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Cox models for mortality risk and multistate models for extra length of



Among the 6069 inpatient stays, 771 (12.7%) presented at

least one NI. The proportion of in-hospital death was 1.6 times higher

among patients with NI. However, the adjusted hazard ratio was not

significant (HR = 1.13, CI95% 0.99

1.29). The crude excess length of stay

was 39 days and, albeit lower, it remained significant with multistate

analysis (13 days, CI95% 9

17). These analyses were performed for each

kind of NI.

Discussion and/or Conclusion(s):

Our results are in favour of a

significant effect of the ICU-acquired NI on length of stay without any

significant effect on mortality.

ID: 4741

Epidemiology of healthcare associated infections (HAIs) in the

neonatal intensive care unit (NICU)

Miguel Rosales.

Complejo Hospitalario Universitario de Granada


Newborns to preterm, have the highest infection rates

of all pediatric patients, it was found that the introduction of a

monitoring system of the lead HAIs to a decrease in these rates.


To know the incidence of HAIs appeared in our

unit during 2015.


We performed a prospective observational epidemio-

logical study. All patients who remained in the NICU more than 24

hours were included.

The classification criteria of HAI were the NEO- KISS.

Incidence rates and cumulative incidence of various infections, as well

as their confidence intervals were calculated.


118 patients, 65 men and 53 women were studied, and 38% of

patients had a weight less than 1500 grams.

The incidence density overall was 11.7 per thousand stays, and

accumulated incidence in 17.8% patients, bacteremia associated

central venous catheter 9.3 per thousand catheter days, I am not

going no pneumonias associated with mechanical ventilation. Preterm

infants less than 1000 grams had the highest infection rate 24.5%.

The most frequent germ were Escherichia coli.

Discussion and/or Conclusion(s):

The most frequent bacteremia

infection has been associated with central venous catheter 8.2 per

thousand catheters day.

The OR of having a HAIs according to weight at birth is 13 for those

under 1000 grams compared to children of 2,500 grams or more.

In relation to infection and sex, we found that men have a slightly

higher risk of infection women, 27.1% versus 17%.

ID: 4751

An economic evaluation of additional costs due to



infection in an Irish Hospital

Fidelma Fitzpatrick


, Padhraig Ryan


, Mairead Skally



Fionnuala Duffy


, Mary Farrelly


, Leah Gaughan


, Pauline Flood



Elaine Mc Fadden




Beaumont Hospital and Royal College of Surgeons in



Centre for Health Policy and Management, Trinity College

Dublin, Ireland;


Beaumont Hospital, Dublin, Ireland


Irish Public hospitals receive annual block funding based

on historical spending and activity patterns, without explicit adjust-

ment for the rate of hospital acquired infection.


We aimed to ascertain additional financial cost

per routine case of

Clostridium difficile

infection (CDI) and the cost of a

CDI outbreak in our hospital.


A micro-costing approach was used to estimate the addi-

tional cost of CDI per patient identified during August 2015 and for a

CDI outbreak managed that month. Resource use was quantified based

on review of patient charts, pharmacy prescribing data, prospective

collection of administrative resource input, and records of cleaning



The additional cost of routine (non-outbreak) CDI in 13

inpatients in August was

75,680 (mean

5,820/patient) with clean-

ing, pharmaceuticals, and additional length of stay (LOS) being key

cost drivers. Additional LOS ranged from 1.75 days to 22.55 days.

Seven patients were involved in a CDI outbreak. Bed closures (58 lost

bed days, estimated value

34,585), five outbreak control meetings

(mean staff cost/meeting

546, aggregate cost

2,728), and additional

outbreak-related cleaning (costing

9,654) represented the additional

CDI outbreak-associated costs. Excluding the value of lost bed days,

outbreak costs were

12,382. Therefore total spending on CDI during

August was

88,062 (a mean of

6,773 across all patients).

Discussion and/or Conclusion(s):

Investment in disease prevention

may be offset by cost savings. This analysis suggests that investment


C. difficile

prevention could offer a net financial benefit in some

circumstances, as well as improving value for money and clinical


ID: 4752

Utilising VNTR typing to identify a dominant EMRSA-15 clone in

Birmingham (UK)

Calum Thomson


, Katie Hardy


, Peter Hawkey




University of



Public Health Laboratory Birmingham (Public Health



EMRSA-15 (ST 22) is the dominant MRSA clone in the

United Kingdom (UK), and understanding the epidemiology is key to



We have utilized whole genome sequencing

(WGS) and variable number tandem repeat typing (VNTR) to esta-

blish the epidemiology and evolution of EMRSA-15 in a large UK

conurbation over time.


171 EMRSA-15 isolates sampled between 1985 and

2015 across Birmingham were whole genome sequenced and VNTR

typed. WGS data was mapped to the reference strain HO50960412

and single nucleotide polymorphisms (SNP) from the core

genome were used to generate a phylogenetic tree using Bayesian


VNTR datawas generated by PCR amplification of 7 tandem repeat loci.


5082 SNP-sites were used to construct a phylogenetic tree

revealing a distinct clade of 91 (52%) isolates (BHM clade) that

diverged from the rest of the Birmingham population in 1995. The

remaining 80 isolates were more diverse with a wider range of

divergence dates (1986 to 2015). Variation in repeat number was only

observed at loci L13, L16 and L21, with L21 and L16 showing the

highest variability. Mapping of VNTR data onto the tips of the tree

revealed that all isolates with two tandem repeats at L13 (n = 91)

mapped to the BHM clade while isolates with 3, 4 or 5 tandem repeats

were dispersed throughout the rest of the tree.

Discussion and/or Conclusion(s):

WGS provides a high degree of

discrimination amongst the Birmingham isolates, highlighting the

presence of a highly related clade, which is identifyable by a specific

repeat number at one loci with VNTR.

ID: 4762

Community management of

Escherichia coli

bacteraemia cases

diagnosed in Wye Valley NHS Trust September 2013



Alison Johnson


, Emma Sneed




Wye Valley NHS Trust,


Worcestershire CCG


A review of

Escherichia coli

bacteraemia cases diagnosed

in Wye Valley NHS Trust between September 2013 and September

2014 was undertaken to determine whether there may be any

opportunities in the community to prevent admission.


A questionnaire was submitted to GPs of all cases.


90 cases were reviewed; 59 (65%) were female; average age 72

with range 0

97 and mode 88; 39 (43%) were

80 years old; 13 (14%)

were care home residents; the commonest source of the bacteraemia

was urinary

54 (60%); 77 had dehydration status recorded on

admission; 13 (20%) of the patients admitted from home were

recorded as dehydrated compared with 5 (38%) of the patients

Abstracts of FIS/HIS 2016

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