1190. Reduction of Carbapenem-resistant Enterobacteria (CRE) infections and total Polymyxin B use due to a Comprehensive Infection Control strategy in Colombia.
Session: Poster Abstract Session: Healthcare Epidemiology: MDR-Gram Negative Infections
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • POSTER 1 CRE AND POLYMYXIN USAGE.pdf (796.1 kB)
  • Background: Colombia is an endemic country for CRE infections, with an increased rate of hospital-acquired infection due to this microorganism. Therefore, we have a high empirical use of carbapenem, colistin and polymyxin B in nosocomial suspected septic patients. Infection control strategies could reduce CRE infection rates and lower antibiotic consumption.

    Methods: Since 2014, a Comprehensive Infection control strategy was implemented in our hospital. This strategy included: 1. Hospital daily CHX bathing (4% soap or 2% pads) was applied to all patients in our institution (intensive care units and medical/surgical wards). Additionally, recommendations for patient care were provided to patients and family. 2. Active surveillance of perirectal CRE screening was implemented toward high suspected patients. 3. Isolation of all CRE colonized or infected patient, and gloves use, and alcohol for hand sanitation was reinforced. To evaluate the effectiveness of this strategy, annually nosocomial infection rates due to CRE were compared. Defined daily dose (DDD) of polymyxin B use was obtained annually.

    Results: After introducing this protocol, we found a progressive decrease in CRE bacteremia from 2.24 infections per 10.000 patients-day in 2014, to 1, 26 during 2015, 0.92 in 2016 and 0.78 infections per 10.000 patients day during 2017. This was also correlated to a decrease in the use of polymyxin in the adult population, DDD drop from 2.36 to 1.06.

    Conclusion: Universal hospital daily CHX bathing, CRE screening, and Isolation as a comprehensive strategy was effective decreasing CRE nosocomial infections and polymyxin use.

    Juan Diego Velez, MD1, Fernando Rosso, MD1, Barbara Lucia Mora, MD1, Jorge Cedano, MD1, Marly Orrego, RN, MSC2, Ivan Andres Beltran, RN2 and Jhon Jairo Echeverry, PharmD3, (1)Infectious Diseases, Fundación Valle del Lili, Cali, Colombia, (2)Infection Control Committee, Fundación Valle del Lili, Cali, Colombia, (3)Pharmacy, Fundación Valle del Lili, Cali, Colombia

    Disclosures:

    J. D. Velez, None

    F. Rosso, None

    B. L. Mora, None

    J. Cedano, None

    M. Orrego, None

    I. A. Beltran, None

    J. J. Echeverry, 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.