Main Menu Browse by Day or Program Author Keywords

310 Attributable Mortality Due to Carbapenem -Resistant Klebsiella pneumoniae (CRKP) Infection in a Tertiary Care Hospital in Colombia, SA

Friday, March 19, 2010
Grand Hall (Hyatt Regency Atlanta)
Ana L. Correa, MD , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Luz M. Mazo , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Monica Valderrama , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Carlos I. Gomez , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Franco E. Montufar , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Andrea V. Restrepo , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Carlos Garces , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Jaime A. Lopez , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Monica Trujillo , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Isabel C. Ramirez , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
John J. Zuleta , Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
Background: Some reports associate CRKP infections to an increment in patient’s mortality. Nevertheless, infections due to this bacterium are more frequently observed in patients with debilitating illnesses, thus creating confusion when such association is estimated either by means of case control studies or by indirect calculations.

Objective: Calculate the mortality due to CRKP infection in an outbreak occurring in the Hospital Pablo Tobón Uribe (HPTU) located in Medellin, Colombia.

Methods: HPTU is a tertiary care university teaching hospital with 288 beds (38 adults and 20 pediatric ICU beds) that offers specialized services including solid organ and bone marrow transplantation.  Shortly after the identification of the 3rd CRPK case, infection control measures were established to prevent transmission in an attempt to control the outbreak.  All throughout the outbreak period whole CRKP cohort (infected and colonized patients), as well as of the corresponding contacts, were evaluated.  

Five infectious diseases physicians grouped by pairs and in independent way, reviewed all CRKP cases charts corresponding to patients who had died in 2008. Their task was to define if death could be attributable to CRKP infection. Death was considered directly related to CRKP if both referees coincided in their judgment. Otherwise, a third physician was appointed to review the clinical chart. This study was approved by HPTU s ethical committee.

Results: Fifty-one CRKP infected patients were diagnosed between January 2008 and October 2009. During 2008, 34 cases of infection were confirmed with 22 (64.7%) deaths. After reviewing the patients chart we found that 14 (63.6%) of such deaths appeared directly related to the CRKP infection.   As it regards the first ten months of 2009, other 17 infected patients were diagnosed with 5 deaths (29.4%); however, these deaths have not yet been evaluated to confirm their direct association with CRKP infection. 

Conclusions: In the HPTU the mortality attributed to CRKP infection was 63.6% at the beginning of the outbreak but with proper measures, this figure was later reduced to 29.4%. Awareness by physicians and healthcare personnel and their subsequent experiences are important in reducing mortality rates.