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ID: 5052
The causative organisms and antimicrobial resistance
seen in asymptomatic and symtomatic renal transplant
recipients
Rebecca Bamber
1
, Harriet Hughes
2
, Shafi Malik
3
, Vinod Mathrani
4
.
1
Microbiology Dept, University Hospital of Wales,
2
Public Health Wales,
3
Univerity Hospital of Wales,
4
University Hospital of Wales
Background:
There is little current UK data on the types and resistance
profiles of the infecting urinary pathogens, and no standard approach
to investigation and treatment of these patients. Some data has been
published from the USA, but this cannot be extrapolated to our local
population.
Aim(s)/Objective(s):
•
To detail the culture results from renal transplant outpatients, both
symptomatic and non-symptomatic with the aim of guiding future
therapy
•
Ensure that our current SOP was being followed and that this was
providing useful information to clinicians. Detail the resistance
profiles of the organisms, with particular reference to the potential
impact of the routine use of co-trimoxazole prophylaxis
Method(s):
The results of the initial pilot study revealed:
•
11% of samples were not identified anywhere on the request form
as transplant patients and were therefore not processed using the
correct SOP
•
78% of patients were asymptomatic despite significant growth on
urine samples.
•
The spectrum of organisms found was unusual (only 26%
E. coli
, for
example)
•
Multi-drug resistance was more common than in the routine
population
We introduced of a
“
transplant
”
barcode sticker. This made it possible
to collect a far larger data set over the next 6 months.
Results:
445 urines collected over a 6 month period following sticker
introduction. Analysis for:
•
Organism grown
•
Resistance patterns
•
Efficacy of transplant SOP
Discussion and/or Conclusion(s):
Results suggest that transplant
patients do benefit from a specific SOP for handling routine urines and
that antibiotic guidelines may need altering to reflect the pathogens
affecting this group.
ID: 5057
Clindamycin resistance rates of Group B Strep (GBS) in perinatal
maternal samples in an East London Hospital
−
an under-
recognised resistance problem
Alleyna Claxton.
Homerton University Hospital NHS Foundation Trust
Background:
Early onset neonatal Group B Streptococcus disease
(EOGBS) is the most frequent cause of severe infection in new born
infants. To reduce the risk, national guidance states that all women
who have GBS detected from vaginal swabs/urine samples in their
current pregnancy should be offered intrapartum antibiotic prophy-
laxis (IAP) during labour. Antibiotics for penicillin-allergic women
are problematic due to GBS resistance to clindamycin. The current
guidance (2012) states GBS clindamycin resistance rates of c.10% in
England & Wales (Health Protection Agency data 2009).
Aim(s)/Objective(s):
To evaluate the current GBS clindamycin resist-
ance rates in peri-natal women in an East London Hospital.
Method(s):
Winpath was searched for the antibiograms for GBS
isolated from vaginal swabs/mid-stream urine samples (MSUs) for
women attending the hospital
’
s maternity services from April 2015
to April 2016. The prevalence of GBS clindamycin resistance was
calculated using this data.
Results:
GBS was isolated from 98 vaginal swabs and 26 MSUs. The
GBS isolates were clindamycin resistant in 27 out of 124 isolates
–
a
resistance rate of 21.8%.
Discussion and/or Conclusion(s):
In our hospital, the GBS clindamy-
cin resistance rate is double that stated in the national guidance.
However, awareness among our Obstetricians is low that the GBS
antibiogram should be checked before prescribing clindamycin for
IAP for penicillin-allergic women and a glycopeptide antibiotic should
be used as an alternative if clindamycin resistance is detected or not
determined, despite this being stated in our antibiotic policy.
Local clindamycin resistance rates for GBS inmaternity samples should
be reviewed to informGBS IAP antibiotic choices for penicillin-allergic
women and Obstetricians should be made aware of this antibiotic
resistance issue.
ID: 5067
Antimicrobial susceptibility and molecular epidemiology of
extended spectrum beta-lactamase producing Enterobacteriaceae
in Hamad Medical Corporations, Qatar
Mazen Sid Ahmed
1
, Anand Deshmukh
1
, Devendra Bansal
2
,
Emad Ibrahim
1
, Ali Sultan
3
.
1
HamadMedical Corporation,
2
Weill Cornell-
Medicine Qatar,
3
Weill Cornell Medicine-Qatar
Background:
Emergence of extended spectrumbeta lactamase (ESBL)-
producing isolates has important clinical and therapeutic impli-
cations. A high prevalence of ESBL-producing Enterobacteriaceae has
been reported in literature from various clinical samples.
Aim(s)/Objective(s):
The present study was undertaken to evaluate
the prevalence of ESBL-producing Enterobacteriaceae, as well as the
molecular characterization and the antimicrobial susceptibilities in
patients admitted in Intensive Care Units (ICUs) at Hamad Medical
Corporations (HMC), Doha, Qatar from November 2012 to October
2013.
Method(s):
A total of 629 Enterobacteriaceae isolates were included
in the study. Identification and susceptibility was done by Phoenix
(Becton Dickinson) and the ESBL-producers were confirmed by double
disk potentiation as recommended by CLSI. Molecular analysis for
the ESBL-producers was performed using polymerase chain reaction
(PCR).
Results:
109 isolates (17.3%) were confirmed as ESBL-producers and all
were sensitive to meropenem in routine susceptibility assay. Most of
ESBL producers (99.1%) were resistant to amoxicillin/clavulanic acid
and ceftriaxone and 93.6% to cefepime. Among ESBL producing genes,
prevalence of bla
CTX-M
(66.1%) was highest, followed by bla
SHV
(53.2%)
and bla
TEM
(40.4%).
Discussion and/or Conclusion(s):
Present study shows high preva-
lence of ESBL-producing Enterobacteriaceae within the ICU facilities at
HMC, Qatar and emphasizes the need for judicious use of antibiotics
and implementation of strict infection control measures.
ID: 5068
Clinical data and antimicrobial susceptibility of multidrug
resistance
Pseudomonas aeruginosa
isolates in Qatar
Emad Ibrahim
1
, Mazen Sid Ahmed
1
, Jana Jass
2
, Suleiman Abu Jarir
1
,
Khalid Zahraldin
1
.
1
Hamad Medical Corporation,
2
Orebro University
Background:
Pseudomonas aeruginosa
is the 2nd most frequent
pathogen isolated from health care associated pneumonia, skin and
soft tissue infection. There is insufficient data on epidemiology of
multidrug resistance
P. aeruginosa
(MDR-PA) available in Qatar.
Aim(s)/Objective(s):
The present study aiming to determine anti-
microbial susceptibilities, molecular epidemiology and risk factors of
MDR-PA from patients, Hamad Medical Corporations (HMC), Doha,
Qatar.
Method(s):
Antimicrobial susceptibility testing: By Phoenix and
results were confirmed by E-test. Descriptive analysis of the risk
factors and clinical outcome of every file of MDR-PA positive patients
were collected.
Results:
Overall prevalence of MDR-PA was 8% (205/2552). Majority
74.6% were male, age range 1.5
–
90 years with a mean age of 45.75
years (SD = 62.58). 64% of patients >50 years, 68% patients non-Qatari,
and majority 74.0% were inpatient.
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S32