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cause analysis (RCA) and ribotyping of isolates did not uncover specific

areas of weakness. A trend of non-compliance with preventative

methods was felt to be the overarching theme.


Primary aim was to raise awareness on prevent-

ive interventions to reduce HCAI. Infection Prevention & Control Team

(IPCT) developed a new strategy which promoted staff engagement,

ownership and healthy competition to improve quality of care to



IPCT had a

light bulb moment

and the

diarrhoea road


was born. Key elements were:

Best practice express train with SIGHT pneumonic became screen


A Carriage with key message added every fortnight

Focus changed to

CDI free days

and wards awarded for


Use SIGHT pneumonic to engage, refresh practice

• ‘


Oscopy was born, a mascot which captured everyone


imagination & won hearts & minds

Discussions from ward to board


Enthusiasm and ownership around being rewarded for

achieving their trajectory for

CDI free

days was infectious amongst

all staff members. Launch of the quality improvement (QI) programme

turned practice and focus to getting on board

best practice express

and and achieve trajectory of 26 CDI cases, originally thought to be an

impossible task.

Discussion and/or Conclusion(s):

Visible Clinical leadership,

innovation by IPC Team and Board engagement made this a

sustainable and successful QI project. Next steps is to continue in

2016/17 and create more innovations and sustain improvements

throughout the year.

ID: 4968

An observational study of the effect of chlorhexidine bathing on

MDR organisms and bloodstream infections in the ICU

Hilde Jansens, Frank Van Laer, Emiel Goovaerts, Herman Goossens,

Philippe Jorens.

University Hospital Antwerp


Colonization is a risk factor for infections with multi-

drug-resistant organisms (MDRO).


To investigate the effect of daily bathing of

patients with chlorhexidine washcloths on the acquisition of MDRO

and on the incidence of central line-associated bloodstream infections



We conducted a singlecenter observational study on the

effect of daily bathing with no-rinse 2% chlorhexidine-impregnated

washcloths in an intensive care unit (ICU) of a university hospital.

The incidence rates of the acquisition of MDRO and the rates of CLABSI

were compared.


The overall rate of MDRO acquisition was 4.38 cases per 1000

patient-days before chlorhexidine bathing versus 2.03 cases per 1000

patient-days after the introduction of the wash cloths, a 53.6%

reduction. The overall rate of CLABSI was 1.95 per 1000 catheter days

at the start of the washing period versus 1.40 per 1000 catheter days at

the end, a reduction of 28.2%.

Discussion and/or Conclusion(s):

Introduction of daily chlorhexidine

washing appeared to be an effective intervention to reduce the rates

of MDRO acquisition and decrease the infection rates in the ICU.

ID: 4979

Characterising dynamics of Staphylococcus aureus carriage in

healthcare workers in critical care

James Price


, Kevin Cole


, Andrew Bexley


, Martin Llewelyn



John Paul




Brighton and Sussex University Hospital NHS Trust,


Public Health England,


Brighton and Sussex Medical School


Colonised healthcare workers (HCWs) have been impli-

cated as sources in nosocomial Staphylococcus aureus outbreaks.

Despite this little is known about dynamics of S. aureus carriage in



We performed a detailed evaluation of S. aureus

carriage in critical care HCWs.


Consenting critical care HCWs in a teaching hospital in

Southern England were serially screened for S. aureus carriage over 14

months. Data on demographics, co-morbidities, and medical carewere

collected. Longitudinal nasal carriage was defined using carriage

profile indices (CPI) (total culture-positive swabs over total swabs).

Measures of association were calculated using multivariate logistic



Of 198 HCWs 147 (74.2%) were female, 146 (73.4%) were <40

years and prevalence of co-morbidities was low. Nasal carriage at

study entry was identified in 54/149 (36.2%) nurses, 16/40 (40.0%)

doctors and 3/9 (33.3%) physiotherapists (8MRSA (all nurses)) andwas

associated with concurrent nursing home employment (OR 11, 95%CI


106.1, p = 0.038) and living with a partner (OR 2.2, 95%CI 1.1


p = 0.02).

Serial screening revealed 73 HCWs (38.2%) intermittently carried

S. aureus (CPI = 0.07

0.93), 36 (18.9%) were always culture-positive

(CPI = 1) and 82 (42.9%) always culture-negative (CPI = 0). Of

these serially screened HCWs, 54 (28.3%) (52 nurses, p < 0.001)


1 course of antibiotics during the study. HCWs receiving

antibiotics were twice as likely to carry S. aureus intermittently

(OR 2.5, 95%CI 1.3

4.7, p = 0.006).

Discussion and/or Conclusion(s):

Longitudinal nasal carriage of

S. aureus in critical care HCWs reveal diverse intermittent carriage

profiles associated with receipt of antibiotics. Further work is required

to determine the implications of carriage profiles and transmission.

ID: 5001

Clinical factors associated with E-coli bacteraemia and risk factors

associated with 30-day all-cause mortality in East Kent Hospitals

Nuzhath Khan


, Srinivasulu Reddy


, Nash James





Department, William Harvey Hospital,


East Kent Hospitals, Microbiology


Escherichia Coli (E. coli) bacteraemia is rising in

incidence. It has a comparative mortality rate double that of other

bacteraemia, including methicillin resistance S. aureus (MRSA).



Analyse clinical factors associated with E-coli bacteraemia;


Identify risk factors associated with 30-day all-cause mortality in



Retrospective analysis of 68 E. coli bacteraemia cases

in East Kent Hospitals over three months was applied. Risk fac-

tors analysed included age, gender, antibiotic non-susceptibility,



-lactamase (ESBL) production, number of

hospitalisations in the previous year, co-morbidities and source of

bacteraemia. Binary logistic regression model was applied to identify

risk factors for mortality.


Thirty-day all cause mortality rate was 20.6%

Higher mortality rate associated with male gender (p = 0.02);

underlying hepatobiliary focus (p = 0.04); and resistance to

amoxicillin/clavulanate (p = 0.06)

25.0% resistance to amoxicillin/clavulanate and ciprofloxacin

10.3% of cases were ESBL E. coli

61.8% of patients had one or more previous hospital admissions in

the previous year; 20.6% had an intervention in the previous year,

including biliary intervention (11.8%); and 88.2% had one or more


Discussion and/or Conclusion(s):

Results suggest that elderly male

patients may have a higher risk of mortality from E. coli bacteraemia.

There is need to further investigate the possible link between

higher mortality and hepatobiliary source. High rate of resistance to

commonly used antibiotics such as amoxicillin/clavulanate highlights

the need to maintain use of appropriate antibiotics.

Abstracts of FIS/HIS 2016

Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24