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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


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


Abstracts of FIS/HIS 2016

Invited Speaker Abstracts / Journal of Hospital Infection 94S1 (2016) S1