24 / 150
Dragging the rim of the agar plate over the fabric pile may release
organisms that would not be recovered by other methods. Using
selective agar could refine this method specifically for the target
organism in an outbreak.
ID: 4585
Impact of moving to a new hospital build with high proportion of
single rooms on rates of hospital-acquired infection and outbreaks
Julia Vasant
1
, Elizabeth Darley
2
, John Leeming
3
, Samantha Matthews
4
,
Fiona Hammond
4
.
1
Department of Infection Sciences, North Bristol NHS
Trust,
2
Department of Infection Sciences and Infection Control, North
Bristol NHS Trust,
3
Department of Infection Sciences, North Bristol NHS
Trust,
4
Department of Infection Control, North Bristol NHS Trust
Background:
Isolation of patients with transmissible infections is a
major component of hospital infection control. In 2014 North Bristol
NHS Trust (NBT) re-located from a dual-site hospital with 10% single
rooms to a purpose-built design with 75% single rooms.
Aim(s)/Objective(s):
To determine whether moving from a 1000-bed
hospital with 10% single rooms to newpremises with 75% single rooms
resulted in reduced hospital-acquired infection rates.
Method(s):
NBT annual mandatory reporting data for hospital-
acquired
C. difficile
, meticillin-susceptible
Staphylococcus aureus
(MSSA) bacteraemia,
E. coli
bacteraemia and ward closures for
norovirus outbreaks were analysed from April 2011 to March 2016
inclusive. (MRSA bacteraemia rates were zero).
Results:
Annual incidence per 100,000 bed-days over study period:
•
C. difficile
: reduction from 23.3 to 15.8, no increased rate of decline
post-move.
•
MSSA bacteraemia: reduction from 9.6 to 7.1, no decrease in the
year immediately post-move.
•
E. coli
bacteraemia: reduction from 23.2 to 13.0 (reporting
commenced July 2011), no increased rate of decline in the year
post-move.
•
Norovirus ward closures: Pre-move 21, 34 and 13 (2011/12, 2012/
13 and 2013/14 respectively). Post-move 1 and 4 (2014/15 and
2015/16).
Discussion and/or Conclusion(s):
Transfer of
C. difficile
, MSSA and
E. coli
requires contact between colonised patients or their environ-
ment, and is largely controlled by optimal infection control practice
and cleaning. Hospital-acquired bacteraemia frequently originates
from in-patients colonising flora, hence minimal impact with
increased isolation facilities. Norovirus transmission, in contrast, has
a significant airborne component and outbreak frequency and
duration have been notably reduced following greatly increased
ability to isolate cases.
ID: 4809
The development of methods to investigate Dry Surface Biofilms in
Intensive Care Units and methods to assess cleanliness challenges
Greg S. Whiteley
1
, Karen Vickery
2
, Iain Gosbell
3
, Slade Jensen
3
,
Helen Hu
2
, Trevor Glasbey
4
, Ahmed Almatroudi
2
, Jessica Knight
5
,
Durdana Chowdhury
2
, Shamaila Tahir
2
, Khalid Johani
2
.
1
Western
Sydney University,
2
Surgical Infection Research Group, Faculty of Medicine
and Health Sciences, Macquarie University,
3
Molecular Medicine Research
Group, School of Medicine, Western Sydney University,
4
Whiteley
Corporation,
5
Antibiotic Resistance and Mobile Elements Group, Ingham
Institute for Applied Medical Research, Liverpool, New South Wales,
Australia
Background:
The spread of multi-resistant-organisms (MRO) within
intensive care units (ICU) is a significant concern for infection
prevention of healthcare associated infections (HAI). The presence of
MRO embedded within biofilms on dry surfaces has recently been
confirmed. The ability of these organisms to both survive and resist
normal hygiene measures has also now been confirmed.
Aim(s)/Objective(s):
1.
To investigate the presence of dry surface biofilms in ICU settings;
2.
To investigate the cleanliness within ICU settings;
3.
To replicate dry surface biofilms under Laboratory conditions
similar to an ICU;
4.
To investigate the behaviour and resistance of MRO following
growth in biofilms similar to those found in ICU.
Method(s):
The presence of biofilms and MRO has been undertaken
using microbial techniques suitable for recovery of sessile bacteria.
Cleaning conditions and disinfecting and sterilising techniques were
applied to bacteria grown under simulated biofilm conditions similar
to those found in ICU. Surface to surface contamination via hands
(gloved and ungloved) was investigated.
Results:
Bacteria including MRO found in biofilms in ICU have exagge-
rated longevity and enhanced resistance to surface disinfection
(chlorine) and sterilisation (autoclaving). These organisms demon-
strate transfer via hand contact onto multiple subsequent surfaces.
Discussion and/or Conclusion(s):
The transmission of MRO within
ICU and other healthcare settings is often via hands that can be
contaminated following touching of environmental biofilms. The
implications of dry surface biofilms acting as a reservoir for MRO is
highly significant for aseptic technique and hygiene management
within ICU settings.
ID: 4848
Fire burns, smoke kills. Microbial risk assessment of smoke
and heat exhaust ventilation system (SHEVS) tests in a hospital
building
Céline Hernandez, Laure Belotti-Ehrhard, Céline Ménard,
Jacinthe Foeglé, Thierry Lavigne.
Hôpitaux Universitaires de Strasbourg
Background:
There is some concern among infection control
specialists that hospitals smoke and heat exhaust ventilation system
(SHEVS) may present a threat for immunocompromised patients.
Smoke inhalation being the primary cause of death in indoor fires,
SHEVS is mandatory and requires regular testing. Yet a current of
unfiltered air running through unused ducts and spreading in the
very core of a ward is bound to induce a burst of airborne contamina-
tion. Besides, fire dampers in ventilation ducts close during the
tests, causing vibrations in the ductwork and maybe sending dust
downstream, to other wards.
Aim(s)/Objective(s):
Finding no data about this potential danger, we
opted for our own environmental investigation.
Method(s):
Air was sampled for bacteria and fungi before, during and
after SHEVS tests, in several wards corridors directly subjected to the
essay and a few levels above, in our pediatric oncology unit. We also
reviewed the results of systematic samplings, paralleled with the
date of previous tests or accidental fire alarms. This was intended as a
complement to the systematic study of a contamination episode in
pediatric oncology we presented at the HIS 2014 meeting, the impact
of incidental triggering of the fire alarm, elsewhere in the building,
being an unresolved question at the time.
Results:
In most cases, SHEVS tests induced a sharp, yet variable,
elevation of the fungal contamination. Nonetheless, this effect was
restricted to the ward directly under test.
Discussion and/or Conclusion(s):
This result comforts us about the
legitimacy of the containment measures we empirically enforce
during SHEVS tests.
Topic: Outbreaks
ID: 4501
Detection of blaIMP producing Enterobacteriaceae in a tertiary
care centre in the UK
Surabhi Taori
1
, Kirstin Khonyongwa
1
, Nergish Desai
2
.
1
King
’
s College
Hospital,
2
King
’
s College Hospital NHS Foundation Trust
Background:
The incidence of Carbapenemase producing Entero-
bacteriaceae has been increasing worldwide. In the UK, outbreaks of
organisms with
bla
K
PC
,
bla
NDM
,
bla
OXA48
and
bla
VIM
have been reported
whereas
bla
IMP
has been relatively rare.
Abstracts of FIS/HIS 2016
–
Oral Presentations / Journal of Hospital Infection 94S1 (2016) S11
–
S21
S19