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ID: 4466
A simple
“
bundle targeting hubs
”
approach for the management of
an increased incidence of glycopeptide resistant
Enterococcus
without active surveillance
Manjula Meda
1
, Victoria Gentry
2
, Amanda Walker
2
, Ian Fry
3
.
1
Frimley
Health NHS Trust,
2
Frimley Health NHS Foundation Trust,
3
Frimley Health
Foundation NHS Trust
Background:
Recent data on glycopeptide resistant
Enterococcus
(GRE) incidence from PHE and Eurosurveilance indicate increase in
rates of GRE in healthcare.
Aim(s)/Objective(s):
To investigate and manage the increasing GRE
incidence in the hospital.
Method(s):
Between Jan-Jun 2015, the infection prevention and
control team investigated the increase in the number of GRE reports
issued by the laboratory using passive surveillance. All necessary data
required for the investigation was collected prospectively. All isolates
during the same 6 month period were sent for typing.
Results:
The increase in incidence was localised to 4 specific
“
hub
”
sites in the hospital. These included the general surgical ward, critical
care unit, haemato-oncology ward and general medical ward. Patients
in the medical wards carried GRE in predominantly their urine
samples, while patients on the surgical and critical care wards were
more often colonised inwounds or on devices. Of the 40 isolates typed
by PFGE, 18 were reported to be unique strains. Only one of these 40
had no contact with healthcare in the last year. There were three
probable cross transmission events. Antibiotic use and presence of
indwelling device was most common risk factors. An infection control
bundle was instituted in July 2015 following which a significant
reduction in GRE was noted.
Discussion and/or Conclusion(s):
Targeted invention control bundle
in surgical, critical care and haemato-onclogy wards which included
1. weekly antibiotic audits 2. enhanced environmental cleaning
3. cohorting/isolating patients, without recourse to active surveillance,
and 4. emphasis on hand hygienewas successful in reducing incidence
significantly in the trust.
ID: 4522
To what extent Arab pilgrims are aware of Middle East Respiratory
Syndrome Corona Virus (MERS-CoV) and the protective
precautions against it?
Mazin Barry, Abdulaziz Alsubaie, Meshal Alotaibi,
Abdulrahman Aljadoa, Abdulaziz Alhamad, Turki Alotaibi,
Khaled Almohaimede, Omar Alharbi.
King Saud University, College of
Medicine, Riyadh, Saudi Arabia
Background:
Many cases of Middle East Respiratory Syndrome Corona
Virus (MERS-CoV) have been confirmed worldwide. Around 80% of
the cases have been diagnosed in the Kingdom of Saudi Arabia (KSA).
The risk of international disease spread is especiallyworrying given the
KSA
’
s role as the home of the most important Islamic pilgrimage sites.
Aim(s)/Objective(s):
To determine the knowledge about MERS-Cov
among Arab pilgrims and to assess the relationship between the
knowledge and different socio-demographic characteristics.
Method(s):
A cross-sectional study was carried out during Ramadan
2015 in the Holy Mosque in Mecca, Saudi Arabia. Self-developed
questionnaires were collected conveniently from417 Arab participants
Results:
The majority of the respondents were familiar with MERS-
CoV (91.3%). Saudis had a significantly higher knowledge about
MERS-CoV compared to non-Saudis. (56.92 ± 18.55 vs. 44.91 ± 25.46,
P = 0.001). The average knowledge was significantly higher in
respondents who had received health advice on MERS-CoV (56.08 ±
20.86 vs. 50.65 ± 22.51, P = 0.024). With respect to stepwise linear
regression, knowledge about MERS-CoV tended to increase by 14.23
(B = 14.23%, P = 0.001) for participants who were familiar with MERS-
CoV, and by 8.50 (B = 8.50, P = 0.001) for respondents who had
perceived MERS-CoV as a very serious disease.
Discussion and/or Conclusion(s):
The lack of awareness among the
pilgrims about MERS-CoV, which is a potentially serious infection,
especially during Ramadan and Hajj, indicates that health authorities
in the pilgrims
’
countries of origin should take a more active role in
sharing health education and awareness, especially in the absence of
an effective treatment or vaccine for MERS-CoV.
ID: 4536
Clostridium difficile infection. What happened in 2015?
Thressia Puthussery Devassy, Sheila Donlon, Caoimhe Finn,
Fionnuala Duffy, Helen Good, Helen Cox, Pauline Flood,
Dorothy Costello, Eric Watson, Margaret Fitzgerald, Mairead Skally,
Sinead McDermott, Karen Burns, Edmond Smyth, Hilary Humphreys,
Lilian Rajan, Karina O
’
Connell, Fidelma Fitzpatrick.
Beaumont Hospital,
Dublin
Background:
Clostridium difficile infection (CDI)
•
Leading cause of infectious healthcare-associated diarrhoea
•
C. difficile infected and colonised patients contaminate their
environment with spores
•
Spores have a key role in the acquisition and transmission of CDI
•
In recent years, Beaumont hospital has managed number of CDI
outbreaks, including the hyper virulent strains 027 and 078
•
In February 2015, FIVE clusters of CDI were identified
Aim(s)/Objective(s):
To reduce the number of hospital acquired CDI by
improving:
•
C. difficile laboratory testing protocol
•
CDI treatment guidelines
•
Decontamination practices of bedpans, urinals, jugs, commodes,
mattresses and environmental surfaces
Method(s):
Multidisciplinary approach:
Clinical
•
Fidaxomicin as first line therapy
•
Ward review of patients with CDI
•
Updated CDI management sticker in clinical notes
Laboratory
•
Change in the C. difficile testing algorithm
•
Enteric Bio (PCR) and confirmation of positive PCR result with
toxin EIA
•
New interpretative comments on laboratory reports
Infection prevention and control
•
Mattress audit and replacement programme
•
Updated SOP for mattress check including tag with time and date
of inspection
•
Replacement programme for bedpans and commodes
•
Introduction of Pulp disposal units (Macerators) for disposable
bedpans in two areas
•
Feedback of CDI figures in real-time to senior management team
Results:
57% reduction in hospital acquired CDI from Q1 to Q4 in 2015.
Discussion and/or Conclusion(s):
This mutidisciplinary involvement
included weekly measurement of CDI numbers to inform improve-
ment in real time, changes in the testing for and treatment of CDI and
the improvement to ensure effective decontamination of mattresses,
commodes and bedpans. The overall result was 57% reduction in the
number of hospital acquired CDI in 2015.
ID: 4661
No further regional spread of MRSA MLVA type 1352 in the
Netherlands, will it decline?
Paul Gruteke
1
, Thijs Bosch
2
, Annelot Schoffelen
2
, Leo Schouls
2
.
1
OLVG
Hospital Amsterdam The Netherlands,
2
National Institute for Public
Health and the Environment (RIVM) Bilthoven The Netherlands
Background:
The Netherlands is known for its low prevalence of
MRSA, also in long-term care facilities (LTCF). However, in 2011 MRSA
MT1352, also known as
spa
t1081, was noted as an upcoming MRSA
variant in health care facilities in the Amsterdam region. The striking
similarity both epidemiologically and genetically withMRSA
spa
t1081
from Hong Kong have been described.
Aim(s)/Objective(s):
Evaluate the course of the emergence of MT1352
in the Netherlands.
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S104