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Introduction to the NIHR CRN Infection Specialty Group
Jane Minton.
Infectious Diseases, Leeds Teaching Hospitals NHS Trust
The NIHR Clinical Research Network provides the infrastructure in
England to enable the NHS to participate in high-quality clinical
research so that people can benefit from new and better ways of
treatment. NIHR CRN provides support to researchers to set up clinical
studies quickly and effectively; collaborates with the life-sciences
industry to deliver their work programmes; provides health profes-
sionals with research training; and works with patients to ensure they
are at the centre of all research activity. The NIHR CRN comprises 15
Local Clinical Research Networks covering England, each one deliver-
ing clinical research across 30 clinical specialties. Each Specialty Group
consists of representatives from the regions in England and the
devolved nations and other stakeholders such as Public Health
England. The Infection Specialty Group supports and promotes
research in Microbiology, Infectious Diseases and Genitourinary
Medicine by supporting studies on the NIHR Portfolio. These cover a
wide range of topics including antimicrobials, diagnostics, and
vaccines and include both interventional and observational projects.
We also support investigators and other stakeholders planning new
Infection studies to ensure that those studies will address patients
’
needs and can be successfully delivered in the NHS.
Zika: the evolving outbreak of an old infection
Dilys Morgan.
Emerging Infections and Zoonoses, Public Health England
Zika is a mosquito-borne viral infection principally transmitted Aedes
aegypti mosquitoes. Infection is often asymptomatic or generally mild
with symptoms similar to, but usually milder than dengue or
chikungunya virus. In 2007, an epidemic occurred in Yap Islands in
the Pacific Ocean, causing 5,000 infections. Outbreaks were then
notified in several islands of the Pacific region in 2013 and 2014. Cases
of Zika infection were first reported in Brazil from February 2015
onwards and by August 2016, 56 countries were reporting autoch-
thonous transmission in the last three months An association between
Zika infection in pregnancy and foetal microcephaly was first reported
in October 2015 following a large increase in cases of microcephaly in
Brazil. Based on a growing body of research, there is an international
scientific consensus that Zika virus is a cause of microcephaly and
other congenital anomalies (congenital Zika syndrome). Cases of
Guillain-Barré Syndrome following suspected or confirmed Zika virus
infection have also been reported. Although Zika virus was identified
in 1947, new developments related to the disease and transmission
continue to reported. This produces challenges for ensuring that
guidance for travellers and their contacts who may be at risk of Zika
infection remains consistent with the latest scientific evidence
From zero to hero
Sara Mumford.
Infection Prevention and Control, Maidstone and
Tunbridge Wells NHS Trust
In 2006 Maidstone and Tunbridge Wells NHS Trust had one of the
largest C. difficile outbreaks in the UK. The subsequent Healthcare
Commission report was published in October 2007. Over the last 10
years the Trust has successfully defined and implemented a successful
Infection Prevention strategy which has taken the Trust from theworst
fifteen Trusts for C. difficile rates to the highest performing fifteen
with a rate of infection last year of 7.4 per 100 000 bed days. The
strategy has been underpinned by a staff engagement and education
programme, together with innovative practice and true Board to ward
accountability and responsibility. In this presentation I will share some
of the highs, lows, innovations and lessons learned of the Trust
′
s
journey to turnaround its infection prevention performance and
discuss the key drivers of our success.
Novel educational solutions to drive better prescribing
–
evidence
of effectiveness?
Dilip Nathwani.
Ninewells Hospital and Medical School
The critical role of education in supportive prudent prescribing is well
recognised. This presentation will focus on the role of educational
solutions in the context of antimicrobial stewardship. Key topics will
include: 1. Why education delivery in theworkplace can be so complex
and challenging? 2. The educational needs of medical students and
healthcare professionals 3. the governing principles of educational
programmes and a framework for educational competency for
stewardship 4. Evidence of the effectiveness of traditional and
novel educational solutions in the context of prescribing 5. Review
the experience and impact of e-learning interventions includ-
ing the MOOC
[https:/
/www.futurelearn.com/courses/antimicrobial-
stewardship
] and the evolving concept of space learning.
Update on the epidemiology of MERS
Ali Omrani.
Infectious Diseases, King Faisal Specialist Hospital and
Research Centre, Riyadh
Since its first description in September 2012, over 1,700 laboratory-
confirmed cases of Middle East Respiratory Coronavirus (MERS-CoV)
infections have been notified to the WHO. The clinical spectrum of
MERS-CoV infection in humans ranges from an asymptomatic or mild
respiratory illness to severe pneumonia, multi-organ failure and high
mortality. A few potential therapeutic agents have been identified but
none has been conclusively shown to be clinically effective. Human to
human transmission is well documented, but the epidemic potential
of MERS-CoV remains limited at present. Healthcare-associated
clusters of MERS-CoV have been responsible for the majority of
reported cases. The largest outbreaks have been driven by delayed
diagnosis, overcrowding and poor infection control practices.
However, chains of MERS-CoV transmission can be readily interrupted
with implementation of appropriate control measures. Bats harbor
several betacoronaviruses that are closely related to MERS-CoV.
Evidence from multiple sources implicates dromedary camels as
natural hosts of MERS- CoV. Camel to human transmission has been
demonstrated, but the exact mechanism of infection remains
uncertain. Strict regulation of camel movement, regular herd screen-
ing, isolation of infected camels, use of personal protective equipment
by camel handlers are potentially useful measures to prevent primary
MERS-CoV infections.
To what extent does the environment contribute to gastroenteric
infections
–
Review
Jon Otter.
Epidemiology, Imperial College Healthcare NHS Trust
I suspect that if you were to ask this same question to 10 experts, you
’
d
get more than 10 different answers, ranging from
‘
not very much at all
’
right through to
‘
the most common transmission route
’
. This talk will
outline the evidence base that contaminated surfaces
–
and perhaps
contaminated air
–
contributes to the transmission of key gastrointes-
tinal pathogens Clostridium difficile and norovirus. The relationship
between the level of surface contamination and the risk of transmis-
sion has not been studied in detail. It depends on various factors,
including the characteristics of the organism involved, patient
susceptibility and staff compliance with infection control policies
(for example hand hygiene following contact with environmental
surfaces). A number of studies have identified a correlation between a
quantitative or semi-quantitative measure of the level of environ-
mental contamination and the risk of pathogen acquisition. However,
further studies are required to quantify the relationship between
surface contamination and the risk of pathogen acquisition, and help
us to direct prevention activities and resources.
Abstracts of FIS/HIS 2016
–
Invited Speaker Abstracts / Journal of Hospital Infection 94S1 (2016) S1
–
S10
S6