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logistics, patient perception and a lack of local expert clinical advice.
The frozen FMT service was designed to overcome these issues and
provide an accessible, timely, widespread service.
Aim(s)/Objective(s):
The aims of the service evaluation are to describe
the demographics of FMT patients, establish whether the clinical
outcomes are comparable to those described in the literature, evaluate
patients
’
acceptance of FMT and determine if an FMT bank can provide
a regional service.
Method(s):
The service has been evaluated using clinical outcomes,
patient satisfaction surveys, and quality of life (QoL) surveys. Data is
collected pre-procedure, immediately post-procedure, at 6 week and 6
month.
Results:
Fifteen patients were treated in the first 6 months of
operation. Preliminary data shows the demographics of patient
receiving FMT are similar to those with chronic CDI (mean age 69,
Charlson comorbidity index 4 M:F ratio 1:1). Outcomes are similar to
those reported in the literature; 80% of patients resolving symptoms
following first FMT. Patient feedback is positive; QoL has increased
significantly (Mean: 20 point increase). Information and the procedure
have an average rating >4/5. FMT uptake in Wessex; All regional
hospitals perform FMTs locally.
Discussion and/or Conclusion(s):
The service is achieving promising
clinical and QoL outcomes, patients are positive about FMTs and the
uptake shows a regional bank is a desirable resource.
ID: 4861
PPI exposure and carriage of multi-resistant Gram negative
bacteria
Lewis Jones
1
, Richard Cunningham
1
, Doyo Enki
2
, Robert Tischhauser
1
.
1
NHS,
2
Plymouth University Peninsula Schools of Medicine and Dentistry
Background:
Gram-negative bacterial resistance is a major cause of
infection, which is usually preceded by ingestion and colonization of
the gastrointestinal tract. Proton Pump Inhibitor (PPI) use is a proven
risk factor for infectionwith gastrointestinal pathogens. We carried out
a case-control study to determine whether PPI use is also associated
with an increased carriage rate of multi-resistant Gram negative
bacteria.
Aim(s)/Objective(s):
To determine whether prior use of PPIs is a risk
factor for diagnosis of multi-resistant Gram-negative infection
compared with a matched control group with no infection or infection
with a sensitive organism.
Method(s):
A retrospective case note review of Plymouth Hospital
inpatients between 1/4/14 and 31/3/15 was performed. 130 patients
with ESBL producing E. coli or K. pneumoniae (cases) were identified
and compared with 130 controls without identified resistance.
Controls were matched by age, gender, admission date, source
(hospital, nursing home, home) and admitting Care Group (Medical,
Surgical, Women & Children).
Results:
Preliminary results after analyzing the first 78 patients
suggest that the proportion of cases taking PPI is higher than in the
control group. 21 of 40 cases and 13 of 38 controls were taking a PPI on
or during the 6 months before admission. Full results and statistical
analysis after inclusion of all subjects will be presented.
Discussion and/or Conclusion(s):
Preliminary results suggest a
positive association between carriage of ESBL producing Gram-
negative bacteria, and PPI use. If confirmed in a larger sample, PPI
stewardship may be an additional control measure to reduce
transmission of resistant Gram negative bacteria.
ID: 4984
10 year case review of bacteraemias due to
Mycobacterium
abscessus
in a UK tertiary hospital
Huina Yang
1
, Luke Bedford
2
, Charlotte Summers
3
, Sani Aliyu
1
,
David Enoch
1
.
1
Cambridge University Hospitals NHS Foundation Trust,
2
Papworth Hospital NHS Foundation Trust,
3
University of Cambridge
Background:
The
Mycobacterium abscessus
complex are a group of
rapidly growing, multidrug-resistant non-tuberculous mycobacteria.
They are associated with a wide range of clinical syndromes in both
immunocompetent and immunosuppressed individuals.
M. abscessus
are successful pathogens due to their ability to form biofilms which
aids environmental survival and easy colonisation of mucosal surfaces
and invasive devices.
Results:
We reviewed the medical notes and laboratory data of all
patients with
Mycobacterium abscessus
bacteraemia over a 10 year
period. Five patients were identified over this period. All 5 patients
had at least one central intravascular device at the time of the
bacteraemia. Four out of 5 were health-care associated. Four of the
patients were also post transplantation. The time to positivity of
the blood culture bottles ranged from 5 to 10 days. The majority
(4 out of 5) had multiple sets of blood cultures with
M. abscessus
.
In our series, the 30 day mortality was 20% and 90 day mortality
was 40%.
Discussion and/or Conclusion(s):
In our experience,
M. abscessus
frequently causes an indolent infection associated with intravascu-
lar devices. Increased morbidity is associated with subsequent
seeding to distant sites, particularly in imunocompromised indivi-
duals. Although the diagnosis is often delayed, the increase use of
new diagnostics in the routine laboratory, such as MALDI-TOF has
helped to improve early identification and treatment.
M. abscessus
should be regarded as a true pathogen when identified in blood
cultures, and prompt removal of suspected infected intravascular
catheters may be essential for the successful management of this
infection.
Topic: Decontamination
ID: 4687
Use of wipes for patient hand hygiene
Christina Bradley
1
, MartynWilkinson
2
, Adam Fraise
2
, Martin Kiernan
3
.
1
Hospital Infection Research Laboratory, Queen Elizabeth Hospital
Birmingham,
2
Hospital Infection Research Laboratory, Queen
Elizabeth Hospital Birmingham,
3
Visiting Clinical Fellow, University
of West London
Background:
Much attention has focussed on hand decontamination
for healthcare workers; little attention has been paid to patient hand
hygiene. Patients confined to bed are often unable to access hand
washing facilities. They could use an alcohol hand rub but these are not
advised for soiled hands or social hand hygiene. One alternative is the
use of a hand wipe, similar to those supplied by airlines and
restaurants. However, is this an effective way of removing transient
micro-organisms from the hands? This study was designed to assess
the efficacy of an antimicrobial hand wipe (Clinell
®
Antibacterial
Handwipe) compared with hand washing.
Method(s):
The methodology was based on EN 1499 (2013) and EN
1500 (2013) as there is no standard for this type of product. The hands
of 20 volunteers were artificially contaminated by immersion in
Escherichia coli
and then sampled before and after using a reference
soft soap or a wipe with and without an antimicrobial agent for 60
seconds. The counts obtained were expressed as log
10
and the log
10
reductions calculated.
Results:
The patient hand wipe with no antimicrobial agent was
inferior to the soft soap. However, the antimicrobial wipe was
statistically non-inferior to the soft soap. A log
10
reduction of 3.54
was obtained for the reference, 2.46 for the control patient wipe, and
3.67 for the antimicrobial patient wipe.
Discussion and/or Conclusion(s):
The evidence suggests that the
antimicrobial patient wipe, when applied for 60 seconds, is at least as
good as soap and water, representing an acceptable alternative to
handwashing from a bactericidal perspective.
Abstracts of FIS/HIS 2016
–
Oral Presentations / Journal of Hospital Infection 94S1 (2016) S11
–
S21
S17