2061. Epidemiology and Management of Skin and Soft Tissue Infection colonization using standard criteria.

ng standard criteria. Predictors of surgical debridement were

(SSTI) Due to Carbapenem-Resistant Enterobacteriaceae: A Report From analyzed.
The Consortium on Resistance against Carbapenems in Klebsiella
pneumoniae (CRaCKle) Table: Predictors of Surgical Intervention
Oryan Henig, MD1; David Van Duin, MD, PhD2; Eric Cober, MD3; Sandra S. Richter,
MD4; Federico Perez, MD5,6; Robert Salata, MD7; Robert Kalayjian, MD8; Surgical No Surgical
Richard Watkins, MD, MS9,10; Yohei Doi, MD, PhD11; Scott Evans, PhD, MS12; Vance debridement debridement Adjusted OR
G Fowler Jr, MD, MHS13,14; Robert Bonomo, MD7,15,16,17; Keith Kaye, MD, MPH18; N = 68 (%) N = 74 (%) OR (95% CI) (95% CI)
1
Infectious Disease, Wayne State University, Detroit Medical Center, Detroit, Pitt score >3 28 (41.2%) 17 (23%) 2.35 (1.14- 4.85) 2.15 (0.95-4.87)
Michigan; 2Division of Infectious Diseases, University of North Carolina, Chapel Hill, Origin
North Carolina; 3Department of Infectious Diseases, Cleveland Clinic, Cleveland, Home 26 (38%) 19 (25.7%) 1.79 (0.87- 3.66)
Ohio; 4Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio; SNF 25 (36.8%) 44 (59%) 0.39 (0.20- 0.78) 0.4 (0.19-0.86)
5
Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Long term acute
Center, Cleveland, Ohio; 6Division of Infectious Diseases and HIV Medicine, care 4 (5.9%) 6 (8.1%) 0.7 (0.19-2.6)
Department of Medicine, Case Western Reserve University School of Medicine, Hospital transfer 19 (19.1%) 5 (6.8%) 3.26 (1.09- 9.7)
Cleveland, Ohio; 7Division of Infectious Diseases and HIV Medicine, Department of
Medicine, Case Western Reserve University School of Medicine, Cleavland, Ohio; SSTI 43 (63.2%) 19 (25.7%) 4.97 (2.43-10.20) 4.26 (2.0-9.08)
8
Department of Medicine, MetroHealth Medical Center, Cleveland, Ohio; 9Division of Extremity 24 (35.3%) 15 (20.3%) 2.14 (1.01-4.56) 1.9 (0.81-4.53)
Infectious Diseases, Akron General Medical Center, Akron, Ohio; 10Department of wound
Internal Medicine, Northeast Ohio Medical University, Rootstown, Ohio; 11Division of
Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh,
Pennsylvania; 12Department of Biostatistics and the Center for Biostatistics in AIDS
Research, Harvard School of Public Health, Boston, Massachusetts; 13Duke Clinical Results. Of the 142 patients with CRE isolated from a wound culture, 62 had SSTI
Research Institute, Duke University, Durham, North Carolina; 14Infectious Diseases, (44%) and 82 (56%) were colonized. The mean age was 61 years, 48% were male and
Duke University Medical Center, Durham, North Carolina; 15Department of 56% were white. Forty-eight percent of the patients were admitted from skilled nursing
Pharmacology, Case Western Reserve University School of Medicine, Cleveland, Ohio; facilities (SNFs), and 31% from home (table). The median Charlson score was 3.0
16
Department of Molecular Biology and Microbiology, Case Western Reserve (range 0-9). Fifty-three percent of patients had diabetes and 13% were immunocom-
University School of Medicine, Cleavland, Ohio; 17Research Service, Louis Stokes promised. Most of the patients (67%) were cared for in intensive care units or on sur-
Cleveland Department of Veterans Affairs Medical Center, Cleavland, Ohio; 18Detroit gical wards. 68 patients (48%) had surgical intervention, half of whom underwent
Medical Center and Wayne State University, Detroit, Michigan debridement in the operating room.
In bivariate analysis for the entire cohort (table), PITT score >3 and SSTI were as-
Session: 229. Antimicrobial Resistant Infections: Treatment
sociated with debridement (OR 2.35, 95% CI 1.14-4.85; OR 4.97, 95% CI 2.43-10.20,
Saturday, October 29, 2016: 12:30 PM
respectively). In multivariable analysis, SSTI was associated with surgical debridement.
Background. SSTI due to carbapenem-resistant Enterobacteriaceae (CRE) are Among patients with SSTI (n = 62), those admitted from a SNF were less likely to un-
management challenges due to limitations in effective antimicrobial options. The ob- dergo surgical debridement (OR 0.16, 95% CI 0.04-0.66).
jectives of this study were to describe the epidemiology and clinical course of SSTIs Conclusion. Patients with CRE SSTI who were admitted from SNFs were signifi-
and/or wound colonization due to CRE and to identify variables associated with sur- cantly less likely to undergo wound debridement.
gical debridement. Disclosures. S. S. Richter, bioMerieux: Research funding, Research support.
Methods. CRaCKle is a prospective multicenter consortium. Data pertaining to Nanosphere: Research funding, Research support. BD Diagnostics: Research Funding,
patients with wound cultures positive for CRE were prospectively collected from 24 Research support. Roche: Research funding, Research support. Biofire: Research fund-
December 2011 to 1 October 2014. Wound cultures were classified as SSTI or ing, Research support. OpGen: Research funding, Research support

Poster Abstracts • OFID 2016:3 (Suppl 1) • S599