15 / 150
good although response rates in randomised studies are not as high as
those reported in open series of patients.
Case 2: Carbapenemase producing enterobacteriacae in a
rehabilitation centre
–
not quite the community but not an acute
setting
Mandy Wootton.
Public Health Wales
Spinal injuries units often house patients for long periods of time
during rehabilitation, making transfer of colonising organisms
between patients more likely. Carbapenemase producing organisms
(CPO) limit clinical management of seriously ill patients but in
specialist units may restrict rehabilitation and pose a serious public
health risk. An OXA-48 containing K. pneumoniae was isolated from
urine of a patient at UHW in February 2014. Retrospective testing of
faeces from the same patient stored after C. difficile tests also was
positive for K. pneumoniae and also E. coli, both containing OXA-48.
Comprehensive screening of 62 patients, using enrichment techni-
ques, over the next 18 months revealed 7 positive for OXA-48. Multiple
infection control measures were implemented and communication
between the unit and transferring hospitals was heightened. No
patient had an acute infection due to the OXA-48 carrying organisms,
however this study demonstrated the factors which were addressed in
order to restrict the spread of colonising agents and procedures to be
followed if infection did occur. Genetic characterisation of the OXA-48
isolates showed that genetic transfer of the OXA-48 had occurred
between species and that the carbapenemase was present in multiple
clones of both E. coli and K. pneumoniae.
Pneumocystis jirovecii
–
outbreaks and control of transmission
Eftihia Yiannakis.
Worcestershire Acute Hospitals NHS Trust
Pneumocystis jirovecii pneumonia (PCP) is an important cause of
morbidity and mortality in immunocompromised patients. Several
nosocomial outbreaks of PCP have been reported in HIV-negative,
immunocompromised patients. The primary route of P. jirovecii
transmission has yet to be proven, however these outbreaks of
infection suggest either inter-human transmission or a common
environmental source. On formal review of the reported outbreaks,
epidemiological and genotypic links between patients were identified.
The evidence for nosocomial acquisition of PCP and possible person-
to-person transmission of infection, suggests the need for formal
infection control policies. These policies should include the routine
surveillance for PCP in vulnerable populations as well as measures that
should be considered to prevent the spread of infection between
patients.
Abstracts of FIS/HIS 2016
–
Invited Speaker Abstracts / Journal of Hospital Infection 94S1 (2016) S1
–
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