Chang, Su-Jung

Chen, Cheng-Hui

Chou, Mei-Jen

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Epidemiology of healthcare-associated bloodstream infections in cancer patients: Experiences from a medical center of southern Taiwan 

S182 Abstracts of the 7th International Congress of the Asia Pacific Society of Infection Control, Taipei, Taiwan, March 26-29, 2015isolates being Methicillin-Resistant Coagulase-Negative Staphylococci
(15.0%) and Methicillin-Susceptible Coagulase-Negative Staphylococci
(15.0%), followed by gram-negative isolates (n Z16; 40.0%),and Candida
spp. (n Z 6; 15.0%).
Conclusions: In conclusion, the incidence of CRBSI in gastrointestinal sur-
gery revealed a non-ICU, high-risk sector that needs further investigation.
Detectection of risk factors and pathogenesis of CRBSI in patients undergoing
gastrointestinal surgery was expected to provide better prevention mea-
sures to reduce CRBSI in non-ICU.PS 2-510
EPIDEMIOLOGY OF HEALTHCARE-ASSOCIATED BLOODSTREAM
INFECTIONS IN CANCER PATIENTS: EXPERIENCES FROM A MEDICAL
CENTER OF SOUTHERN TAIWAN
Cheng-Hui Chen, Su-Jung Chang, Mei-Jen Chou. Department of Nursing,
National Cheng Kung University Hospital, College of Medicine, National
Cheng Kung University, Taiwan
Purpose: Cancer patients are more susceptible than other patients to
healthcare-associated infections due to compromised immune systems, sur-
gery, invasive technology, and environmental factors. They are at unusually
high risk for developing bloodstream infections (BSI), which are a major
cause of inpatient morbidity and mortality among cancer patients. The
aim of this study is to describe the epidemiological characteristics and the
etiology of healthcare-associated BSI in cancer patients.
Methods: This was a retrospective study and conducted at an oncology
unit of the medical center in southern Taiwan. During one year period
all hospitalized patients with clinically significant BSI were evaluated,
in which samples representing healthcare-associated BSI sent from the
Infection Control Centre at the hospital during the year of 2013 were
analyzed.
Results: The study enrolled 70 episodes of healthcare-associated BSI (65
patients), 43 patients (61.4%) were male and 27 patients (38.6%) were fe-
male, with a combined median age of 55 years (range, 21 to 83 years). The
majority of the episodes occurred among solid cancer patients (60.0%).
Central venous catheters (CVC) were present in 64.3% of the episodes. Fe-
ver was the common clinical symptom present in 60 patients (85.7%) and 10
patients (14.3%) had accompanying septic shock. After immediate applica-
tion of antibiotics and removal of central venous port for 15 patients
(44.1%), death after the occurrence of CVC-BSI was recorded in 21 patients
(39.6%). Overall, there were 94 isolates that represented BSI. The common
causative microorganisms were found to be Gram-negative bacilli (75.7%).
Oxacillin resistance was detected in 50.0% of Staphylococcus aureus iso-
lates and in 16.7% of coagulase-negative Staphylococcus. Fungi just were
identified in 1.4% of BSI.
Conclusions: The recognition of possible risk factors in high-risk cancer pa-
tients may help in planning and conducting more effective infection control
and preventive measures.
PS 2-511
CLOSTRIDIUM DIFFICILE-ASSOCIATED DIARRHEA IN MEDICAL INTENSIVE
CARE UNITS OF A MEDICAL CENTER IN SOUTHERN TAIWAN: A
PROSPECTIVE SURVEILLANCE STUDY
Jen-Chieh Lee a, Yuan-Pin Hung b,c, Pei-Jane Tsai d, Wen-Chien Ko a.
aDepartment of Internal Medicine, National Cheng Kung University, Medical
College and Hospital, Tainan, Taiwan; bDepartment of Internal Medicine,
Ministry of Health and Welfare, Tainan, Taiwan; cGraduate Institute of
Clinical Medicine, National Health Research Institutes, Tainan, Taiwan;
dDepartment of Medical Laboratory Science and Biotechnology, National
Cheng Kung University, Medical College, Tainan, Taiwan
Purpose: Clostridium difficile infection is the leading etiology among
nosocomial infectious diarrhea and is associated with morbidity and mor-
tality. Critically ill patients are thought to be more susceptible to C.
difficile-associated diarrhea (CDAD), however the epidemiology and
characteristics of CDAD in patients in intensive care units (ICUs) are
scanty. The purpose of this study is to analyze the impact of CDAD in
medical ICUs.
Methods: From March 2013 to March 2014, we prospectively enrolled adult
patients developing diarrhea 72 hours after admitted to ICUs. Stool culture
for C. difficile was done. All C. difficile isolates were tested for tcdA andtcdB by polymerase chain reaction. A case of CDAD was defined as the devel-
opment of diarrhea and toxigenic C. difficile detected in stool.
Results: In the study period, total 77 diarrheal patients were enrolled and
among them 15 CDAD cases were identified. None had pseudomembraneous
colitis or toxic megacolon. The incidence rate of CDAD was 9.45 cases per
10,000 patient-days in medical ICUs. Compared to non-CDAD cases, CDAD
cases have had a higher body mass index (23.94.2 vs. 21.75.4,
PZ0.033). There were no differences in underlying disease, disease
severity, and in-hospital mortality rate between the two groups. Nine of
15 cases of CDAD received antibiotic treatment, mostly oral metronidazole,
and recovered well.
Conclusions: The incidence of CDAD in our ICUs was lower than that ex-
pected and was associated with a higher body mass index.PS 2-512
HEALTHCARE ACQUIRED INFECTION IN INDIA e A LITERATURE REVIEW
Vivek Iyer, Sandeep Sewlikar, Anish Desai. Johnson and Johnson Limited,
Mumbai, India
Purpose: Hospital acquired infection (HAI) is the commonly reported compli-
cations of hospital care, increasing clinical and economic burden. World
Health Organization estimates the HAI prevalence rate between 7 to 12%
globally. However, HAI prevalence rate would be higher in the developing
countries like India, due to inadequate resources, insufficient processes
and underreporting. This is a comprehensive review of literatures published
on incidence rates of HAI and types of HAI in different kinds of hospital set-
tings to understand the clinical burden of HAI in India
Methodology: This is a systematic clinical review of published literature on
the HAI in India. The literature was performed using the Medline database,
Pubmed website and general search engines. The studies specific to India
were considered for the review.
Results: The numbers of studies referred were 8 for HAI, 10 for surgical site
infections (SSI), 8 for catheter related blood stream infections (CRBSI), 7 for
Ventilator-Associated Pneumonia (VAP) and 5 for Catheter-Associated Uri-
nary Tract Infections (CAUTI). The International Nosocomial Infection Con-
trol Consortium (INICC) have reported the HAI infection rate (from 12 ICUs
at 7 hospitals) of 4.4% corresponding to 9.06 infections per 1000 ICU days.
However, there are wide variations in HAI rate in different parts of country
and hospital set up (4.4% to 83.09%). The overall incidence rate of SSI varies
from 2 to 21%. INICC has reported CRBSI rate of 7.7 per 1000 catheter days
and other literatures showed 0.2 to 27%, with a rate of 0.5 to 47 per 1000
catheter days. The infection rate for VAP was reported as 8.9 to 31.4 per
1000 ventilator days and CAUTI as 0.54 to 11.4 per 1000 catheter days.
The most commonly identified gram positive micro-organisms were Staphy-
lococcus aureus both Methicillin sensitive (MSSA) and Methicillin resistant
(MRSA) and gram negative micro-organisms - Klebsiella pneumonia and
Escherichia coli.
Conclusions: The incidence rate of HAI in India seems high compared to the
developed world, which may be leading to increased morbidity, mortality
and subsequent economic burden on the health care system. However,
considering the diversities in India, more data would be required to assess
the prevalence rate of vsrious types of HAIs and in various types of hospital
settings across India.PS 2-513
EFFECT OF ACTIVE SURVEILLANCE AND DECOLONIZATION PROGRAMS ON
THE INCIDENCE OF CARBAPENEM-RESISTANT ACINETOBACTER
BAUMANNII INFECTIONS IN ADULT INTENSIVE CARE UNITS IN A TEACHING
HOSPITAL IN TAIWAN
Pi-Chu Teng a, Chuen-Hua Jong a, Jen-Jun Chen a, Chia-Hei Su a, Yu-
Shan Lin b, Yuarn-Jang Lee a,b. aDepartment of Infection Control, Taipei
Medical University Hospital, Taiwan; bDivision of Infection Diseases,
Department of Internal Medicine, Taipei Medical University Hospital,
Taiwan
Purpose: To evaluate whether the effects of active surveillance and decol-
onization programs on the incidence of Carbapenem-resistant Acinetobacter
baumannii (CRAB) infections in the adult intensive care units.
Methods: We conducted a retrospective cohort study in the adult surgical
intensive care unit (SICU) and adult medical intensive care unit (MICU) of a


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Epidemiology of healthcare-associated bloodstream infections in cancer patients: Experiences from a medical center of southern Taiwan

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