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in the blood and positive in the CSF indicating a likelihood of active


Discussion and/or Conclusion(s):

Identification of the aetiology

of encephalitis is crucial to the management of the condition

and this study provides evidence that suggests the inclusion of HHV-

6 in routine diagnostic screening of CSF may be beneficial in


ID: 4791

Use of genome sequencing to identify hepatitis C virus

transmission in a renal healthcare setting

Mark Garvey, Kerry Holden, Craig Bradley, Erasmus Smit, Peter Hewins,

Pauline Jumaa.

University Hospitals Birmingham NHS Foundation Trust


Hepatitis C virus (HCV) is a significant human pathogen

affecting nearly 3% of the world

s population and is a leading cause of

chronic liver disease including cirrhosis and hepatocellular carcinoma.

There are several risk factors for haemodialysis patients acquiring HCV

infection including: lifestyle risk factors; treatment-related infections;

haemodialysis procedures; noncompliance by health care workers

with standard infection control precautions.


We describe the investigation and management

of a case of transmission of HCV in a Renal unit.


NS5B sequencing identified a healthcare associated HCV

transmission and was used to guide our investigations. An outbreak

team was convened and infection control audits were undertaken on

the affected areas.


Based on infection control inspections we identified multiple

routes of potential transmission from poor hand hygiene, inappropri-

ate PPE usage, environmental cleanliness issues and issues around

phlebotomy practice using reusable Asceptic Non Touch Technique

(ANTT) trays. We found multiply phlebotomy procedures reusing

ANTT trays which were often inadequately cleaned in some instances

being soiled with blood. Disposable ANTT trays are now used for

separate phlebotomy procedures. Despite the fact that the exact route

or routes of infection were not identified, inappropriate hygiene

standards in parenteral treatment leading to viral hepatitis transmis-

sion was the likely source of transmission.

Discussion and/or Conclusion(s):

The report highlights that trans-

mission of healthcare-associated HCV infection continues to occur. The

results suggest that use of NS5B sequencing can reduce ambiguity

about potential transmission events in healthcare and inform infection

prevention control about the routes of transmission.

ID: 4812

Post-exposure prophylaxis of seasonal influenza in hospitalized


Ons El Hayet Ben Ismail, Jennifer Hart, Tehmina Bharucha,

Beatrice Cockbain, Neal Marshall, Paul Griffiths, Tanzina Haque,

Dianne Irish, Tabitha Mahungu.

Royal Free NHS Trust


Neuraminidase inhibitors (oseltamivir or zanamivir), are

licensed for the antiviral treatment and prophylaxis of seasonal

influenza. The National Institute for Health and Care Excellence (NICE)

has provided guidance stating that they can be used for chemo-

prophylaxis in persons in specified at-risk groups following exposure

to virologically confirmed influenza infection if they are not

adequately protected by vaccination.


To characterize the use of neuraminidase

inhibitors for influenza post-exposure prophylaxis.


We performed a retrospective review of all hospitalised

patients who received antiviral prophylaxis after influenza exposure

during the 2015

2016 influenza season.


150 patients had confirmed exposure to an influenza

infection. Of these, 110 (73%) were over 65 years, 7 (5%) were pregnant,

2 (1%) were children under six months of age, 39 (26%) were diabetic,

94 (63%) had one or more chronic conditions (cardiovascular/liver/

neurological/renal/respiratory), 21 (14%) had severe immunosuppres-

sion, 4 (3%) were obese and 3 (2%) did not have any risk factors.

Influenza vaccination status was not recorded for any of the patients.

The median length of stay was 20 days (range 2

165 days).

149/150 patients received oseltamivir prophylaxis and one patient

received zanamivir prophylaxis. 2/150 of our patients developed

influenza A in hospital while on prophylaxis. One of themwas a stroke

patient on inhaled Zanamivir and the other had only 7 days of

oseltamivir prophylaxis.

Discussion and/or Conclusion(s):

Antiviral drugs should not be used

as a substitute for influenza vaccination. It is more cost-effective

to vaccinate individuals as opposed to offer chemoprophylaxis.

Opportunities to vaccinate long stay patients in hospitals should be


ID: 4967

The use of a point of care test for influenza on the medical

assessment suite: Experience of a tertiary referral centre 2015/2016

Shirelle Burton-Fanning, Sheila Waugh, Brendan Payne,

Jayne Harwood, Chris Gibbins, Manoj Valappil, Ashley Price.


upon Tyne Hospitals NHS Foundation Trust


Influenza infections can pose significant health care

burden during winter months. UK guidance advises that patients with

suspected influenza are isolated to reduce transmission, and where

indicated, antiviral treatment should be started within 48 hours of

presentation. An audit of isolation of patients with influenza during

the previous year had shown that only 41% of patients admitted via the

medical assessment suite (AS) were empirically isolated due to limited

isolation facilities.


We describe our experience with introduction of

a commercial molecular assay as a point of care test (POCT) in the AS

during the 2015/16 season for rapid diagnosis of Influenza to improve

of the management of patients and reduce exposure to susceptible



A Cepheid GeneExpert

analyser was placed in a

designated testing area in the AS. Junior medical staff in the unit

were trained to perform the test. Standard operating procedures for

the collection and analysis of the samples and written guidance on

management of patients and their contacts were provided. Electronic

records were interrogated to obtain data on time of admission, result

availability, isolation and antiviral prescription for 2014/15 and



Interim data analysis showed significant reductions in:

Median time from admission to result availability (38 hours to 4


Median time to isolation/discharge (16 hours to 7 hours)

Median time to initiation of antiviral treatment (37 hours to 15


Discussion and/or Conclusion(s):

Interim data indicates POCT for

influenza on the assessment suite aids the management of patients

with influenza and reduces exposure to susceptible contacts.

ID: 4972

Norovirus disease leads to higher hospitalization rates in older

adults with chronic medical conditions

Thomas Verstraeten


, Baoguo Jiang


, John Weil





Pharmacovigilance and Epidemiology Services,


Takeda Development

Center Americas,


Takeda Pharmaceuticals International


Norovirus is the main cause of acute gastroenteritis

across all age groups. Older adults are particularly at risk of severe

disease potentially leading to hospitalization. An estimated 86% of US

adults over 65 have at least one, and 61% more than one chronic

medical condition.


We assessed the impact of norovirus acute

gastroenteritis (NGE) on hospitalizations among older US adults

with various chronic underlying conditions.


Retrospective cohort study using MarketScan data 2002

to 2013, comparing rates of hospitalizations for NGE in patients with

one or more chronic conditions (renal, cardiovascular, respiratory,

Abstracts of FIS/HIS 2016

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