The Journal of Hospital Infection - Supplement 1

Repeat specimens were collected following an enhanced deep clean

using acticlor and hydrogen peroxide vapour.

Results:

The same genotype 811/81 was found in patients and the

healthcare environment. 9/10 stacks (air handling unit) were PJPCR

positive. 81/811 strainwas present on the intake filter serving the renal

ward and on another extract filter. In wards that had previously had

patients with PJP, 7/12 surface samples from air vents, pathology chute,

light fitting, supply air-vents were PJPCR positive. No genotyping was

possible. Air sampling was negative for PJPCR. Following the deep

clean, all samples were negative.

Discussion and/or Conclusion(s):

Further work is required to under-

stand the significance of environmental PJ and its role in the

transmission and pathogenesis of PJP.

ID: 4863

A nosocomial outbreak of rotavirus infection on a Care of the

Elderly ward

–

an under-recognised event?

Stella Barnass

, Elizabeth Ashley

, Linda Woodward-Stammers

Yolanda Hedges

, Nupur Goel

, Margie Meltzer

, Farhana Butt

West

Middlesex University Hospital, Chelsea and Westminster NHS Foundation

Trust,

Nuffield Department of Medicine, Centre for Tropical Medicine and

Global Health,

West Middlesex University Hospital, Chelsea and

Westminster NHS Foundation Trust,

North West London Health

Protection Team, Public Health England

Background:

Two patients on a Care of the Elderly Ward were

diagnosed as having rotavirus in stool samples taken on Friday 29 May

2015. The results were available on Monday 1 June. Three further

patients developed laboratory-confirmed rotavirus infection between

1 and 6 June. Of the five cases, three had diarrhoea and vomiting, one

had diarrhoea only and one had vomiting only. Typing results were

available for four patients and all had the same non-vaccine strain:

G12P8. All the infections were hospital acquired but it was not possible

to establish the source.

Results:

In all, 21 patients were assessed for gastrointestinal sym-

ptoms and thirteen had stool samples tested, of which five tested

positive. The bays containing the symptomatic patients were closed,

confirmed cases were transferred to side rooms, and remained

there until at least 8 days after the onset of symptoms or until they

had been asymptomatic for 48 hours, whichever was the later.

Enhanced infection control (EIC) measures were implemented.

All the patients recovered. The bays were deep-cleaned and re-opened,

and EIC measures were stood down on 17 June.

Discussion and/or Conclusion(s):

In the literature rotavirus is rarely

described as a cause of diarrhoea and/or vomiting in adults, and

the outbreak highlights the need to test for this pathogen. While

there is no specific treatment, identification of rotavirus enables

advice to be given on the duration of isolation, important in a

clinical setting where length of stay often exceeds the infective

period.

ID: 4868

Duration of Zika virus RNA detection in semen

Christina Petridou

, Fiona Thorburn

, Barry Atkinson

, Emma Aarons

Rare and Imported Pathogens Laboratory, Public Health England,

Rare and Imported Pathogens Laboratory, PHE

Background:

The current explosive outbreak of Zika virus (ZIKV) and

its potential for sexual transmission due to the presence of ZIKV in

semen has significant consequences for pregnant women and couples

planning a pregnancy due to the risk of adverse fetal outcomes if

women become infected during pregnancy. ZIKV RNA has been

reported in semen up to 62 days post onset of symptoms however the

duration of viral persistence in semen is unknown and transmission

has been reported in an asymptomatic couple. Detection of ZIKV

RNA in the UK is performed at Public Health England, Porton Down by

rRT-PCR.

Aim(s)/Objective(s):

To determine the duration of detectable ZIKV

RNA post onset of symptoms in semen samples received at PHE.

Method(s):

rRT-PCR was performed on all semen samples and CT

values determined. We offered a service of 2-weekly testing for

patients with detectable RNA to determine whether clearance had

occurred and looked at whether the patients had detectable RNA in

urine and blood.

Results:

The longest duration of virus in semen was 91 days, much

longer than the previously reported 62 days.

Discussion and/or Conclusion(s):

Our results suggest the duration of

persistence of ZIKV in semen is variable but may be protracted in some

individuals, indicating the potential for prolonged sexual trans-

mission. Our findings are useful for establishing the likelihood of

sexual transmission, informing family planning and national guide-

lines which currently recommend that asymptomatic males return-

ing from countries with ongoing ZIKV transmission should only

use barrier protection for 8 weeks to reduce the risk of sexual

transmission.

ID: 4899

Failure of routine practice to detect a community MRSA cluster of

EMRSA15: description of a public health investigation

Tom Williams

, Michelle Toleman

, Emmeline Watkins

Francesc Coll

, Bernadette Nazareth

, Belinda Sadler

Nicholas Brown

, Julian Parkhill

, Sharon Peacock

University of

Cambridge,

University of Cambridge, Wellcome Trust Sanger Institute,

Cambridge University Hospitals NHS Foundation Trust,

Health Protection

Team, PHE East of England,

Infection Prevention & Control

Cambridgeshire & Peterborough CCG,

Cambridge University Hospitals

NHS Foundation Trust, Public Health England, Clinical Microbiology and

Public Health Laboratory, Cambridge,

Wellcome Trust Sanger Institute,

University of Cambridge, Wellcome Trust Sanger Institute, Cambridge

University Hospitals NHS Foundation Trust, London School of Hygiene and

Tropical Medicine

Background:

Here we report a public health investigation of a cluster

of genomically related isolates of epidemic methicllin resistant

Staphylococcus aureus-

15 (EMRSA-15), the dominant lineage in UK

hospitals and long-term care facilities. These isolates were identified

through whole-genome sequencing (WGS) in patients residing in the

same geographical area and registered to the same general practice.

This cluster had not been detected by routine practice, including Post

Infection Review (PIR).

Aim(s)/Objective(s):

We aimed to identify related cases, epidemio-

logical links between patients and the potential for ongoing

transmission.

Method(s):

Closely related MRSA isolates were identified using WGS

from a 12-month prospective observational study that was conducted

between 2012 and 2013 at a regional microbiological laboratory, and

additional case-finding. Public health investigation consisted of a

retrospective analysis of healthcare data to identify potential epi-

demiological links and prospective on-site observation and sampling

to determine the potential for ongoing transmission.

Results:

The cluster comprised 27 isolates from15 cases, including two

bacteraemias. The cluster lacked a clear epidemiological link to a single

hospital, suggesting community transmission. On-site observation

identified several areas where practice could be improved, but samples

from staff and environmental sites were negative for MRSA.

Discussion and/or Conclusion(s):

The dependence on WGS for

identification of this community cluster of EMRSA-15, despite the

presence of two fatal bacteraemias, suggests a potentially beneficial

role for targeted WGS in routine practice. As highlighted by this study,

community spread of MRSA is an increasingly recognised transmission

pathway, but hospital-centric infection control procedures do not

reflect this.

Abstracts of FIS/HIS 2016

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

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S134

S107