135 / 150
schedule. The Meningococcal Antigen Typing System (MATS) estab-
lished coverage estimates for Bexsero
®
of 73% in England and Wales,
assessing phenotypic and functional properties of circulating menin-
gococci from 2007
–
08. The increasing availability of whole genome
sequencing (WGS) allows rapid, scalable and real-time genomic
analysis.
Aim(s)/Objective(s):
To estimate Bexsero
®
coverage of UK isolates
using genomic and genotype-phenotype modelling approaches.
Method(s):
All culture-confirmed IMD isolates (n = 2016) from
2010
–
11 to 2013
–
14 from UK (Meningitis Research Foundation
Meningococcus Genome Library) and Republic of Ireland were
included. WGS were hosted on PubMLST database
(http:/ /pubmlst. org/neisseria/). The Bexsero
®
Antigen Sequence Type (BAST) scheme
identified antigenic variants (fHbp, NadA, NHBA and PorA). Projection
Pursuit Regression modelling predicted phenotype (MATS outcome)
from genotype (sequence type) calibrated on 508 serogroup B isolates
from 2007
–
08.
Results:
Exact genotypic matches to vaccine BAST-1 (
≥
1 matching
antigen) reduced over time, from 179/582 (30.8%) in 2010
–
11 with to
100/439 (22.8%) in 2013
–
14. Considering cross-reactive antigens,
coverage ranged from 58.3
–
60.3%. Using genotype-phenotype mod-
elling, MATS outcome was predicted for 887/1393 (63.7%) serogroup B
isolates, mean coverage estimate across four years was 66.1% (95% CI
61.5
–
70.7%).
Discussion and/or Conclusion(s):
The variation in genotypic analysis
of vaccine antigens and that described by MATS, may be due to secular
changes in the bacterial population or different experimental
approach. WGS allows detailed analysis of vaccine antigens, but does
not take into account cross-reactivity or protein expression. We further
demonstrate an example of combining a stable genomic BAST
nomenclature with phenotypic data.
ID: 5127
Financial analysis of carbapenemase producing
Enterobacteriaceae acquisitions post infection control cohort ward
introduction in an Irish tertiary hospital
Nuala O
’
Connell
1
, Patricia Treacy
2
, Eimear O
’
Donovan
2
,
Alan O
’
Gorman
3
, Marion Commane
2
, Lorraine Power
2
,
Maureen O
’
Hara
4
, Siobhan Barrett
3
, James Powell
5
, Ruth Martin
3
,
Barbara Slevin
6
.
1
UL Hospital Group Limerick,
2
Ul Hospitals Group,
3
UL
Hospitals Group,
4
Ul Hospitals group,
5
Ul Hospitals Limerick,
6
UL
Hospitals Limerick
Background:
The emergence and spread of carbapenemase producing
Enterobacteriaceae (CPE) is a clinical and public health concern both
nationally and internationally. In this hospital, the first documented
case of CPE was described in 2009 and since then the number of new
cases has risen exponentially year on year since 2013 accounting for
53% of the total national burden in 2015.
Aim(s)/Objective(s):
The aim of a quality improvement project
(QI) was to reduce newly identified CPE cases from 27 (the total for
the first 6 months in 2015) to 13 for the first 6 months 2016. It was
opportune to review all aspects of the management of CPE from a QI
perspective including financial costs and the impact of an infection
cohort ward.
Method(s):
A series of PDSA cycles were undertaken, as a consequence
of baseline audits, to enhance compliance with CPE infection
prevention and control processes around screening and diagnostics,
hand hygiene, care bundles for devices and contact precautions. The
daily cost of each of the patients in the project group and an average
cost per night identified for each bed night attributable to the CPE care
element of the patient stay was calculated.
Results:
Sixteen newCPE cases were identified for the first 6months of
2016 with a cost saving of
€
682,086 for this time frame.
Discussion and/or Conclusion(s):
The impact of the QI measures
utilised have evidenced a safer, more efficient and higher quality of
care provided to the patient population on the cohort ward.
ID: 5145
Disappearing dysgalacticae? Group C&G streptococcus
epidemiology in North West London
William Nevin
1
, Luke Moore
2
, Shiranee Sriskandan
3
, Lionel Tan
3
.
1
Chelsea and Westminster Hospital NHS Foundation Trust,
2
Imperial
College Healthcare NHS Trust,
3
Imperial College London
Background:
Group C and G streptococci (GCS, GGS) are associated
with pharyngitis and skin/soft tissue infections, and bear genetic
similarities to Group A Streptococcus (GAS). Increased incidence of
invasive GAS in the UK suggests analysis of the epidemiology of GCS/
GGS is warranted.
Aim(s)/Objective(s):
To identify epidemiological trends in GCS/GGS
isolates among beta haemolytic streptococci (BHS) in community and
inpatient settings across a population of 2.5 million in North West
London, over six years.
Method(s):
All BHS isolates were retrospectively identified from
clinical samples submitted to a centralised laboratory serving the
study population from March 2009-February 2015.
Results:
Community: 9069 BHS isolates were identified. There was a
negative temporal correlation in the proportion of GCS/GGS among
BHS from 27% in 2009 to 12% in February 2015 (rs
−
0.66, p < 0.001),
concomitant with a fall in GAS from 38% to 22% (rs
−
0.44, p < 0.001).
Hospital: 2670 BHS isolates were identified. For GCS/GGS as a
proportion of BHS there was again a negative temporal correlation
from 18% in 2012 to 12% in 2015 (rs
−
0.52, p = 0.002), yet GAS rose from
10% to 19% (rs + 0.40,p = 0.02).
Discussion and/or Conclusion(s):
Among BHS, GCS/GGS from
community and hospital samples fell between 2009 and 2015. A less
significant fall was seen in GAS in the community, yet GAS in a hospital
setting increased. This is in keeping with increased invasive GAS
incidence under investigation by Public Health England. The con-
comitant fall in GCS/GGS warrants further investigation of transmis-
sion patterns, including network analysis and molecular virulence and
fitness.
ID: 5150
Impact of an online web module with real time feedback on data
entryand compliance to hand hygiene, the case of the Belgian hand
hygiene campaigns
Sylvanus Fonguh
1
, Boudewijn Catry
1
, Anne Simon
2
.
1
Scientific Institute
Of Public Health Belgium,
2
Université Catholique Louvain (UCL)
Background:
Nation-wide campaigns to promote hand hygiene in
Belgian hospitals have been ongoing since 2005. The campaigns
combined educational sessions for healthcare workers, promotion of
alcohol-based hand rubs and patient awareness. Hand hygiene
compliance of healthcare workers was measured by direct observation
and data transferred by email to the Scientific Institute of Public Health
(WIV-ISP), between 2005 and 2011. A new web tool compatible with
wireless tablets was developed in 2013 for both direct data entry and
real time feedback to hospitals.
Aim(s)/Objective(s):
The objective of the web tool was to provide
hospitals with a user friendly password protected system for easy/
direct data entry and real time performance feedback.
Method(s):
Using SharePoint technology, an observation roster
standardised according to World Health Organisation specifications
was designed and built for data entry. The data entered are stored
directly into tables in an SQL database. Data integrity and validity
are automatically done upon entry. SAS Enterprise Guide is then used
to analyse data using SAS stored processes and results are then
reported back to hospitals depending on the selection made from the
prompts.
Results:
The number of opportunities (compliance rates) before
intervention increased from 73,663 (49.6%) during the first campaign
to 123,204 (64.1%) during the fifth campaign when the tool was
introduced.
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S130