The Journal of Hospital Infection - Supplement 1

prescriptions within 30 days from the date of delivery. In order to

evaluate the consumption of antibiotics, daily defined dose (DDD) per

100 deliveries was used.

Results:

In the analyzed period, 68,088 deliveries were recorded in

the Ma

opolska province, out of which 56.5% were vaginal and 43.5%

by cesarean section. The average length of hospital stay was 4.1 days.

In this group, 7.4% of women purchased antibiotics as part of the

outpatient obstetric care. The average consumption of antibiotics in

studied population was 108.3 DDD. Increased consumption of

antibiotics was observed in case of C-sections, among the youngest

patiens and the patients from the countryside.

Discussion and/or Conclusion(s):

According to official data in years

2013

–

2014, fewer than one patient per 100 births by C-sections

developed a surgical site infection. According to the Polish PPS data,

rate of all forms of infections among obstetric patients was 1.2%.

These ratios are much lower than the literature data for this

patient population (5

–

7%). Presented results of antibiotic consumption

show that surveillance of infections in this population poses a

challenge for infection control teams and staff looking after the

patients in Poland.

ID: 4839

A retrospective analysis of contact screening for pulmonary and

non-pulmonary tuberculosis cases in Lothian, Scotland

Millicent Goodwin

, Eleanor Strong

, Ceri McSparron

Susan Vaughan

, Janet Stevenson

, Adam T Hill

, Ian F Laurenson

University of Edinburgh,

Lothian TB service, Royal Infirmary of

Edinburgh

Background:

The NICE tuberculosis clinical guideline (NG33) update

in January 2016 amended guidance to only offering screening to

contacts of patients with pulmonary or laryngeal TB. The revision was

“

limit testing to contacts of people with potentially infectious TB

”

suggesting that non-pulmonary TB (NPTB) infection did not pose such

a risk.

Aim(s)/Objective(s):

To assess the possible impact of the changed

guidance.

Method(s):

Outcomes of contact screening pulmonary (PTB) and

NPTB cases within Lothian prior to the guideline amendment were

assessed by reviewing records of patients with PTB or NPTB and their

contacts over an 8 year period (2008

–

2015 inclusive) within Lothian,

Scotland. All contacts were screened for latent and active infection

using a combination of IGRA testing, chest Xrays, and tuberculin skin

testing.

Results:

1502 contacts of PTB cases and 519 contacts of NPTB cases

were successfully screened. 142 (9.45%) contacts of PTB cases had

latent TB infection, whilst 27 (1.80%) had active TB infection. In

contrast, 67 (12.91%) of NPTB contacts had latent TB infection, and 13

(2.50%) were considered to have active TB. Latent TB was identified

more frequently in NPTB contacts (p = 0.03) but no difference in active

TB cases (p = 0.3).

Discussion and/or Conclusion(s):

These results demonstrate that

NPTB in addition to PTB is an excellent target for screening as

significant case finding of both latent and active TB cases are identified.

This study provides clear evidence that not screening contacts of NPTB

cases will hinder Scotland achieving the WHO target of elimination of

TB by 2050.

ID: 4841

Nosocomial bloodstream infections following surgery in a Finnish

tertiary care hospital, 2009

–

2014

Kirsi Skogberg

, Keiju Kontula

, Asko Järvinen

, Outi Lyytikäinen

Helsinki University Central Hospital,

National Institute for Health and

Welfare

Background:

Surgical patients are one of the most common patient

groups acquiring nosocomial bloodstream infections (BSI). Since the

risk of BSI is related to length of hospital stay, BSI rates are usually

reported by patient-days. However, the risk likely varies by patient

characteristics and operation types.

Aim(s)/Objective(s):

We evaluated the risk and outcome of BSIs

following surgery by different operation types.

Method(s):

Data on BSI cases was collected in Helsinki University

Hospital (1922 beds) during 2009

–

2014 as a part of the national

hospital-wide surveillance for nosocomial BSIs and the number of

operations was obtained from the hospital database. Unit of pediatric

surgery was excluded.

Results:

A total of 711 BSIs (29% of all nosocomial BSIs) following

427518 operations were identified; 244 (34%) were related to intensive

care. The rate was highest in cardiovascular (8.7/1000 operations) and

urogenital (3.6/1000) surgery and lowest in gynecology (1.0/1000)

and orthopedics (1.2/1000). Of the BSIs, 347 (49%) were primary and

364 (51%) secondary. Surgical site infection was the most common

source of secondary BSIs. The most common pathogens in primary BSIs

were coagulase negative staphylococci (16%) and Staphylococcus

aureus (14%) and in secondary BSIs S. aureus (26%) and Escherichia

coli (20%). 28-day case fatality ranged from 0% in gynecology/

obstetrics to 21% in cardiovascular surgery.

Discussion and/or Conclusion(s):

Risk and outcome of BSI varied

considerably by operation type, most likely partly related to patients

’

underlying illnesses. Besides surgical site infections, remarkable

proportion of BSIs was associated to central lines, providing an

additional focus for preventive efforts.

ID: 4842

Efficacy of an infection control program to reduce the circulation

of carbapenem-resistant Klebsiella pn. in intensive care units at a

large Italian hospital

Cristiano Alicino

, Cecilia Trucchi

, Daniele Roberto Giacobbe

Federico Grammatico

, Angela Battistini

, Barbara Guglielmi

Filippo Ansaldi

, Angelo Gratarola

, Paolo Pelosi

, Claudio Viscoli

Andrea Orsi

Department of Health Sciences, University of Genoa,

Infectious Diseases Unit, I.R.C.C.S. University Hospital San Martino

–

IST National Institute for Cancer Research, Genoa, Italy;

Hygiene Unit,

I.R.C.C.S. University Hospital San Martino

–

IST National Institute for

Cancer Research, Genoa, Italy;

Intensive Care Unit, I.R.C.C.S. University

Hospital San Martino - IST National Institute for Cancer Research,

Genoa, Italy

Background:

In recent years, carbapenem-resistant

Klebsiella pneu-

moniae

(CR-Kp) has become endemic in Italy and effective strategies

are needed to reduce its burden in the hospital setting, particularly in

high risk wards.

Aim(s)/Objective(s):

To assess the effect of intensified infection con-

trol measures, including active surveillance of gastrointestinal colo-

nized patients, on reducing the circulation of CR-Kp and the incidence

of the CR-Kp bloodstream infection in the intensive care units (ICUs),

equipped with nearly 40 beds, of the tertiary 1,300 acute-care beds

regional referral center university hospital, I.R.C.C.S. AOU San Martino-

IST of Genoa, Liguria region, north-west Italy.

Method(s):

The intervention effect was analyzed with interrupted

time series regression analysis. The study included a pre-intervention

period (January 2009

–

December 2011) and an intervention period

(January 2013

–

December 2015). During 2012, intensified control

measures, particularly routine rectal screening, were implemented

and reached high level of adherence. Monthly incidence of first

positive culture result for CR-Kp, either including or excluding rectal

swab, and CR-Kp BSI were compared.

Results:

Preliminary results demonstrated that the incidence of first

positive culture results for CR-Kp, including rectal swab, significantly

decreased in the intervention period compared with pre-intervention

period (slope:

−

0.15; p-value: <0.05). A similar result was obtained

also excluding rectal swab (slope:

−

0.17; p-value: 0.005). A decreasing

trend, even though not statistically significant, was observed for the

incidence of CR-Kp BSI (slope:

−

0.08; p-value: 0.11).

Abstracts of FIS/HIS 2016

–

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

–

S134

S121