Table of Contents Table of Contents
Previous Page  62 / 150 Next Page
Show Menu
Previous Page 62 / 150 Next Page
Page Background


Little is known about the use of antibiotics and the

extent of antibiotic associated diarrhoea (AAD) in spinal cord injuries

(SCI) patients.


The study aim was to (i) record the use of

antibiotics; (ii) establish the prevalence of AAD and; (iii) assess if there

is any seasonal variationwith respect to antibiotic use and incidence of



A retrospective study was conducted in three British SCI

centres during October 2014 to June 2015. Data was collected using a

standardised questionnaire. We define AAD as 2 or more watery stools

type 5, 6 or 7 (Bristol stool scale) over 24 hours.


Six-hundred-and-twenty-five adults (median age: 55

years, 31.5% female) with SCI (54.4% tetraplegia; 39.3% complete SCI)

were included. Of 124 (19.8%) patients on antibiotics, the top

three indications for antibiotics were urinary-tract infections,

skin-infections and pressure ulcers infection. Twenty-one of 124

(16.9%) developed AAD. No statistical difference was observed on

number of antibiotics, severity of SCI, use of proton-pump-inhibitors

and H


-blockers and use of laxatives in both groups. AAD was

more common in the summer season when compared to spring,

autumn and winter. (32.3%, 6.9%, 16%, 16.1%, p = 0.04). AAD was

associated with older adults (p < 0.01); tetraplegia (p < 0.01); hypoal-

buminaemia (p = 0.02) and elevated body-mass-index (p = 0.02).

Urinary-tract-infection was more common during the autumn

season (p < 0.01).

Discussion and/or Conclusion(s):

This multi-centre study found AAD

is common in SCI patients and maybe a risk factor for poorer outcome

and increased hospital cost. Further study testing whether probiotics

can reduce incidence of AAD is warranted, especially during summer


ID: 4513

Effect on

Staphylococcus aureus

removal and recovery of properties

against skin damage by using new hand-cleansing formulation

without sanitizers

Kentaro Asaoka


, Shiro Endo


, Yuki Suzuki


, Satoru Komuro



Tadanobu Nemoto


, Mitsuo Kaku




Department of Infection Control and

Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate

School of Medicine,


Department of Research and Development,

Household Laboratory, Kao Corporation,


Geriatric Health Services





Izumi Orthopedic Hospital


Staphylococcus aureus


S. aureus

) is known to form a

biofilm and colonize on damaged skin of the hands.


We investigated changes in the quantity of

S. aureus

on the hands and changes in skin damage when using a

hand-cleansing formulation with potassium oleate but without a

sanitizer (Formulation A), which is highly effective in removing



biofilm and causes minimal skin damage.


Prospective, crossover, double-blind commissioning test.

Setting and participants:

This study included 14 medical staff

members at Geriatric Health Services Facility




The participants used two types of hand-cleansing

formulations (Formulations A and B), each for 4 weeks.

S. aureus

of the

hands was cultured from swab samples on agar plates. Surface

Evaluation of scaliness (SEsc), an indicator of scaliness and dryness of

keratin, was measured using a UV-microscope as a marker of skin



The quantity of

S. aureus

after using Formulation A for 4 weeks

was 10


colony-forming units (CFU)/mL, a statistically signifi-

cant decrease from the quantity of

S. aureus



CFU/mL) just

before use (


= 0.029). Additionally, the SEsc after using Formulation A

for 2 weeks (2.02 ± 0.59) was significantly lower than the SEsc 2

weeks before use (2.85 ± 0.48) (


= 0.042). With Formulation B, the

quantity of

S. aureus

and the SEsc did not significantly change from

before to after use (


> 0.05).


Formulation A removed

S. aureus

from the hands of

participants, and skin damage on the hands improved. This presum-

ably occurs because Formulation A gently removes

S. aureus


ID: 4558

An evaluation of the clinical utility of positive pneumocystis

pneumonia PCR in a large teaching hospital

Isobel Ramsay, Huina Yang, Vanessa Wong, Jumoke Sule.




Pneumocystis pneumonia (PCP) therapy is not covered

by empirical broad spectrum antibiotics used for treatment of

pneumonia. A positive PCP-PCR result alone is not diagnostic of

infection and may represent colonisation.


To determine the clinical utility of a positive PCR

result in guiding PCP therapy.


PCP PCR is performed on all respiratory samples including

sputum where requested using an in-house assay. CT value

35 is

deemed positive.

The laboratory database was searched for patients with a positive

result for a 12-month period ending September 2015. Demographic,

clinical, diagnostic and therapeutic data that contributed to

therapeutic decision making were collected from hospital information



We identified 28 patients with a positive result: 27 were

immunosuppressed, 1 unknown; 27 had abnormal chest radiology (CT

or chest radiograph) with 8 mentioning PCP; samples from four of 19

patients sent for Grocott staining were positive.

Twelve of 28 patients started treatment before sample collection

(median 2 days; range 1

7 days), 1 was on prophylaxis. Two were

treated after sample collection before the result.

Following the positive result, 14 continued treatment, 9 started

treatment and one prophylaxis. Twenty of 23 patients received


days of treatment. Three of the treated patients died during the

hospital admission, 2 were discharged but died within 90 days from

admission. The remaining 18 treated patients and all untreated

patients survived over 90 days from admission.

Discussion and/or Conclusion(s):

A positive PCR helped clinical

decision making, with 82% of patients starting or continuing PCP


ID: 4678

Creatine kinase monitoring in patients receiving daptomycin

Jon Urch, Maha Albur.

North Bristol NHS Trust


In clinical studies increases in plasma creatine phos-

phokinase (CK) levels associated with muscular pains and/or weak-

ness have been reported during therapy with daptomycin. The product

license states that plasma CK levels should be measured at baseline

and at least once weekly during therapy.


Primary outcomes were (i) Compliance with

recommendations of measurement of baseline and weekly CK levels;

(ii) significant elevation (>5 times baseline) of CK leading to cessation

of therapy.


We conducted a retrospective study in a tertiary hospital

in England using the pharmacy system to identify patients who had

received daptomycin over three years. Baseline CK level was defined

as measurement at any point either in the previous six months or on

the day of first dose. For patients who had received more than 7 doses,

a subsequent level would be expected at around 7 days (margin of

error was 2 days).


A total of 108 patients were identified with 117 different

patient-episodes. Baseline CK levels were measured in 62 cases (53%)

and 55 patients (47%) had no baseline levels. Sixteen patients (14%)

had no CK levels measured at all. Eighty-one patients (75%) received

more than seven doses of daptomycin and only 33 of these (41%) had

a repeat CK level taken at the appropriate time of around a week after

starting daptomycin therapy. There were four patients who had a high

level during daptomycin treatment.

Abstracts of FIS/HIS 2016

Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24