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Analysis of the national MRSA surveillance database at the



From virtually absent in 2008 and 2009, the number of

MT1352 isolates increased to 191 of 2254 referred non-LA-MRSA

isolates in 2015 (8.5%). From 2011 onward, MT1352 spread to the East

and North-West of the country, but no new provinces were affected

since 2012. The large province of Gelderland in the East saw rising

numbers up to 2014, followed by a slight decline. North Holland faced

the highest figures in 2015; 2016 numbers remained low up to May.

MT1352 affected LTCFs more frequently than hospitals.

Discussion and/or Conclusion(s):

MRSA MT1352 is part of Clonal

Complex 45, and is PVL-negative. Colonization is common, and serious

infections are rare. The strain is easily transmissible in healthcare

settings. Reconstruction of transmission routes within and to LTCFs

proved difficult. Little genetic variability of MT1352 limits the use of

current typing methods to elucidate the micro-epidemiology. NGS

might be helpful although sufficient numbers of strains and

epidemiological data will be needed.

The next few years will learn whether MT1352 disappears or will

remain at an endemic level.

ID: 4712

Outbreak Support Team; the Belgian answer to the emerging treat

of multidrug resistant organisms (MDRO) and MDRO-outbreaks in

care facilities

Barbara Legiest, Annie Uwineza, Beatrice Jans, Boudewijn Catry.

Scientific Institute of Public Health


Healthcare associated infections, caused by multidrug

resistant organisms (MDRO), signifie a therapeutic impasse as

infections are more difficult to treat and the hospitalisations last

longer. Consequently morbidity, mortality, and hospital costs increase.

Moreover, MDROs are easily transmitted and cause outbreaks often

difficult to contain in care facilities.


In Belgium, the Outbreak Support Team (OST) is

created to give the opportunity to the care facilities, struggling with

outbreaks involving MDROs, to call for help from an external partner

without being blamed or stigmatized.


This OST is a collaboration between the regional health

authorities in charge of infectious diseases, the Scientific Institute of

Public Health, and the National Reference Laboratories.

The help, offered by OST, includes scientific support, site visits, advice

on prioritizing actions, and (rarely) enforcement.


The contribution of the OST to outbreak management will be

described. Several tools have been developed: a checklist to inventory

the measures, transfer- and transport documents to standardize the

communication about MDRO contaminated patients, initiatives to

increase the knowledge of MDRO at other care sectors like nursing

homes, revalidation centers, and homecare.

Based on our experience and on the hand of examples, some recurrent

triggers for the development of and fitfalls in the control of an

outbreak can be listed.

Discussion and/or Conclusion(s):

Despite the expertise present and

the measures taken in the hospitals, the OST can help to control the

outbreak. At the national level, the OST contribute to a more

coordinated approach to the MDRO battle.

ID: 4717

Management of a parainfluenza 3 outbreak on a Special Care Baby

Unit including Neonatal ICU

Gavin Boyd, Jean Robinson, Christine Bishop, Sahar Musaad.


and Huddersfield NHS Foundation Trust


In April 2016 four infants on the special care baby unit

baby required ventilation over a 24 hour period, and two infants

developed signs of a respiratory tract infection. A viral pathogen

was suspected. We describe the control measures that we but in

place before and after confirmation of the aetiological pathogen as

parainflunza 3 virus.


To share the timeline of the outbreak, describing

how it evolved, the control measures that were put in place and our

communication strategy.


The outbreak was managed through a series of outbreak

control meetings. Decisions around closure of the unit, cohorting,

personal protective equipment for both staff and visitors, restrictions

to the visitor policy, enviornmental cleaning and communication with

parents and staff were all agreed and reveiwed at each meeting.


Twenty infants were on the special care baby unit at the

time the outbreak started. Four required intubation and mechanical

ventilation. Two other infants were confirmed postive cases but

did not require ventilatory support. The unit was closed to admissions

for a period of four days. Visiting was restricted to parents only. PPE

initally included full use of gloves, aprons and surgical masks. Cotside

cleaning was increased to three times per day. Parents received daily

written updates on the situation. We do not believe there was any

further cross tranmission following identification that we had a

potential outbreak.

Discussion and/or Conclusion(s):

This was a rapidly evolving

outbreak successfully controlled by the control measures described.

Changes made in light of our experiences will hopefully prevent a

similar outbreak in the future.

ID: 4719

The sink as a potential source of transmission of carbapenemase-

producing Enterobacteriaceae in intensive care unit

Deborah De Geyter


, Lieve Blommaert


, Nicole Verbraeken



Denis Piérard


, Ingrid Wybo




University Hospital Brussels,



Hospital Brussels/Microbiology and Infection Prevention




(CPE) are

emerging pathogens that represent a major public health threat. In the

University Hospital of Brussels, the incidence of new patients with CPE

rose from 1 case in 2010 to 35 cases in 2015. Between January and

August 2015, 6 patients became infected/colonized with CPE during

their stay in the same room in intensive care unit (ICU).


The time period between those patients was relatively small

and although the strains belonged to different species with different

antibiograms and mechanisms of resistance, the hypothesis was

that the environment could be a possible source of transmission.

Investigation suggested that the evil doer was a contaminated sink.

Besides other strains,

C. freundii

type OXA-48 was frequently isolated

from patients and sinks. To investigate the phylogenetic relationschip

between those strains, PGFE was performed. The strains isolated from

patients and the sink in the implicated room were highly related and

pointed to sink to patient transmission. Samples in the other ICU

rooms were also taken, revealing that 9 out of the 32 sinks were

contaminated with CPE. To control the outbreak, the sinks and their

plumbings were replaced by new ones with another structure, they

were flushed every morning with a glucoprotamin solution and

routines regarding sink practices were improved. In the eight months

period after replacements of the sinks, only one new patient with CPE

was detected in ICU.

Discussion and/or Conclusion(s):

In conclusion, this outbreak high-

lights that sink drains can accumulate strains with resistance genes

and become a potential source of CPE.

ID: 4820

Outbreak of respiratory syncytial virus in an adult haemato-

oncology unit

Kirsty Ferguson, Alison Edwardson, Teresa Inkster.


Infection Control


Respiratory Syncytial virus (RSV) can cause upper

respiratory tract infection and/or pneumonia in immunocompromised

adults such as bone marrow transplant patients and those with



We describe a recent outbreak of RSV on a 19

bedded adult haemato-oncology ward.

Abstracts of FIS/HIS 2016

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