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Antimicrobial use and incidence of MDRO in bloodstream

infections are mandatorily reported by intensive care units to Sao

Paulo State Health Department. Antibiotics were grouped by class and

expressed in defined daily doses (DDD) per 1000 patient-days(pd),

from 2009 to 2013. MDRO were grouped into resistant to 3rd

generation cephalosporins, carbapenems and oxacillin and compared

to carbapenems, polymyxins and glycopeptides use. Hospitals were

grouped in private, philanthropic and public. Public hospitals were

divided into social organization (SO) or not, the former is privately

managed with public funding. Correlation between MDRO incidence

and antibiotic use was investigated for 2012 and 2013.


Between 2009 and 2013, mean number of reporting hospitals

was 198. 35% of reporting hospitals were public and 33% of these

were SO. Cephalosporins were the most prescribed drugs, although

there was a decreasing trend in the period. Polymyxins had the

greatest increase in use (125%), mostly in public hospitals. Among

public hospitals, comparing SO and public administration there was a

difference in antimicrobial use for glycopeptides, carbapenems and

polymyxins (p = 0.04, 0.008 and 0.001). There was no difference in

MDRO incidence.

Discussion and/or Conclusion(s):

In conclusion, we observed a

significant increase in polymyxin use. In the public level, we observed

a discrepancy between the incidence of MDRO and broad-spectrum

antibiotics use in different administrative regimens. These data should

guide public health policies.

ID: 4671

Long-term validity of preventive measures against needlestick

injuries in the operating theatre

Shigeru Koyama, Yuko Momoi.

Tokyo Metropolitan Hiroo Hospital


Due to the high reporting rate of needlestick injuries in

the operating theatre, we implemented new preventive measures in

2006. These preventivemeasures were previously found to be effective

in a 4-year research project (J Hosp Infect. 2010 Oct (76): S64).


To estimate the long-term validity of our pre-

ventive measures against needlestick injury in the operating theatre.


We examined reports of needlestick injury between 2001

and 2015, and compared the 5 years before the implementation of the

preventive measures (Period I: 2001

2005) with the subsequent 10

years (Period II: 2006

2015) to evaluate the validity of these measures

in the operating theatre.


A total of 439 reports were made between 2001 and 2015,

including 114 reports from the operating theatre. The reporting rate

fell significantly from 32% (52/164) in Period I to 23% (62/275;

p = 0.0036) in Period II. Analysing the contents, rates at intraoperative

management and delivery of instruments were significantly reduced

from 17% to 12% (p = 0.015) and from 7% to 3% (p = 0.015), respectively.

Conversely, the rate at equipment disposal showed no change (4%). The

rate of hepatitis C virus-positive injuries showed no significant change

(Period I, 15%; Period II, 16%), suggesting that the submission rate of

reports was largely static. Results after implementation were also

similar, comparing the first 5 years with the subsequent 5 years.

Discussion and/or Conclusion(s):

Our preventive measures against

needlestick injuries in the operating theatrewere confirmed as valid in

this long-term research. Further measures are needed to prevent

injuries during equipment disposal.

ID: 4679

Does observational hand hygiene auditing reduce the incidence of

bacteraemia? A retrospective time series analysis with control


Maura Smiddy


, Anthony P Fitzgerald


, Olive M Murphy



Eileen Savage


, John Browne




Department of Epidemiology and Public

Health,University College Cork,


Department of Statistics / Department of

Epidemiology and Public Health, University College Cork,


Bon Secours

Hospital, Cork,


Catherine McCauley School of Nursing and Midwifery,

University College Cork,


Department of Epidemiology and Public Health,

University College Cork.


Observational hand hygiene auditing (OHHA) involves a

trained observer monitoring healthcare worker compliance with five

identified moments for hand hygiene. The effectiveness of OHHA is

uncertain despite widespread adoption.


To examine the effect of OHHA on the incidence

of methicillin resistant

Staphylococcus aureus

(MRSA) and vancomycin

resistant enterococci (VRE) bacteraemia.


We conducted a retrospective time series in four acute

hospitals in the Republic of Ireland over the period 2009 to 2014. The

OHHA intervention was introduced to three sites in 2011; the fourth

site acted as a control and did not introduce OHHA. We compared the

change in the incidence of methicillin resistant

Staphylococcus aureus

(MRSA) bacteraemia, vancomycin resistant enterococci (VRE) bacter-

aemia and alcohol based hand gel (ABHR) consumption, in interven-

tion versus control sites.


There was a significant reduction in MRSA bacteraemia in the

control (p < 0.01) but not the intervention (p = 0.77) sites over the

study period. When the difference of the differences was compared

there was no statistically significant difference (p = 0.09) between

intervention and control sites. There was no significant reduction in

VRE bacteraemia in the control (p = 0.18) or intervention (p = 0.42)

sites. There was a significant increase in ABHR consumption in the

intervention (p = <0.01) sites and a decrease in ABHR consumption in

the control (p = 0.05) site. When the difference of the differences was

compared this was not statistically significant (p = <0.07) in either the

intervention or control sites.

Discussion and/or Conclusion(s):

The implementation of OHHA does

not appear to be associated with a reduction in bacteraemia or with an

increase in ABHR consumption.

ID: 4689

SABs, What

s Your Source, What

s Your Solution

Alan Milne


, Carolyn Sinclair


, Fiona Smith


, Benjamin Parcell



Karen Wares




NHS Grampian,


NHG Grampian



Staphylococcus aureus


Surveillance (eSABS) to standardise the reporting of SAB infections

were introduced nationally in 2014. The Infection Prevention and

Control Team (IPCT) formed a group to facilitate the appropriate data

collection. Focusing on risk and contributory factors the group aimed

to determine if SABs were avoidable or not. All cases were reviewed to

ensure they were managed in line with guidance on management of

proven or suspected


in adults


This initiative aimed to better understand

the cause of the SAB, determine the potential avoidance, to intervene

to minimize the risk of a SAB occurring due to the same cause



Using the Plan Do Study Act cycle and the national eSAB

tool, a surveillance form was created for the IPCT to investigate the

SAB. Identifying the entry point, source and record procedures/

interventions in the last 30 days. Assessments were made regarding

medical history, device placement, and whether the patient had

any prosthetics. For quality improvement the group reviewed the

implementation and completion of bundles such as Peripheral, Central

Vascular and Urinary Catheter.

Discussion and/or Conclusion(s):

The IPCT along with the multidis-

ciplinary team discuss the results of the surveillance and identify

quality improvement. Audits ar carried out if the SAB is found to be

related to a device. IPCT engage with clinical teams to assist with the

implementation of bundles and support auditing. Clinicians in

charge received a letter detailing the outcome of SAB surveillance,

offering the chance to respond to the information. The Microbiologists

offer to attend educational meetings for further discussions.

Abstracts of FIS/HIS 2016

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