Reasons for non use of ACTs SPECTRUM OF MULTI-DRUG RESISTANT GRAM NEGATIVE BACTERIA ISOLATED FROM HOSPITALIZED CHILDREN WITH FEBRILE ILLNESS IN FIVE REFERRAL HOSPITALS IN UGANDA NO: 471 James Kapisi1, Asadu Sserwanga1, Ruth Kigozi1, Catherine Maiteki1, Mohammed Lamorde3, Richard Walemwa3, Franklin Kizito3, Gilbert Aniku4, Jane Frances Nanteza5, Abner Tagoola6, Jeff N. Borchert7, Matthew Mikoleit7, Paul S. Mead8, Kiersten Kugeler8, Ron Rosenberg8, Henry M. Kajumbula9, Hannington Baluku9, Molly Freeman10 , Eric Mintz10, Moses R. Kamya1, Arthur Mpimbaza2 1Infectious Diseases Research Collaboration, Kampala, Uganda, 2 Child Health and Development Centre, Makerere University, Kampala, Uganda, 3 Infectious Diseases Institute, 4 Arua Hospital, Ministry of Health, Arua, Uganda, 5 Mubende Hospital, Ministry of Health, Mubende, Uganda, 6 Jinja Hospital, Ministry of Health, Jinja, Uganda, 7 Division of Global Health Protection, Centre for Global Health, Centres for Disease Control and Prevention, Atlanta, GA, 8 Division of Vector-Borne Disease, Centres for Disease Control, Fort Collins, CO, 9 Department of Microbiology, Makerere University, Kampala, Uganda, 10 Division of Foodborne, Waterborne, and Environmental Diseases, National Centre for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA Results Background Antimicrobial resistance is a global public health problem contributing to childhood morbidity and mortality In resource-constrained countries, identification of bacterial isolates and antimicrobial susceptibility testing (AST) are a challenge due to limited laboratory capacity. As part of an ongoing acute Febrile illness (AFI) surveillance programme, we report the prevalence of multidrug-resistant (MDR) gram-negative bacteria (GNB) among children at five regional reference hospitals Reasons for non use of ACTs Methods The AFI surveillance programme is running at the following hospitals All hospitalized children ≤ 14 years of age were tested for malaria by microscopy or RDT Those with a negative malaria test qualified for a blood culture A single blood culture bottle was collected per patient and incubated in Bactec machines at the respective hospitals. Positive samples from the Bactec machines were sent for sub-culturing at a central reference Laboratory (Department of Microbiology, Makerere University, Kampala Uganda) Antimicrobial susceptibility testing (AST) was done using the Kirby-Bauer disk diffusion method MDR resistance among gram-negative bacteria was defined as resistance to ≥ 3 of the following antimicrobials or antimicrobial classes: Extended-spectrum penicillins (ampicillin-sulbactam or piperacillin-tazobactam), Third-generation cephalosporins (ceftazidime or ceftriaxone), Aminoglycosides (gentamicin), Fluoroquinolones (ciprofloxacin) Carbapenems (meropenem) This analysis represents patients’ data from 01st July 2016 to 31st August 2017 Summary of results Multi-drug resistant Gram-negative bacteria are frequently isolated from hospitalized children and pose a treatment dilemma to health workers. The ongoing surveillance programme will continue to yield critical information on bacterial pathogens and their antimicrobial susceptibility patterns to inform patient care decisions and antimicrobial stewardship guidelines.