P219 Diversity of vancomycin resistant Enterococcus in a low endemic area

Objectives: Catheter-related bloodstream infections (CRBSI) cause significant morbidity and mortality in patients with cancer. The present study aims to describe the epidemiology, microbiology, and incidence of CRBSIs among cancer patients with an implantable vascular access device. Methods: A retrospectivelycollected cohort of patientsfollowed for more than 6 months following device implantation was included between January 1, 2009 and September 30, 2010 at an universityaffiliated medical center in Tainan, Taiwan. Results: 1754 consecutive cancer patients who received a Port implantable venousaccess device were included, and 315 patients with at least one episode of bloodstream infections were recorded, 51 (16.2%) episodes were identified as Port-A implanted CRBSI. Of 328,420 catheter days, the incidence of CRBSIs was 0.15 episode per 1000 catheter-days. Patients with leukemia (25%, 7/28) had a higher rate of CRBSI than those with lymphoma (1.25%, 1/80) or solid tumor (2.6%, 43/1646) (P < 0.001). The predominant organisms were Gram-negative bacilli (51%), fungus (27.5%) and Gram-positive isolates (21.6%). A significant increase in the case number of fungal CRBSIs was found, from 3 (8%) in 1996–2001 to 14 (27.5%) in 2009–10 (P =0.03). CRBSIs due to fungus (10/14, 71.4%) were associated with a higher crude [??] mortality than those due to bacteria (7/37, 18.9%; P = 0.001) Conclusion: Approximately 18% of cancer patients with a vascular accessdevicedeveloped BSI. Fungiwere increasingly recognizedas the cause of CRBSIs and associatedwith a poorprognosis, highlighting the need of empirical antifungal therapy.