Of the 41 staff members, 24 (58%) had been vaccinated before
the outbreak. 10 staff members were found to be high risk: of these,
2 were not vaccinated while 9 were.
Discussion and/or Conclusion(s):
As anticipated, vaccinated patients
had a lower rate of Influenza infection.
The low rate of vaccinated staff members suggests that staff working
with the elderly should be encouraged to undergo vaccination to
reduce risk of outbreak transmission.
Norway losing its antimicrobial innocence?
Kristin Stenhaug Kilhus
, Dorthea Oma
Department of Research and
Development, Division of Patient safety and Infection Control, Haukeland
Department of Research and Development, Division
of Patient Safety and Infection Control, Haukeland University Hospital
Norway is considered a country of prudent use of
antibiotics and few problems with multidrug resistant bacteria. We
describe the first hospital outbreak of vancomycin-resistant entero-
cocci (VRE) in Norway and the control measures implemented to
Main interventions were:
Establishing a local VRE control committee
Multidisciplinary communication and leadership
Systematic surveillance screening and contact tracing
Cohorting and contact isolation
VRE labelling of patient journals
Optimizing laboratory diagnostics
Reinforcing environmental cleaning and disinfection
Adherence to standard precautions
From June 2010 to June 2016 499 cases with vancomycin-
genotype were identified.
More than 90% (461/499) were asymptomatic carriers identified
through screening or contact tracing. 11 blood culture isolates were
identified. 21 different wards had at least one patient with VRE.
Pulsed-field gel electrophoresis (PFGE) and Multi-locus sequence
typing (MLST) indicated a single-strain outbreak.
Containing the outbreak was costly and tedious. We
believe this was mainly due to the lack of guidelines, standardized
laboratory methodology and organizational culture. Despite increas-
ing rates of colonization in our hospital, there have been few adverse
outcomes related to VRE. What actually defines a cost-effective
infection control intervention? Antibiotic resistance knows no
geographic borders and VRE is said to be
a canary in the mine
Should VRE actually be one of our main concerns in the future?
VRE has not been eradicated form our hospital. We must
remain vigilant to prevent another large outbreak but getting back to
baseline may be illusive.
outbreaks in Belgian maternity wards
, Béatrice Jans
, Barbara Legiest
, Caroline Broucke
, Wouter Dhaeze
, Sofie Theunis
, Isabelle Bendels
, Sylvanus Fonguh
, Boudewijn Catry
Institute of Public Health (WIV-ISP),
The Scientific Institute of Public
Health (WIV-ISP), Outbreak Support Team,
Agency for Care and Health,
Prevention Division, Infectious Disease Control and Vaccination, Outbreak
Belgian National Reference Centre for Staphylococcus
In recent years, Community-Associated Methicillin-
(CA-MRSA) prevalence increased in
Belgium. Since 2014, at least 3 Belgian hospitals reported outbreaks
involving PVL + CA-MRSA in maternity wards.
Our aim is to describe the three CA-MRSA
Healthcare facilities with outbreaks involving multi-drug
resistant organisms (MDRO) can ask for support from the national
Outbreak Support Team (OST).
Outbreak1: September 2014-April 2015 (strain USA300,
t008): 14 infected and 5 colonized persons among 10 families,
several relapses observed. The index case had a history of non-
investigated relapsing skin infections. The outbreak was reported 5
months after onset.
Outbreak2: September-December 2015 (strain USA300, t008): 3
families involved with 4 infected and 4 colonized cases. A HCW with
a known CA-MRSA history started working in theward few days before
the index case was identified.
Outbreak3: January-April 2016 (strain USA400, t1931): 6 families
involved with 6 infections (mostly breast abscesses) and 6 coloniza-
tions (4 patients, 2 HCW). The index case was a patient with non
investigated relapsing skin infections who probably contaminated
HCW1, who further contaminated HCW2. The outbreak spread among
mothers and babies.
All outbreaks were successfully managed through close collaboration
between OST, Medical direction, infection control teams, maternity
Discussion and/or Conclusion(s):
Controlling the spread of CA-MRSA
requires carefully elaborated strategies. Although mothers are mostly
in good health, compliance to hand hygiene recommendations
remains essential in maternity wards. Early declaration of outbreaks
is important. Screening mothers with skin disease history before
delivery could be a protective measure.
Healthcare associated infection incident epidemiology in
Catherine Dalziel, Lisa Ritchie.
Health Protection Scotland
In NHSScotland infection incidents (outbreaks) are
reported to Health Protection Scotland (HPS) using the Healthcare
Associated Infection Incident Assessment Tool (HIIAT) which assesses
infection incidents as red, amber or green based on risk. Recently, HPS
performed a descriptive epidemiological analysis of reported infection
incidents between 01/04/2015 and 31/03/2016.
As well as describing the organisms, infection categories
and care settings involved in infection incidents during this time
period the report also highlighted potential reporting biases. The
report found lower levels of reporting of CDI and S
than expected given that there has been no significant change
in infection incidence for these pathogens according to national
surveillance; there was also considerable variation in reporting (no.
of reports) between boards. Previously, NHS Boards were required to
report all incidents assessed as amber or red to HPS, reporting of
HIIAT green incidents to HPS was voluntary; if a bias exists it is
possibly due to variation in application of the HIIAT resulting in
Discussion and/or Conclusion(s):
In April 2016 reporting of all non-
norovirus HIIAT green incidents was made mandatory in NHSScotland.
It is anticipated that this mandatory reporting will reduce potential
reporting biases and enable HPS to provide a more accurate picture of
infection incident epidemiology in NHSScotland. This study provides a
baseline against which to measure the impact of non-norovirus HIIAT
green reporting and may also provide an opportunity to improve
consistency of healthcare associated infection incident assessment in
An outbreak of
bacteraemia in a Scottish
, Huma Changez
, Kate Hamilton
, Elizabeth Dickson
, Gillian Mills
, Jennifer Slorach
University Hospital, Glasgow,
Abstracts of FIS/HIS 2016
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24