The Journal of Hospital Infection - Supplement 1 - November 2016

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become a major problem worldwide due to its significant impact
in both the community and the hospital. Some bacteria acquire
antimicrobial resistance against a range of antibiotics, which has
created a serious concern to the public health. Therefore, it is vital for
health professionals to recognize the presences of antibiotic-resistant
organisms and to take appropriate actions where required.
Aim(s)/Objective(s): The purpose of this study is to estimate the
prevalence of antibiotic-resistant organisms – ESBL (Extended
Spectrum Beta-Lactamase producers), C. difficile, VRE (Vancomycin-
Resistant Enterococci) andMRSA (Methicillin-Resistant Staphylococcus
aureus ) isolated in stool samples of both in-patients and the
community, and calculate %carriage of each resistant organism
within the two groups.
Method(s): 200 diarrheal stool samples from both inpatients and the
community were collected and cultured.. The bacterial growth in the
cultured samples were identified and recorded after 24 and 48 hours
of incubation.
Results: 25% of samples were positive for Gram negative bacilli
resistant organisms; 2% were positive for VRE; 4% were positive for C.
difficile; 0.5% were positive for MRSA.
Discussion and/or Conclusion(s): The prevalence of ESBL found in
this study showed an increasing trend compared to the results of
previous studies and the amount of VRE found was lower. The %
carriage of C. difficile was found higher compared to the values in the
past. Only 0.5% was found to be MRSA positive, which is consistent
with the decreasing trend suggested in other reports.
ID: 5066
An audit of microbiological sampling and antimicrobial
management of patients with suspected infection in the
Immediate Assessment Unit (IAU)
Amrita Randhawa1, Beth White2, Pauline Wright2. 1Queen Elizabeth
University Hospital, 2QEUH, Glasgow
Background: Suspected infection is one of the commonest presenta-
tions in medical receiving. The use of antibiotics is increasing across
NHS Greater Glasgow & Clyde. Obtaining appropriate samples for
microbiological investigation before antibiotics are commenced may
allow a switch to a narrower spectrum alternative, and reveal when
empirical coverage is inadequate.
Aim(s)/Objective(s): We aimed to establish whether appropriate
microbiological sampling and antimicrobial management of patients
was achieved in acute receiving following the diagnosis of infection.
Method(s): This retrospective single centre study was performed in
medical receiving over a 6 week period. Case notes were reviewed
daily following a consultant review.
Results: Our study included 62 patients, the majority diagnosed with
respiratory tract infections, followed by genito-urinary tract and skin
and soft tissue infections. 38 patients (61%) were prescribed antibiotics
according to local guidelines and the median time to administration of
antibiotics in patients with sepsis syndrome was 3 hours 48 minutes.
Of 32 patients with sepsis syndrome, 19 (59%) had at least 1 set of
blood cultures taken. With regard to microbiological sampling in
patients diagnosed with severe community acquired pneumonia, 67%
had sputum samples sent and 11% had atypical screens performed. 15/
19 (79%) organisms isolated from sampling were classed as significant.
4/15(27%) pathogens identified were resistant to empirical therapy.
Discussion and/or Conclusion(s): Our study highlights that further
work is required to improve antimicrobial sampling in an acute
medical receiving setting. If this could be achieved, this could
influence future empirical antimicrobial guidelines.
ID: 5093
Effect of Staphylococcus aureus PSMα 3 toxin on human platelets
Sultan Alnomasy. University of Reading
Background: CA-MRSA is a serious human pathogen because its
ability to resist the host immune defences. CA-MRSA has the ability to
cause acute infections such as meningitis and endocarditis due to
production of toxins such as Phenol-Soluble Modulins (PSMs) toxins
which play important roles in pathogenesis of S. aureus.
Aim(s)/Objective(s): This research aims to study the effect of S. aureus
PSMα3 toxin on human platelet activity, what effect S. aureus PSMα3
have on platelet functions and to identify the mechanism of
interaction between S. aureus PSMα3 and human platelets.
Method(s): Aggregometer was used to measure the effect of S. aureus
PSMα3 on platelet aggregation. Flow cytometry was used to measure
the effect of S. aureus PSMα3 on affinity of integrin αIIb β3 to fibrinogen
and exposure of P-selectin on surface of platelets. Phospho-VASP
(Ser239) and phospho-VASP (Ser157) antibodies were used to
determine the mechanism of this effect.
Results: S. aureus PSMα3 showed ability to inhibit platelet aggregation.
The level of fibrinogen binding to integrin αIIbβ3 was significantly
reduced in response to thrombin or CRP-XL due to presence of S.
aureus PSMα3 and exposure of P-selectin on the surface of platelets
was also reduced. This indicates that platelet fail to activate and recruit
other platelets. S. aureus PSMα3 induced VASP phosphorylation in
human platelets at residue Ser157.
Discussion and/or Conclusion(s): The experimental data from this
study show that S. aureus PSMα3 toxin to be an inhibitor of platelet
activation. This inhibition due to increasing the levels of cAMP that
activate the PKA that prevents any further platelet activation.
ID: 5101
The St George’ s mycoplasma experience
Charlotte Patterson1, Jonathan Youngs2, Joanna Peters3. 1Royal Free
Hospital, 2London School of Tropical Medicine, 3Royal Sussex County
Hospital
Background: Mycoplasma pneumoniae is a common cause of upper
and lower respiratory tract infections (LRTIs) in Autumn and Winter.
Outbreaks are a recognised phenomenon.
Aim(s)/Objective(s): We analysed data from patients diagnosed with
Mycoplasma at St. George ’s Hospital, focusing on patient demograph-
ics, symptoms and treatment.
Method(s): We performed a retrospective analysis of all adult patients
diagnosed with Mycoplasma on respiratory PCR September 2015 –
April 2016. Data was collected from patient’s notes, discharge
summaries, electronic pathology, imaging and microbiology results.
Results: 30 adults tested positive for Mycoplasma. 60% (18/30) were
male, mean age was 45 years (21–82). 43% had an underlying chest co-
morbidity or were immunocompromised. Commonest presenting
symptoms were cough (93%), fevers (93%), sputum production (79%)
and shortness of breath (66%). The mean peak WBC count was
10 ×109/L, CRP 161 mg/L and ALT 142 IU/L. 85% (22/26) patients had
abnormal chest X-rays. 87% (26/30) received an initial antibiotic
effective against mycoplasma. After PCR result, use of beta-lactams fell
from 16 to 6 whilst tetracycline monotherapy rose from 6 to 15
patients. Mean length of hospital stay was 5 days. 47% (14/30) were
tested for antibody titre. 3/14 had negative serology but these were all
tested within 8 days of symptom onset.
Discussion and/or Conclusion(s): Our cohort were predominantly
young, male patients presenting with LRTI symptoms. It included
patients with erythema multiforme major, myocarditis and acute
delirium, which are all recognised phenomena associated with
mycoplasma. Most patients received initial antibiotics effective
against mycoplasma and many had treatment rationalised following
PCR result suggesting that testing changed practice.
ID: 5109
2 year review of ‘Streptococcus bovis’ group bacteraemias in NHS
Greater Glasgow and Clyde
Mairi Macleod, Aleksandra Marek. NHS Greater Glasgow and Clyde
Introduction: The Streptococcus bovis group has an association with
endocarditis and gastro-intestinal tract malignancy. This association
is strongest with S. gallolyticus subspecies gallolyticus previously
known as S. bovis biotype I. We reviewed the clinical presentation and
Abstracts of FIS/HIS 2016 – Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24–S134 S62