1546. Incidence of Carbapenemase-Producing Klebsiella pneumoniae Colonization in Hematopoietic Stem Cell Transplant Recipients in King Chulalongkorn Memorial Hospital (KCMH), Thailand

BACKGROUND: Carbapenemase-producing Klebsiella pneumoniae (CPKP) is an emerging pathogen which had the serious clinical infections, high mortality and difficult to control. Hematopoietic stem cell transplantation (HSCT) patients are particularly susceptible to multidrug-resistant bacteria especially carbapenemase-producing Enterobacteriacae. CPKP infections are an emerging cause of death after HSCT and the mortality rate was reported up to 60%. The major risk factors of CPKP infections were colonization these organism before transplantation. However, in Thailand, the incidence rate of CPKP colonization and clinical outcome in HSCT was limited. Objectives. To determine the incidence rate of CPKP colonizationand risk factors of 30-day-hospital mortality in HSCT patients at King Chulalongkorn Memorial Hospital. METHODS: A prospective study was conducted in total of 96 consecutive HSCT patients at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from July 2016 to March 31, 2018. RESULTS: Incidence rate of CPKP colonizationin HSCT patients was 22.2% (18/96 patients) and incidence rate of CPKP infections was 5.2% (5/96 patients). Both bla(OXA-48) and bla(NDM) were the most common carbapenemase gene (50%). Patients with CPKP infection were more likely in ICU setting than colonization group. CPKP colonization was more significantly found in urinary specimens (P = 0.029) whereas CPKP infections were common found in respiratory tract, but not significantly (P = 0.583). In CPKP infection group, the 30-day mortality rate was significantly higher than colonization group; 80% (4/5) vs. 23% (3/13), P = 0.047). Using univariable analysis, ICU setting was associated with CPKP infection (RR = 6.27 95% CI, 0.87–45.34) and had a worse outcome.The risk factor associated with 30-day mortality was CPKP infection (RR = 3.47 95% CI 1.17–10.26). CONCLUSION: In our study, the incidence of CPKP colonization in HSCT patients was 22.2%. The incidence of CPKP infections found only 5.2% in HSCT patients, but there was significantly associated with increased 30-day-hospital mortality. DISCLOSURES: All authors: No reported disclosures.