P0614 / #1185: GRAM NEGATIVE BACTERIAL INFECTIONS (GNB) IN PEDIATRIC INTESIVE CARE UNIT (PICU): CLINICAL AND MICROBIOLOGICAL CHARACTERISTICS AND OUTCOME

Abstract

Aims & Objectives: GNB are a major cause of morbidity and mortality in critically ill patients. .To determine the characteristics of GNB acquired in the community (CA) vs associated with health care (IAAS) in PICU. Methods: Retrospective, observational study that included childrens admitted to PICU from 2013 to 2019 with a diagnosis of GNB. Clinical, microbiological and outcome were obtained from patient records, and analyzed Results: During the study period, 70 children with GNB were admited to PICU: 35 with CA and 35 IAAS, with similar mean age (18 and 22 months, respectively) (p=0.33). The majority of the patients required mechanical ventilation, 83 % in CA and 88.6% in IAAS (p=0.73). Shock was presented in 60% in CA and 51.4% in IAAS (p=0.33). E. coli (17% in both groups), P.aeruginosa (17% in CA vs 14% in IAAS), K. pneumoniae (14% in CA vs 20% in IAAS), and E. cloacae were the most frequent organisms isolated. Anemia was significant more frequent in patients with IAAS (n=30, 86%) (p=0.008) and was associated to mortality [p=0.008; RO=0.19 (0.06-0.6)]. The duration of stay in the PICU was more prolonged in IAAS patients (26.4± 28 days vs 14.9 ± 21 days) (p<0.05). The final mortality was higher in patients with CA GNB (n=14, 40%) compared to IAAS infections (n=5, 14%) [p= 0.03, RO=4 (1.24-12.8)]. Conclusions: The study reveals the high mortalitity of gram-negative infections especially in those with community adquisition. We identified anemia as important risk factor for mortality.