Abstract

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 vs. non-colonized patients. We compared the annual proportion of CRE bacteremia in this two groups. Nonparametrical statistic χ2 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.

Disclosures

All authors: No reported disclosures.

Details

Title
1188. Could Chlorehexidine (CHX) Bathing Decrease the Incidence of Carbapenem-Resistant Enterobacteria (CRE) Bacteremia in Previously Colonized CRE Hematopoietic Stem Cell Transplant Recipients (HSCT)?
Author
Juan Diego Velez 1 ; Rosso, Fernando 1 ; Cedano, Jorge 1 ; Mora, Barbara Lucia 1 ; Orrego, Marly 2 ; Estacio, Mayra 3 ; Ivan Andres Beltran 2 

 Infectious Diseases, Fundación Valle del Lili, Cali, Colombia 
 Infection Control Committee, Fundación Valle del Lili, Cali, Colombia 
 Clinical Research Center, Fundación Valle del Lili, Cali, Colombia 
First page
S359
Publication year
2018
Publication date
Nov 2018
Publisher
Oxford University Press
e-ISSN
23288957
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3171030719
Copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.