1249. Images vs. C-Reactive Protein Follow-up of Patients with Organ/space Surgical Site Infections

Abstract

BackgroundEnd-of-treatment images of infections after intra-abdominal infection could increase costs. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are used to define and predict the evolution of infectious diseases. The aim of this study was to describe clinical outcomes of adult patients with end-of-treatment images or CRP and ESR follow-up, during treatment of organ/space (OS) (intra-abdominal) surgical site infection (SSI).MethodsObservational retrospective cohort. Hospitalized patients older than 16 years were included, who developed OS SSI after abdominal surgery, in a general hospital, from June 2014 to June 2018. Population variables: age, gender, comorbidities (cancer, diabetes mellitus, cirrhosis, chronic renal failure, tobacco, immunosuppressants, Charlson score and obesity), ESR, quantitative CRP, imaging study (tomography (CT)/ ultrasound), type of drainage route (surgical, percutaneous). Outcomes variables: antibiotic patient-days, time to infection (TTI), CRP and ESR at the time of diagnosis (TD) and at the end of treatment (TET), rate of relapsing infection. Statistical analysis: Description of variables sort by patients under images follow-up and patients under CRP and ESR follow-up. Fisher test of relapsing infection was calculated between groups.ResultsIncluded: 76 patients. Twenty-six were followed with CT or ultrasound and 50 were followed with CRP and ESR. Forty women, with a mean age of 55 years (19–91) and an average score of the Charlson of 3.64 (0–10). Forty patients had cancer before surgery (52.63%). Microbiological diagnosis: 70/76 patients, the majority was polymicrobial. Average of antibiotics patient-days was 24.4 days (14 days of intravenous therapy). TTI: 8.65 days. Average CRP at the TD was 87.5 mg/L and 17.5 mg/L at TET. No differences in ESR values (31.9 mm to 33.5 mm). Percutaneous drainage: 46 patients. Surgical procedure: 27. Relapsing infection: 11,5% in images group vs. 4% in no images group; P = 0.33.ConclusionQuantitative CRP monitoring was useful to guide the duration of antimicrobial treatment. No differences of relapsing infection between groups was found.Disclosures All authors: No reported disclosures.