P086: Prospective surveillance from the laboratory of multidrug-resistant bacteria (MDRB) bacteremia

Abstract

Introduction: The control of the diffusion of the MDRB in health establishments is a priority. Objectives: Our work studied the incidence of bacteremia due to MDRB in a hospital environment. Methods: Microbiological surveillance was led in three departments of a teaching hospital during a period of six months going from April till October 2012 and concerning only blood cultures with diagnostic aim. Results: During the study period, 123 patients were followed and 30 episodes of bacteremia were described that is 21 % of all the blood cultures taken. The average age of the patients was 49 years±18.31 and the sex-ratio 0.66. The majority of the patients (78.6 %) were sent by a health care structure, 14.3 % came from the place of residence and 7.1 % were the object of internal transfer. Thirty six percent of the patients were admitted for a neurological disorder with an average duration of stay of 19.66 days ±14.62. Positive blood cultures were attributed to nosocomial infections in 22 cases (75.9 %) with an average delay of acquisition of 14.55 days. On the bacteriological plan, the responsible microorganisms were established: Enterobacteriaceae17 (56.7 %) among which 11 (64.7 %) producing extended-spectrum beta-lactamases (ESBL), non fermenting Gram- negative bacteria 4 (13.3 %), Gram-positive bacteria 9 (30 %) among which 4 methicillin-resistant Staphylococcus aureus (MRSA). Klebsiella pneumoniae was the dominant microorganism 8 (26.7 %). The presence of a catheter was identified in 7 cases of bacteremia associated with an Enterobacteriaceae producing ESBL. The rate of attack MDRB was 1.54 for 100 admissions and the incidence rate was 1.66 for 1000 patient-days. After bacteremia, the death rate was 61.5 %. Conclusion: The incidence of the MDRB during bacteremia is high in our structure. A program of prevention of the diffusion of the MDRB should be set up, accompanied with a training of nursing staff.