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18th Symposium on Infections in the Immunocompromised Host

International Immunocompromised Host Society

15. to 17.06.2014, Berlin

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Active Surveillance of Infections Caused by Multidrug-Resistant Gram-Negative Bacteria in a Solid Organ Transplantation Department

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  • A. Geladari - 3rd Pediatric Department, Aristotle University of Thessaloniki, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
  • T. Karampatakis - Greece
  • O. Tsiatsiou - Greece
  • V. Pentsioglou - Greece
  • P. Christoforou - Greece
  • E. Iosifidis - Greece
  • C. Antachopoulos - Greece
  • V. Papanikolaou - Greece
  • E. Roilides - Greece

18th Symposium on Infections in the Immunocompromised Host. Berlin, 15.-17.06.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14ichs41

doi: 10.3205/14ichs41, urn:nbn:de:0183-14ichs415

Published: June 3, 2014

© 2014 Geladari et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: The recent emergence of carbapenem-resistant (CR) gram-negative bacteria represents a major threat for hospitalized patients, especially for solid organ transplant (SOT) recipients. Implementation of infection control measures has proven to effectively reduce the cross-transmission between hospitalized patients.

Objectives: Our purpose was to study the incidence of colonization and infection caused by CR Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii in a solid organ transplantation department. Furthermore, to assess the impact of infection control measures in the incidence of colonization and infections.

Methods: In the Solid Organ Transplantation Department of Hippokration General Hospital of Thessaloniki incidence of colonization and infection caused by these CR bacteria was recorded. The study was divided into 4 periods (retrospective study: March- August 2012 without active surveillance and, prospectively, 1st period: September 2012- February 2013 with implementation of active surveillance programme (ASP), 2nd: March- June 2013 and 3rd: July- December 2013 with enhanced infection control measures). Infection control measures included active surveillance (weekly taken rectal swabs cultured on MacConkey agar containing 1µg/ml meropenem), contact precautions, hand hygiene, education of health care workers (HCWs), audit and feedback.

Results: The incidence of infection caused by these CR bacteria had a statistically significant increase (p<0.001), from approximately 2 to 7.5/ 1000 bed-days. However, this increase had not such a strong trend in the ASP period. During this period, incidence of colonization reduced from approximately 20% to 14% (p=0.088). In the 3rd period of ASP this reduction was statistically important (p<0.001). The compliance of HCWs with contact precautions and implementation of hand hygiene after patient contact were also improved.

Conclusion: Colonization and infection rates by these CR bacteria were found to be high among SOT recipients. By applying a set of enhanced control measures, a reduction in colonization rates by these bacteria has been achieved.