Download 987Carbapenem-resistant Klebsiella pneumoniae (CRKp) in

987. Carbapenem-resistant Klebsiella pneumoniae (CRKp) in
Children. Clinical and Epidemiological Characteristics from Infected
and Colonized Inpatients in a Tertiary care Hospital in Medellín,
Colombia
Alejandro Diaz, MD1; Andrea Restrepo, MD2; Diana Ortiz, MD3; Mónica Trujillo,
MD, MSSc2; Carlos Garcés, MD2; Fabián Jaimes, MD, PhD2; 1Universidad CES,
Medellin, Colombia; 2Hospital Pablo Tobón Uribe, Medellín, Colombia; 3Universidad
CES, Medellín, Colombia
meropenem containing regimens ( p = 0,03).
Session: 117. Pediatric Healthcare Associated Infection Epidemiology and Prevention
Friday, October 10, 2014: 12:30 PM
Background. Multidrug resistant Gram-negative infections represent a growing
problem and a serious global threat. Data in children is scarce. K. pneumoniae carbapenemases (KPC) are the most common mechanism of resistance this bacteria have
developed. We report the clinical characteristics and outcomes from a cohort of children infected or colonized with carbapenem-resistant K.pneumoniae at Hospital Pablo
Tobón Uribe in Medellín, Colombia. A KPC-2 producing K. pneumoniae outbreak
started in our institution in 2008. Despite the implementation of several control measures including strict contact isolation, patient cohorting and routine surveillance cultures, the outbreak spread from adult to pediatric wards.
Methods. We performed a retrospective chart review of all pediatric cases in
whom CRKp were identified from 2008 to 2013. Clinical and demographic characteristics and outcomes were recorded.
Results. A total of 34 infected children (median age 22,8 months) with 43
episodes (1 had two episodes, 2 patients had three and one with 5) and 55 colonized
patients (median age 33 months) were identified. Demographic and clinical characteristics from infected and colonized patients are shown in Table 1. Urinary tract and
intra-abdominal infections were the most common type of infections (Figure 1). Antimicrobial therapy and outcomes from infected patients are presented on Table 2. Severely ill children received combined antimicrobial therapy. Mortality was lower with
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Poster Abstracts
Conclusion. CRKp infections occur more frequently in children with comorbidities, prolonged hospital stays and prior antibiotic exposure. Mortality is high. A meropenem containing regimen seems to be the best choice in severely ill children.
Disclosures. All authors: No reported disclosures.