35 / 150
cephalexin, ciprofloxacin, nitrofurantoin, and trimethoprim were
94.4%, 92.4%, 92%, 90.3% and 65.2% respectively. In this study, only 3
out of 118 isolates were mecillinam-resistant ESBL positive isolates
with no resistance observed amongst Amp-C producers.
Discussion and/or Conclusion(s):
Mecillinam shows excellent
in-vitro
activity against common community-acquired uropathogens.
In-vitro
resistance of mecillinam to isolates producing ESBL and Amp-C
producers is low. Our study provides evidence to support the current
national guidance recommendation.
ID: 4901
Virulence and resistance features in microbial strains recovered
from hospital surfaces
Mihaela Magdalena Mitache
1
, Georgeta Totea
2
, Irina Gheorghe
3
,
Coralia Bleotu
4
, Carmen Curutiu
3
, Nicoleta Amariei
3
,
Mariana Carmen Chifiriuc
3
.
1
University Titu Maiorescu of Bucharest,
Faculty of Medicine,
2
Maria Burghele Hospital Buftea,
3
Department of
Microbiology, University of Bucharest, Faculty of Biology,
4
Stefan
S. Nicolau Institute of Virology, Bucharest
Background:
The incidence of nosocomial infections increased with
diversification of medical services provided.
Aim(s)/Objective(s):
Investigation of resistance and virulence markers
in microbial strains isolated from the hospital environment recovered
after surfaces decontamination with quaternary ammonium com-
pounds, triclosan, iodine in order to predict their role in healthcare-
associated infections.
Method(s):
The resistance phenotypes were established using disk
diffusion and double-disk diffusion test. The investigated virulence
factors were adherence to Hela cells and to inert substratum, haemo-
lysins, lecithinase, gelatinase, lipase, DN-ase, amylase and iron
chelating agents. Simple and multiplex PCR assays were used to
identify the genetic support of cell-associated and soluble virulence
factors (plcH, plcN, protease IV, alg, coag, ExoU,T and S, pldA, HelD,
eaea, bfpA, eaf, AggR, EAggE, EAST1, VT1, VT2, pap, afa,sfa) and of
resistance to beta-lactams, aminoglycosides, tetracyclines, quinolones,
macrolides and disinfectants (intI1, qacG, qacH,qacE, NfxB, Fab).
Results:
The isolated strains
E. coli
, Klebsiella,
Pseudomonas aeruginosa
and
Staphylococcus
sp. exhibited resistance to trimetroprim sulpha-
metoxazole,
nitrofurantoin,
ampicillin,
piperacillin-tazobactam,
amoxicillin clavulanic acid, cefaclor, ceftibuten, aztreonam, tobrami-
cin, amikacin. The pore-forming enzymes, proteases and sidero-
phores-like production, as well as the adherence to inert and cellular
substrata were among the most frequent virulence factors. The Gram-
negative non-fermentative bacilli exhibited resistance to beta-lactams
and gentamycin and pan-resistance phenotypes, the Enterobacteria-
ceae strains to tetracyclines, beta-lactams, aminoglycosides, quino-
lones and
Staphylococcus
sp. strains showed the MLSBi phenotype.
The molecular assays allowed to identify the genetic support of
virulence and resistance.
Discussion and/or Conclusion(s):
The microbial strains proved
to exhibit multiple drug resistance and virulence determinants,
suggesting their potential to persist and initiate hospital-associated
infections.
ID: 4915
Frequency and risk factors for aciclovir-associated AKI in adults
Lucy Ryan
1
, Christopher Duncan
2
, Jonathan Foster
3
, Manoj Valappil
4
,
Matthias Ludwig Schmid
2
.
1
Newcastle University Medical School,
2
Infectious Diseases, Royal Victoria Infirmary, Newcastle upon Tyne NHS
FoundationTrust,
3
Pharmacy, Newcastle uponTyne NHS FoundationTrust,
4
Virology, Public Health England
Background:
Acute kidney injury (AKI) is awell-established side effect
of parenteral aciclovir, but there are limited data on its prevalence in
adults in route clinical practice.
Aim(s)/Objective(s):
To describe the prevalence of, and baseline/
treatment-related risk factors for, aciclovir-related AKI.
Method(s):
We performed a pilot retrospective analysis using
electronic prescribing, laboratory medicine and patient record
databases. Data on all doses of parenteral aciclovir administered in a
tertiary infectious diseases centre over a three-year period (2013
–
2016) were extracted. All patient episodes in which a baseline serum
creatinine was available prior to, and within 48 h/7 d of aciclovir
dosing were included. Patients on dialysis were excluded. AKI
incidence and severity was graded according to KDIGO criteria.
Continuous data were normalised by log-transformation for unpaired
t test; categorical datewere analysed by Fisher
’
s extract test (GraphPad
Prism).
Results:
We identified 80 aciclovir treatment episodes in 77 patients.
Fifteen episodes in 14 patients were associated with AKI (grade1: 8;
grade 2: 3; grade 3: 4), giving an overall prevalence of 18.8%. Patients
with AKI were significantly older (mean age 62.5 v 50.4, P = 0.039)
and exposed to a larger cumulative dose of aciclovir (11.9 g v 6.2 g,
P = 0.037). There were non-significant associations with plausible
baseline or treatment-related risk factors, probably due to the modest
sample size.
Discussion and/or Conclusion(s):
AKI is an appreciable risk with
parenteral aciclovir, particularly in older patients, and warrants close
monitoring. These data justify the assessment of intervention(s) to
reduce the risk of AKI.
ID: 4917
Virulence factors and antibiotic susceptibility patterns of
coagulase-negative staphylococci strains isolated from Intensive
Care Unit and Cardiology
Mihaela Magdalena Mitache
1
, Georgeta Totea
2
, Carmen Iordache
3
,
Marcela Popa
3
, Carmen Chifiriuc
3
.
1
University Titu Maiorescu of
Bucharest, Faculty of Medicine,
2
Maria Burghele Hospital Buftea,
3
University of Bucharest, Faculty of Biology, Department of Microbiology
Background:
Coagulase-negative staphylococci CoNS is one of the
major causes of nosocomial infection, most infections being associated
with different types of prostheses. Even though this bacteria has a
low pathogenicity, the impact of the global CoNS infections is
considerable, medical and socio-economic.
Aim(s)/Objective(s):
Evaluation of microbiological risk represented by
CoNS strains isolated from different hospital environments, in order
to establish potential contamination risk for patients.
Method(s):
The isolated strains have been identified using miniAPI
galleries and investigated for antibiotic susceptibility profiles using
disk difusion method. The production of cell-associated factors,
adherence to inert and cellular substratum, biofilm development and
soluble enzymatic virulence factors, hemolysins, lecithinase, lipase,
caseinase, gelatinase, amylase, esculin hydrolysis, DN-ase was assesed
using phenotypic methods, microdilution methods for adherence to
inert substratum and biofilm, selective media for enzymatic factors
production and molecular methods PCR-based methods.
Results:
CoNS strains isolates exhibited an antibiotic resistance
pattern with high resistance to penicillin 34%, erythromycin 22%,
tetracicline 18% and kanamicin16%. Regarding virulence factors, the
strains isolated exhibited with higher prevalence pore forming toxins
(lecithinase) and proteases (caseinase, gelatinase), with potential roles
in pathogenesis. All tested strains presented capacity to adhere to inert
and cellular substrate presenting different adherence patterns and to
develop biofilm.
Discussion and/or Conclusion(s):
The presence of virulence
factors, and antibiotic resistance among analized straince, and also
the ability of these strains to form microbial biofilms create difficult
medical problems, especially because widespread use of large invasive
medical procedures (probes, catheters, heart valves, prostheses).
Contamination of this devices is associated with risk of subsequent
development of human infections.
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S30