197. The challenging endemic and epidemic enterobacteria increase of ESBL producers and Carbapenemases producers, detected by Vitek II and the CarbaR (Cepheid) in isolations From de the adult intensive care and pediatric icu of Roosevelt Hospital in ICUs in Guatemala (2014-2015)
Session: Poster Abstract Session: Diagnostics: Bacteriology, Sequencing, and Resistance
Thursday, October 27, 2016
Room: Poster Hall
Background:

The increase of multi-resistant gram negative bacteria, is a current problem in hospitals around the world that requires an immediate awareness and rapid approach in big hospitals. The ESBL and carbapenemase producing enterobacteria represent a challenge for public health and hospitals.

Methods:

Objective: To determine the presence of ESBL and Carbapenemases in Enterobacteriaceae with resistance or diminished susceptibility to carbapenems from August 2014 - July 2015 at Roosevelt Hospital.

The Xpert Carba-R® test (GeneXpert, Cepheid), was used on isolates from of Enterobacteriaceae, with MIC ≥ 2 ug/ml or an inhibition halo ≤ 21 mm for Imipenem (IMP), in the period from August 2014 to July 2015. The data analysis was performed using WHONET® softwar. The susceptibility analyses was carried out using the VITEK 2 compact equipment (Sanofi-Pasteur). The results were registered in an Excell data base and a descriptive analysis is presented.

Results:

8,126 gramnegative isolates were obtained from August 2014 to July 31 of 2015. The microorganism isolated most frequently was A. baumannii, 17%, E. coli, 16%, and K. pneumoniae (kpn), 13%. ESBL was present in 61.9% of kpn n=1283 and 45.9% E coli (eco) n=1044, with the highest rate in kpn ESBL, in tracheal aspirates, 69.6%. In eco strains, the highest rate was in urine isolates with 68.1%. The Imipenem (IMP) for carbapemenase determination was performed in 602 isolates, 202 strains with carbapenemase production were detected by screening test. By the Carba-R test we found: 97% (n=196) are NDM type and the 3% are KPC and VIM.

Conclusion:

The rate of ESBL producing enterobacteria is high: 52.3% globally, mainly in kpn isolates . The rate of carbapenemase production rate in Enterobacteriaceae isolates was 2.48 %, mainly the NDM type (97%), the represents a real ongoing challenge for Roosevelt Hospital

Maria Gordillo, QB1,2, Rosa Cortes, Microbiologist1 and Carlos Mejia-Villatoro, MD Infectious Diseases and Internal Medicine3, (1)Hospital Roosevelt, Guatemala, Guatemala, (2)Laboratorio De Microbiología, Rosa Cortes, Guatemala, Guatemala, (3)Internal Medicine, Hospital Roosevelt, Guatemala, Guatemala

Disclosures:

M. Gordillo, Merck: Investigator , Research grant
Cepheid: Consultant and Scientific Advisor , Consulting fee and Speaker honorarium

R. Cortes, Merck: Investigator , Research grant

C. Mejia-Villatoro, Merck: Investigator , Research grant and Speaker honorarium
Abbvie: Investigator and Scientific Advisor , Consulting fee and Research grant
Roche: Scientific Advisor , Consulting fee

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