P0553 / #1614: RAOULTELLA TERRIGENA INFECTION: A NEW THREAT IN PEDIATRIC ICU

Aims & Objectives:Raoultella terrigena (known as Klebsiella terrigena) is a rarely encountered gram-negative bacterium. Litterature about nosocomial infections due to this multidrug resistant misroorganism is scarce. The aim our study is to describe the evolution of patients with Raoultella terrigena infection in the pediatric intensive care unit, and therefor highlight the challenges physicians face while managing these multi drug resistant emergent pathogen. Methods: We conducted a retrospective study, over a period of 4 months (01/10/2019 to 01/02/2020) including all pediatric patients with Raoultella terrigena infection. Medical records were analysed. Results: Ten cases of Raoutella Terrigena infection have been reported over a period of 4 months.The mean age was 52 months. All of these patients were intubated and ventilated. The length of hospital stay varied between 3 days and 2 months. Nosocomial infection was diagnosed after a mean of 5 days of hospitalisation.The microorganism was isolated in sputum in 80%, from a central venous catheter in 10% and from a lumbar puncture in 10%. Raoultella terrigena was multi drug resistant il all cases. Antibiotherapy associating Colistin and Tigecycline was prescribed in 40% of cases while in 60% of cases, precited antibiotics were associated to Rifampicin.The duration of treatment varied between 4 and 20 days. The mortality rate was 70% of the cases, due to refractory septic shoc. Conclusions: Raoultella terrigena is a potentially emerging pathogen. It can lead to fatal nosocomial infections. Managing patients with these multi drug resistant infections is extremely difficult. Antimicrobial stewardship must be reinforced in pediatric ICU, along with infection control programs.