Containment of Carbapenem-Resistant Enterobacteriaceae (CRE) Infections at a Solid Organ Transplant Centre

A. Mularoni,¹ G. Martucci,¹ S. Gruttadauria,¹ M. Campanella,¹ F. Tuzzolino,¹ G. Arena,¹ A. Arcadipane,¹ U. Palazzo,¹ A. Luca,¹ B. Gridelli,¹ P. Grossi.²

¹ISMETT-IRCCS, Palermo, Italy
²University of Insubria, Varese, Italy.

Meeting: 2018 American Transplant Congress

Abstract number: 288

Keywords: Infection, Mortality

Session Information

Session Name: Concurrent Session: Addressing Re-Emerging Infectious Challenges to Transplantation

Session Type: Concurrent Session

Date: Monday, June 4, 2018

Session Time: 4:30pm-6:00pm

Presentation Time: 4:30pm-4:42pm

Location: Room 602/603/604

Objectives The aim is to describe epidemiology and analyze the effectiveness of the intervention in CRE containment in SOT patients (pts).

Methods In 2012 a taskforce implemented CDC guidelines: rectal swab at admission and weekly, pts and staff cohorting, healthcare personnel education on infection prevention, reinforcement of hand hygiene and environmental cleaning. Complete application of interventions required several months. We compare rates of hospital acquired infection (HAI) rates per 1000 SOT patient-days pre- (2009-Aug2013) and post- intervention (Sept2013-2016) through a Generalized Estimating Equation model using weighted moving averages (WMA) to smooth the effect of seasonal peaks.

Results 960 pts underwent 981 SOT, 286 of them had a CRE positive culture (30%), 67 pts developed infection (23% of CREpositive), 219 pts were only colonized (77% of CREpositive).

	SOT	Infections n(%)	Blood Stream	Lower Respiratory Tract	Intra Abdominal	Urinary Tract	Surgical Site
Liver	524	41 (8)	5	3	17	4	12
Kidney	249	15 (6)	0	1	1	7	6
Heart	88	9 (9)	2	2	2	0	3
Lung	99	7 (6)	0	5	0	1	1
Combined	21	3 (10)	0	0	1	2	0
Totals	981	75 (8)	7	11	21	14	22

1 year mortality after SOT was significantly higher in pts with CRE infection. After the intervention the HAI rate in SOT registered a significative inverse trend with an average monthly reduction (Event Rate -1.35, C.I. -1.63-1.07; p<0.01) [Figure 1] and such a positive effect was maintained adjusting the analysis for the contemporary global rate of CRE HAI (SOT and non-SOT patients) and community acquired infection rate (ER -0.57, C.I. -0.87-0.26; p<0.01).Conclusions Application of CDC measures contributed to the reduction of CRE HAI rate at our SOT Centre.

CITATION INFORMATION: Mularoni A., Martucci G., Gruttadauria S., Campanella M., Tuzzolino F., Arena G., Arcadipane A., Palazzo U., Luca A., Gridelli B., Grossi P. Containment of Carbapenem-Resistant Enterobacteriaceae (CRE) Infections at a Solid Organ Transplant Centre Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Mularoni A, Martucci G, Gruttadauria S, Campanella M, Tuzzolino F, Arena G, Arcadipane A, Palazzo U, Luca A, Gridelli B, Grossi P. Containment of Carbapenem-Resistant Enterobacteriaceae (CRE) Infections at a Solid Organ Transplant Centre [abstract]. https://atcmeetingabstracts.com/abstract/containment-of-carbapenem-resistant-enterobacteriaceae-cre-infections-at-a-solid-organ-transplant-centre/. Accessed May 16, 2025.

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