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ID: 4466

A simple

bundle targeting hubs

approach for the management of

an increased incidence of glycopeptide resistant


without active surveillance

Manjula Meda


, Victoria Gentry


, Amanda Walker


, Ian Fry





Health NHS Trust,


Frimley Health NHS Foundation Trust,


Frimley Health

Foundation NHS Trust


Recent data on glycopeptide resistant


(GRE) incidence from PHE and Eurosurveilance indicate increase in

rates of GRE in healthcare.


To investigate and manage the increasing GRE

incidence in the hospital.


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.


The increase in incidence was localised to 4 specific


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


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


s role as the home of the most important Islamic pilgrimage sites.


To determine the knowledge about MERS-Cov

among Arab pilgrims and to assess the relationship between the

knowledge and different socio-demographic characteristics.


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


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,



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


To reduce the number of hospital acquired CDI by


C. difficile laboratory testing protocol

CDI treatment guidelines

Decontamination practices of bedpans, urinals, jugs, commodes,

mattresses and environmental surfaces


Multidisciplinary approach:


Fidaxomicin as first line therapy

Ward review of patients with CDI

Updated CDI management sticker in clinical notes


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


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


, Thijs Bosch


, Annelot Schoffelen


, Leo Schouls





Hospital Amsterdam The Netherlands,


National Institute for Public

Health and the Environment (RIVM) Bilthoven The Netherlands


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


t1081, was noted as an upcoming MRSA

variant in health care facilities in the Amsterdam region. The striking

similarity both epidemiologically and genetically withMRSA



from Hong Kong have been described.


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