138 / 150
in the blood and positive in the CSF indicating a likelihood of active
infection.
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
management.
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
Background:
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.
Aim(s)/Objective(s):
We describe the investigation and management
of a case of transmission of HCV in a Renal unit.
Method(s):
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.
Results:
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
patients
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
Background:
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.
Aim(s)/Objective(s):
To characterize the use of neuraminidase
inhibitors for influenza post-exposure prophylaxis.
Method(s):
We performed a retrospective review of all hospitalised
patients who received antiviral prophylaxis after influenza exposure
during the 2015
–
2016 influenza season.
Results:
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
explored.
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.
Newcastle
upon Tyne Hospitals NHS Foundation Trust
Background:
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.
Aim(s)/Objective(s):
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
contacts.
Method(s):
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
2015/16.
Results:
Interim data analysis showed significant reductions in:
•
Median time from admission to result availability (38 hours to 4
hours)
•
Median time to isolation/discharge (16 hours to 7 hours)
•
Median time to initiation of antiviral treatment (37 hours to 15
hours).
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
1
, Baoguo Jiang
2
, John Weil
3
.
1
P95
Pharmacovigilance and Epidemiology Services,
2
Takeda Development
Center Americas,
3
Takeda Pharmaceuticals International
Background:
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.
Aim(s)/Objective(s):
We assessed the impact of norovirus acute
gastroenteritis (NGE) on hospitalizations among older US adults
with various chronic underlying conditions.
Method(s):
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
–
S134
S133