

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
1
, Elizabeth Ashley
2
, Linda Woodward-Stammers
3
,
Yolanda Hedges
3
, Nupur Goel
3
, Margie Meltzer
4
, Farhana Butt
3
.
1
West
Middlesex University Hospital, Chelsea and Westminster NHS Foundation
Trust,
2
Nuffield Department of Medicine, Centre for Tropical Medicine and
Global Health,
3
West Middlesex University Hospital, Chelsea and
Westminster NHS Foundation Trust,
4
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
1
, Fiona Thorburn
2
, Barry Atkinson
2
, Emma Aarons
2
.
1
Rare and Imported Pathogens Laboratory, Public Health England,
2
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
1
, Michelle Toleman
2
, Emmeline Watkins
3
,
Francesc Coll
1
, Bernadette Nazareth
3
, Belinda Sadler
4
,
Nicholas Brown
5
, Julian Parkhill
6
, Sharon Peacock
7
.
1
University of
Cambridge,
2
University of Cambridge, Wellcome Trust Sanger Institute,
Cambridge University Hospitals NHS Foundation Trust,
3
Health Protection
Team, PHE East of England,
4
Infection Prevention & Control
Cambridgeshire & Peterborough CCG,
5
Cambridge University Hospitals
NHS Foundation Trust, Public Health England, Clinical Microbiology and
Public Health Laboratory, Cambridge,
6
Wellcome Trust Sanger Institute,
7
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
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S107