Four years of experience with carbapenem-resistant Gram-negative bacteria in two tertiary care hospitals in Crete, Greece

Introduction

Carbapenem-resistant gram-negative bacteria (CRGNB, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa)) are important nosocomial pathogens in Greece.

Objectives

To describe the epidemiology of CRGNB in two tertiary care hospitals in Crete, Greece.

Methods

Analysis of infection control records from June 2011 to December 2014 of 450-bed Venizelion Hospital and 750-bed University Hospital, both being referral centres for Southern Greece. Consecutive patients with CRGNB isolation (only first CRGNB per patient) were recorded. Data presented as no.(%) or mean±SD.

Results

A total of 1537 cases with CRGNB were detected: 582 A. baumannii, 510 K. pneumoniae and 445 P. aeruginosa. Mean patient age was 63.6±18.7 years. The greatest burden was in ICU (41.4%) and medical wards (36.7%). Respiratory specimens constituted the most frequent source of A. baumannii (56.3%) and P. aeruginosa (43.6%); urine samples were the most frequent source of K. pneumoniae (28.8%). In-hospital mortality (37.7%) was similar among the 3 pathogen groups; however, ICU patients with CRGNB had higher mortality rates compared to other departments (53.5% vs 26.6%, p<0.001). Similarly, ICU patients had longer hospital stay after CRGNB isolation compared to other departments (median 21 vs 8 days, p<0.001).

Conclusion

This study shows that the burden of CRGNB is much greater in ICUs, accounting for significant morbidity and mortality. Therefore, in Greek hospitals where CRGNB infections are a major problem, infection control measures should mainly focus in critical care departments.

Disclosure of interest

None declared.