1188. Could Chlorehexidine (CHX) bathing decrease the incidence of Carbapenem-resistant Enterobacteria (CRE) bacteremia in previously Colonized CRE Hematopoietic Stem cell Transplant recipients (HSCT)?
Session: Poster Abstract Session: Healthcare Epidemiology: MDR-Gram Negative Infections
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • POSTER 2 CRE AND HSCT.pdf (685.2 kB)
  • Background: CRE colonized patients that undergo HSCT, have a higher incidence of CRE bacteremia, especially during the initial neutropenic period, with a high mortality rate. This situation is critical in countries highly endemic for CRE such as Colombia. It is necessary to find measures that decrease the occurrence of this infection, permitting a safer transplant. Daily CHX bathing could be effective reducing this risk.

    Methods: Since March 2014 in our hospital in Cali, Colombia, all adult patients admitted to the HSCT unit were peri-rectal screened for CRE colonization, and then CHX daily bathing (CHX 4% soap or CHX 2% pads) was used regardless of the screening results. Prospectively all type of microorganism bacteremia were recorded from 2014 to 2017. We compare bacteremia, and CRE bacteremia rates between CRE colonized versus non-colonized patients. We compared the annual proportion of CRE bacteremia in this two groups. Non-parametrical statistic Chi2 for trend was used to compare the difference.

    Results: We analyzed data collected from 155 patients from July 2014 to June 2017. There were 39.5 % females, and the average age was 42 years, 60% were autologous, and 40% were allogeneic. The total of CRE colonized patients was 25/155 (16%), and the overall of bacteremia was 54/155 (34%). All type of microorganism bacteremia and CRE bacteremia were more frequent in CRE Colonized patients. (52% vs 31% and 24% vs 3,8%, RR: 6.24 , 95% CI 2.06-18.8, p: 0.002) . With the increase in compliance with CHX bathing, there was a decreasing trend in CRE bacteremia in the colonized patient, dropping from 50% during 2014, to 14% in 2017. (OR 0.167 p: 0.21).

    Conclusion: Daily CHX bathing in the CRE colonized patient reduce the incidence of CRE bacteremia in HSCT patients. We propose this intervention as a significant protective measure in CRE colonized hospitalized patients.

    Juan Diego Velez, MD1, Fernando Rosso, MD1, Jorge Cedano, MD1, Barbara Lucia Mora, MD1, Marly Orrego, RN, MSC2, Mayra Estacio, MD3 and Ivan Andres Beltran, RN2, (1)Infectious Diseases, Fundación Valle del Lili, Cali, Colombia, (2)Infection Control Committee, Fundación Valle del Lili, Cali, Colombia, (3)Clinical Research Center, Fundación Valle del Lili, Cali, Colombia

    Disclosures:

    J. D. Velez, None

    F. Rosso, None

    J. Cedano, None

    B. L. Mora, None

    M. Orrego, None

    M. Estacio, None

    I. A. Beltran, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.