospital, Helsinki, Finland, (2)Department of Bacteriology, University of Helsinki and Helsinki University Hospital, HUSLAB, Helsinki, Finland

Disclosures:

E. Sarvikivi, None

A. Pätäri-Sampo, None

L. Simons, None

H. Saxén, None

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