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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


journey to turnaround its infection prevention performance and

discuss the key drivers of our success.

Novel educational solutions to drive better prescribing


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




] 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



Jon Otter.

Epidemiology, Imperial College Healthcare NHS Trust

I suspect that if you were to ask this same question to 10 experts, you


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