Carbapenem-Resistant Eneterobactereciae Implications Amongst Patients with Hematological Malignancies and Hematopoietic Stem Cell Transplant Recipients. (4th October 2017) - Schmidt, Monica
Abstract: Background: Carbapenem Resistant Eneterobacteriaceae (CRE) colonization is not well understood in patients with hematological malignancies (HM) and recipients of Hematopoietic Cellular Therapy (HCT). This study analyzes the impact of CRE colonization and infection on mortality. Methods: This IRB approved, retrospective analysis included patients admitted to a Hematology unit between January 2014 and September 2016. The primary outcome was mortality within 1 year. Point prevalence CRE screening utilizing rectal swabs was performed intermittently through July 2015 for all patients on the unit and then on admission and weekly through the end of the study. CRE was defined resistant or intermediate designation for one or more carbapenems. Unadjusted analyses used either t -test for continuous variables or chi-square for binary/categorical variables. A Poisson model was used to calculate incident risk ratios for the adjusted analysis. Results: The population included 587 patients with HM and 204 HCT recipients. CRE was isolated in cultures from 28 patients (15 HM, 13 HCT recipients) who had with 2 infections (deceased) and 26 colonizations. . Analysis showed that patients with CRE colonization did not have higher risk of CRE infection. Mortality rates were similar among HCT recipients and HM patients (3.2% vs. 3.9%; P = 0.65). Patients who died had higher Charlson Comorbidity Indices (CCI) at admission (8.7 vs. 5.9; P < 0.001). In adjusted analysis, hemodialysis, a high CCI score at admission, and advancing age were associated with mortality in the HM/HCT cohort when adjusting for CRE status, race, gender, procedures, and antimicrobial exposures (Table 1). Conclusion: CRE colonization did not increase mortality in HM or HCT patients in this small sample. Further studies are warranted to better understand CRE colonization in this population. Disclosures: All authors: No reported disclosures.