Abstract P-191: A MAJOR CLINICAL CHALLENGE IN PEDIATRIC INTENSIVE CARE UNIT WITH PANDRUG-RESISTANT OXA-48 KLEBSIELLA PNEUMONIAE OUTBREAK

Aims & Objectives: Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has been reported to cause serious outbreaks. In our knowledge it is the first study about pandrug-resistant (PDR) OXA-48 positive CRKP infection in pediatric intensive care unit (PICU). Aim: To share our experience with PDR-CRKP outbreak with survival rate of 14% mortality in our clinic. Methods Between September 2016 and January 2017, PDR Klebsiella pneumoniae outbreak in a 20-bed tertiary PICU was evaluated prospectively. Demographic characteristics, underlying diseases, invasive procedures, previous infection and antibiotics usage, infection center, applying therapies and measures are recorded. Results 7 patients (6 male, 1 female) were followed for PDR OXA-48 positive CRKP. The mean age of the patients was 6 years, the mean time of appearance of infection in PICU was 45 days. Infection was detected in tracheal aspirate culture in 2 patients, catheter-related blood culture in 2, wound culture in 2, and urine culture in 1 patient. Combination therapy with high dose meropenem and imipenem infusion, amikacin, colistin and tigecycline was used in treatment. The mean duration of antibiotic treatment and isolation was 15.7 and 65.4 days, respectively. Skin and digestive tract colonization occurred in all patients. Only one patient lost becouse of her own illness, while there was no active infection. Conclusions PDR-CRKP infection is the most serious form of nasocomial outbreaks for intensive care units due to high mortality rate. We wanted to share our experience, which was for the first time in the PICU with very low mortality.