407. Changing Epidemiology of Central Line Associated Blood Stream Infections (CLABSI) in Cancer Patients: Onset after Insertion
Session: Poster Abstract Session: HAI: Preventing Device-Associated Infections
Thursday, October 27, 2016
Room: Poster Hall
Background: Gram-positive microorganisms have been the predominant pathogens in CLABSIs. We compare the distribution of etiologic organisms in cancer patients at our hospital between two cohorts separated by more than a decade to examine if there is a change in the epidemiology and if the empiric guidelines need to be reassessed in this patient population.

Methods: We evaluated all cancer patients who had simultaneous quantitative blood cultures drawn from the central line and peripheral site at MD Anderson Cancer Center. Cohort 1: between September 1999 and November 2000; and Cohort 2: January 2013 and March 2014. We restricted our analysis to CLABSI patients, excluding cases that had bacteremia secondary to other causes.

Results: When comparing the two cohorts we saw that the frequency of Gram negative organisms as etiologic agents changed form 24% in 2000 cohort to 72% in 2014 cohort, while the Gram positive decreased from 71% in 2000 cohort to 23% in 2014 cohort. Furthermore, we examined the duration form insertion of central venous catheter to development of bacteremia in these cases for the 2014 cohort. We found that coagulase negative staphylococci (CNS) and candida had a much shorter insertion time to the onset of bacteremia duration as compared to the Gram negative bacteria while the Gram positive bacteria (Staphylococci aureus and Streptococci) had the longest duration. CNS: mean=23 days; sd=28 days; Candida: mean=25 days; sd.=22 days; Gram negative bacteria: mean=80 days; sd.=170 days; Gram positive: mean=139 days; sd.=240 days.

Conclusion: We have observed new finding that for CLABSIs in cancer patients , gram negative organisms have become the predominant etiologic organisms and are encountered sooner than pathogenic gram positive CLABSI but on the average after CNS and Candida.

Pankil Shah, MD, MSPH1, Ray Hachem, MD, FIDSA2, Anne-Marie Chaftari, MD3, Alawami Hussain, MD4, Zainab Al Hamal, MD5, Ammar Yousif, MD6, Mary Jordan, M.D2, Majd Micheal, MD5 and Issam Raad, MD, FIDSA, FSHEA7, (1)The University of Texas MD Anderson Cancer Center, Houston, TX, (2)University of Texas, M.D. Anderson Cancer Center, Houston, TX, (3)Infectious Diseases, Infection Control & Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, (4)MD Anderson Cancer Center, Houston, TX, (5)University of Texas MD Anderson Cancer Center, Houston, TX, (6)UT MD Anderson Cancer Center, Houston, TX, (7)UT M.D. Anderson Cancer Center, Houston, TX

Disclosures:

P. Shah, None

R. Hachem, None

A. M. Chaftari, None

A. Hussain, None

Z. Al Hamal, None

A. Yousif, None

M. Jordan, None

M. Micheal, None

I. Raad, None

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