Discussion and/or Conclusion(s):
Though the key factors for success
include among others the multimodal nature of the campaigns, the
political and financial support from the government, the highest
number of observed opportunities and compliance rates recorded in
2013 can also be attributed to the new online tool.
Identifying preventable Gram-negative bloodstream infections
Conor Bowman, Damien Mack, Robin Smith, Susan Hopkins.
London NHS Foundation Trust
In England, from 2010 to 2014,
bloodstream infections (BSI) rose 21% and 16% across England. The UK
government ambition is to half preventable Gram-negative BSI by
To identify the differences between these two
pathogen BSIs to allow focused interventions to be developed.
BSI at a university teaching hospital
between 1/1/2014 and 31/12/2016 were extracted from the laboratory
information management system. Clinical data was extracted from
the patient clinical records and hospital administration system. A
hospital-acquired BSI (HABSI) was defined as onset
day 3 of the
BSI were detected.
Patients with E. coli were less likely to be male (50% v 61%) and were
older (median age 72y V 64y) than those with Klebsiella BSI.
The greatest burden of HAI occurred in
(126 V 84 patients); though 48% of all
were HABSI compared
to 28% of
. The top two commonest sources of BSI were urinary
28%) and hepatobiliary (21% for both
bacteria) infections. Preventable infections were assessed as very
likely or possibly for 36% of
and 47% of
predominantly related to devices, procedures or inappropriate initial
Discussion and/or Conclusion(s):
There are significant demographic
and clinical differences between
targeting device insertion and care, surgical prophylaxis and empiric
treatment guidelines could reduce these HABSI.
Topic: Tropical infections
Transmission study of
in household contact
using polymerase chain reaction method in leprosy endemic area
of Papua Indonesia
, Antonius Oktavian
, Yustinus Maladan
Tri Nury Kridaningsih
National Institute of Health Research and
Development- Institute of Research and Development for Biomedicine
The new case number in Papua, easternmost part of
Indonesia Archipelago is remained stable although so many efforts of
leprosy elimination programs were carried out. It shows that the
is actively happen.
Aims of this study are to detect
using Polymerase Chain Reaction (PCR) in asymptomatic
household contact in order to observe the transmission of
in early stage before the clinical manifestation
and to observe the risk factors of transmission.
This is cross sectional with descriptive design study.
Sample population were 35 symtomatic leprosy patients and 4
asymptomatic household contacts for each patient. Environment
factors that observed are periode of living with the patient, intencity
and number of person in a house. The nasal swab, skin silt and blood
samples was collected from all subjects. The DNA was extracted from
nasal and skin silt.
Thirty five leprosy patients and 107 asymptomatic
household contacts were recruited as subjects in this study. The
result show that
can be detect on 100%
leprosy patients and 19,62% of household contact using PCR. Risk
factors that statistically significant associated with transmission of
is the period of living together with leprosy
patients (P: 0,002).
Discussion and/or Conclusion(s): The conclusion of this study is PCR
can be used to detect
in household contact
without clinical cardinal sign as well as in leprosy patients with
cardinal sign. The risk factors that influence the transmission of
is the period of living together.
Outpatient management of uncomplicated
in returning travellers: benefits & barriers of implementation in a
South-East London DGH setting
Edward Monk, Juliet Uwagwu.
Greenwich and Lewisham NHS Trust
Admission is recommended for all imported
infections, despite studies in UK specialist
and district settings claiming safe selective-outpatient management.
We established admission criteria at Queen Elizabeth Hospital,
and present potential benefits to
outpatient management in a UK district general hospital and
barriers to implementation.
We aim to determine whether it is possible to
implement an ED risk-assessment protocol for outpatient manage-
ment of adult, uncomplicated
infection safely. Objectives
are to determine appropriate referral, audit documentation of
outpatient/admission criteria and ascertain whether outpatient
management is a rational pursuit.
Patient notes were gathered for adults with
positive blood films between 01/08/2014 and 31/11/15 (protocol
implementation from 01/03/2015) and searched retrospectively for
documentation of criteria used to determine uncomplicated infection
and suitability for outpatient management.
During the study period, 52 adults were diagnosed with
with 42.3%(22/54) eligible for outpatient management.
25.0%(13/52) had a heart rate >120 on admission, 17.3%(9/52) a
parasitaemia of >2% and 13.5%(7/52) associated AKI. Of the 13 patients
suitable for outpatient management after pathway implementation, 0
were referred to outpatient services. All had uneventful admissions.
Average admission was 2.05 days; 29 hospital-bed-days could have
been saved with appropriate outpatient referral-pathway use.
Discussion and/or Conclusion(s): Improved staff education and
referral-pathway awareness is required to assess the true feasibility
management; in theory it could save
QEH 32 hospital-bed-days/year (approximately £12,800). Eligibility
criteria were well-documented and suitable patients made quick
recovery. High-powered, multi-centre studies are necessary to
establish statistical safety.
Diarrhoea in a returning traveller from Mexico
Marco Lee, Fauzia Rizwan
Leeds Teaching Hospitals NHS Trust.
A 72 year old female, normally fit and well, returned
from a one month visit to Mexico City. She ate at local restaurants on
many occasions and developed acute onset diarrhoea. She attended
private clinics twice and was given courses of ciprofloxacin and
cephalexin. Symptoms did not improve. On arrival to UK, she had
symptoms of abdominal bloating, vomiting, and type 7 stools.
A bloodborne virus screen (HIV, HBV, HCV) was negative.
Stools were negative for Campylobacter, Salmonella, Shigella,
0157, rotavirus, adenovirus, and
toxin. A stool OCP revealed
Cyclospora cayetanensis oocysts. Diarrhoea improved within 3 days of
starting oral co-trimoxazole. She was discharged to complete a 7 day
course with routine follow-up in the infectious diseases outpatient
Abstracts of FIS/HIS 2016
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24