The Journal of Hospital Infection - Supplement 1

immunocompromising, gastrointestinal, hepatic/pancreatic and

neurological conditions and diabetes) as compared with a healthy

age-matched population. We estimated rates of hospitalizations for

NGE using an indirect modeling approach, stratified into 65

–

74, 75

–

and 85+ year-old age groups.

Results:

In our study, 82.2% and 57.2% of elderlyadults had one or more

than one chronic condition, respectively. Hospitalization rates for NGE

were higher in all risk groups compared with otherwise healthy

subjects. Highest rates were among those with renal conditions

(23.9

–

40.3 episodes per 10,000 person-years across the increasing age

groups), compared with 2.9

–

11.5 episodes per 10,000 person-years

among those without chronic conditions. Among those with more

than one chronic condition, hospitalization rates were mostly

increased in the 65

–

74 year-olds (5.5 compared with 2.9 episodes

per 10,000 person-years).

Discussion and/or Conclusion(s):

Norovirus gastroenteritis leads to

significantly higher hospitalization rates in older adults with a chronic

medical condition compared with otherwise healthy older adults.

Chronic renal patients are at particularly high risk.

ID: 4978

Norovirus gastroenteritis as a cause of nosocomial infections

among hospitalized patients in Germany

Frank Kowalzik

, Daniela Zöller

, Harald Binder

, Thomas Verstraeten

Ralf Clemens

, Fred Zepp

Paediatric Department, University Medical

Center of the Johannes Gutenberg University,

Institute of Medical

Biostatistics, Epidemiology and Informatics, University Medical Center of

the Johannes Gutenberg University,

P95 Pharmacovigilance and

Epidemiology Services,

GRID Europe Consult, Mainz

Background:

Noroviruses are the most important global cause of

acute gastroenteritis (AGE) across all age groups. Testing for norovirus

in patients hospitalized with AGE is incentivized in Germany because a

positive diagnosis impacts reimbursement.

Aim(s)/Objective(s):

We estimated the number of nosocomial infec-

tions overall and by age-group for norovirus gastroenteritis (NGE)

using official/federal German databases.

Method(s):

All hospitalizations in Germany are registered with the

German Federal Statistics Office (DESTATIS). We extracted aggregate

data for patients hospitalized with NGE (ICD-10 codes A08.1) as

primary or non-primary diagnosis for the period 2007

–

2012. Cases

with a non-primary diagnoses were assumed to be due to nosocomial

infection.

Results:

During the six-year study period and based on our assump-

tion, there were a total of 241,667 nosocomial NGE cases among

hospitalized patients in Germany; an average of 40,278 nosocomial

cases per year studied (range 32,259

–

57,561). In any study year the

number of nosocomial NGE cases was 1·3 to 1·7-fold higher than the

number of community acquired NGE hospitalizations. The average

duration of hospitalization was 3.4 to 4.5-fold longer (17

–

18 days

versus 4

–

5 days) when NGE was a non-primary diagnosis and

considered nosocomial. Adults of 85 years of age and older suffered

the highest rate of nosocomial NGE cases (range 33·6

–

59·1/10,000

population).

Discussion and/or Conclusion(s):

Noroviruses are an important cause

of nosocomial infections among hospitalized patients in Germany.

Assuming all non-primary coded NGE episodes to be nosocomial in

nature may have lead to an overestimation.

ID: 4992

Case series of parechovirus in neonates and infants in Leicester UK

Christopher Holmes

, Ayushi Patel

, Fadwa Elsanousi

, Srini Bandi

Rachel Speight

, David Allen

, Julian Tang

University Hospitals of

Leicester NHS Trust,

Public Health England

Background:

First described in the 1960s, parechoviruses (PeV)

belong to the family Picornaviridae and are non-enveloped, single-

stranded, positive-sense RNA viruses. There are multiple genotypes,

but PeV genotype 3 in particular has a noted association with severe

disease in neonates and infants. Currently there is no specific antiviral

drug or vaccine against this virus.

Aim(s)/Objective(s):

To describe an unexpected series of PeV cases in a

local paediatric population.

Method(s):

In infants who present to the emergency department at

Leicester Royal infirmary with signs of sepsis (including fever, lethargy,

poor-feeding, irritability) a lumbar puncture is performed as part of

the routine septic work-up and the cerebrospinal fluid (CSF) is referred

to microbiology for viral PCR testing, including HSV, VZV, enterovirus

and PeV.

Results:

During May

–

June 2016 PeV was detected in the CSF of 15 (and

counting) neonates and infants (median age 33 days; range 8

–

197

days). In addition, for one severely ill neonate on intensive care, further

testing also demonstrated the presence of PeV RNA by PCR testing in

faeces, blood, a broncho-alveolar lavage (BAL) and a throat swab,

confirming disseminated PeV infection. All samples have been sent to

the PHE reference laboratory for viral sequencing and phylogenetic

analysis.

Discussion and/or Conclusion(s):

Since the introduction of this PeV

CSF PCR assay in our laboratory, three years ago, there have only been a

few cases detected per year so these cases represent an unusual surge

in numbers. Further clinical details and molecular epidemiological

analysis will be presented and possible reasons for this sudden rise in

cases discussed.

ID: 5043

Local screening for multiple viral respiratory tract pathogens in a

District General Hospital; is it worthwhile?

Paul Turner

, Matthew Harvey

, Ben Clayton

, Tamsin McAllister

Siba Paul

Torbay and South Devon NHS Foundation Trust,

Dept of

Paediatrics, Torbay and South Devon NHS Foundation Trust

Background:

Torbay and South Devon NHS Foundation Trust intro-

duced an extended panel for screening Respiratory Tract viruses in

2014

–

2016 (FTD Respiratory pathogens 21). Testing was undertaken

within the Microbiology department seven days a week and covered 2

consecutive winter periods.

Aim(s)/Objective(s):

To determine the usefulness of extended

molecular Respiratory testing on patient management and outcomes.

Method(s):

Pathogens tested for included RSV A/B, influenza A,

influenza A (H1N1 pdm09), influenza B, adenovirus, rhinovirus,

metapneumovirus A/B, coronavirus (HKU1, 229E, OC43, NL63),

bocavirus, enterovirus, parainfluenza virus (1

–

4), parechovirus as

well as

Mycoplasma pneumoniae

. This extended screen was applied to

symptomatic children admitted to hospital who were RSV Antigen

negative on NPA and adult symptomatic patients were either

immunocompromised (haematology and oncology) or on ICU with

community acquired pneumonia. Over 1500 samples were tested

during this period.

Results:

For children, analysis showed that co-infection was common

and that a positive result correlated with shorter duration of inpatient

stay. For adults, screening showed that both influenza and RSV

infections had been underdiagnosed/ missed, particularly for critically

ill patients. Screening symptomatic patients on admission led to

improved infection prevention and control measures and better

cohorting including those managed on ITU and a Respiratory ward.

Many immunocompromised patients had co-infections making

cohorting more problematic.

Discussion and/or Conclusion(s):

Following these findings, new

algorithms for testing both short and long respiratory PCR panels

are being introduced for patients admitted during the winter of

2016/17.

Abstracts of FIS/HIS 2016

–

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

–

S134