P86 | Active surveillance: what changed?
M. Lugara1, M. Borrelli2, G. Oliva1, A. Desena1, D.V. Iula3, G. Cuomo2, R. Marra4, F. Gatta2, P. Paradisone1, V. Nuzzo5 | 1Presidio Ospedaliero del Mare, Unit of General Internal Medicine, Naples, 2Department of Clinical Medicine and Surgery; Internal Medicine, Federico II University Hopsital Naples, 3Presidio Ospedaliero del Mare, Unit of Medical Microbiology, Naples, 4Presidio Ospedaliero del Mare, Department of Pharmacology, Naples, 5Presidio Ospedaliero del Mare, Unit of General Internal Medicine, Naples, Italy
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Background: Active surveillance programs aim to prevent the spread of carbapenemase-producing Enterobacterales (CPE). Rectal swab (RS) is used for screening colonized subjects. The samples are analyzed from January 2020 to November 2023 in the Ospedale del mare Clinical Pathology Unit bacteriology. Our focus is on the RS received from Non-Intensive Area (NIA) and Intensive Area (IA).
Design: The protocol involves sowing on KIT CARBA chromogenic medium and on MacConkey Agar with meropenem disk. The XpertCarba-R assay is carried out on positive samples to differentiate the carbapenemase gene. Then the identification and the antibiogram are done with the automatic Vitek2 system.
Results: 7350 RS processed with 366 positive results, 80% positive for KPC, 6.28% for NDM, 3.55% for VIM, 3% for OXA48, 6.28% for 2 carbapenemase genes, 2.73% KPC+NDM, 1.91% KPC+OXA48, 1.36% KPC+ VIM, 0.27% OXA48+VIM. K. pneumoniae was found most frequently (337), follewed by E. coli (20). RS are performed on entry end than once a week in IA, while only once in NIA.
Conclusions: Our data show an increase in positive tests from 2020 to 2023 of 0.08% for IA and 60% for NIA. KPC was most detected resistance mechanism, but NDM, OXA48 and VIM increase. Hospital circulation of resistance mechanism leads to highest positive RS for KPC in IA. Instead, data can offer a picture of a territorial miltiresistance pathogens due to screening or to abuse of antibiotic therapy in NIA. In conclusion, rapid results with the related resistance mechanism is critical for decisions making.
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