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antimicrobial susceptibility patterns of
Streptococcus bovis
group blood
culture isolates in NHS Greater Glasgow and Clyde.
Methods:
Using a list generated using our LIMS system TPath we
reviewed the electronic patient records of all patients who had isolated
Streptococcus gallolyticus
,
Streptococcus lutetiensis
,
Streptococcus infan-
tarius
or
Streptococcus pasteurianus
from blood cultures.
Results:
We present the breakdown of specialities under which
these patients were managed, whether the blood culture was
monomicrobial or part of a mixed culture, whether the patient had
any prosthetic material, the penicillin minimum inhibitory concen-
tration (MIC), whether a deep source was identified and mortality to
date.
Conclusions:
Results have guided the training of medical staff locally
in managing these infections and allowed us to give locally accurate
information to the clinical teams when advising on isolates of these
organisms.
ID: 5155
More than meets the eye: Investigating the microbiology of
ophthalmic infections in a West London Tertiary Hospital
Kanchana Niruttan, Timothy Rawson, Luke Moore.
Imperial College
London
Background:
Antimicrobial resistance (AMR) is a leading patient
health and safety issue, yet there is a paucity of data describing
bacterial epidemiology among UK ophthalmic populations.
Aim(s)/Objective(s):
To explore AMR trends among bacterial isolates
from a tertiary eye hospital in west London.
Method(s):
Interrogation of the laboratory information management
system enabled retrospective identification of all bacterial isolates
from ophthalmic samples in fiscal years 2012 to 2015.
Results:
466 isolates were identified from 401 patients (53% male,
median age 42, range 1
–
92). 31.5% of samples were corneal scrapings
(147/401), 32.4% were eye swabs (151/466). The remainder included
contact lens fluid, wound cultures and skin swabs.
The most common organisms cultured were
S. aureus
(130/466;
27.9%),
P. aeruginosa
(105/466; 22.5%),
H. influenzae
(33/466; 7.1%) and
S. pneumoniae
(29/401; 7.2%).
P. aeruginosa
predominated among
corneal scrapings (70/147; 47.6%), while eye swabs disproportionately
grew
S. aureus
(50/151; 33.1%).
Of the 466 isolates, 262 were tested against chloramphenicol; 16.7%
(44/262) were resistant, including some
P. aeruginosa
,
S. aureus
and
S.
marcescens
. 190 isolates were tested against fusidic acid (the active
component of fucithalmic), with 23.6% (45/190) resistant, including
33.3% (15/45) of
S. aureus
. Among all 110
S. aureus
tested against
methicillin, 30 (27.3%) were resistant.
Discussion and/or Conclusion(s):
Four main pathogens predominate
among ophthalmological samples from a tertiary referral London eye
hospital. Among these pathogens, AMR for commonly used agents is
high. This epidemiology must be integrated into empiric antimicrobial
prescribing decisions for this patient cohort. Furthermore, the high
rates of AMR suggest sampling for culture and susceptibility from all
suspected bacterial eye infections be undertaken, enabling subsequent
targeting of antimicrobial therapy.
ID: 5166
An evaluation of the utility of the Sigma Transwab method of
recovery of
Neisseria gonorrhoeae
in sexual health clinics in Barts
Health, London
Olivia Lucey, Jonathon Lambourne, Heather Dolphin, Martin Hourihan,
Selena Singh, Jayshree Dave.
Barts Health NHS Trust
Background:
Sexual health clinics in Barts Health currently perform
direct near-patient inoculation of selective plates for
Neisseria gonor-
rhoeae
(NG) for all suspected cases of gonorrhoea using disposable
inoculation loops. The Sigma Transwab is a liquid medium transport
swab which is M40-A2 compliant and comprises a cellular polyureth-
ane foam for efficient absorption and release of the specimen. It is
designed to improve the recovery of NG, allowing plate inoculation to
occur centrally under controlled laboratory conditions.
Aim(s)/Objective(s):
To evaluate and compare the recovery of NG from
the Sigma Transwab versus the conventional inoculation loop from
symptomatic patients in sexual health clinics in Barts Health Trust.
Method(s):
80 patients with suspected gonorrhoea had samples taken
with both the Sigma Transwab and the routine disposable loop. The
loop was used to inoculate a selective plate in the peripheral clinic and
the Transwab was transported to the main laboratory for inoculation.
Both plates were incubated in parallel and plates examined at 24 and
48 hours for culture growth.
Results:
18 out of a total of 80 patient samples were culture-positive
for NG. The disposable loop method picked up all 18 positive samples
whilst the Transwab only picked up 9 positive cultures. All 9 positive
NG cultures missed by the Transwab grew after only 24 hours.
Discussion and/or Conclusion(s):
The Transwab was found to be
inferior to the traditional method with regards its ability to recover
viable gonoccocus. Through this evaluation we were able to assess,
improve and evaluate current provision of gonococcal culture as
highlighted by United Kingdom Accreditation Service.
ID: 5180
Mycobacterium mucogenicum
: A case report of a persistent rash
Anna Jarchow-MacDonald, Helen M. Cordey, Alyson M. Bryden,
William J. Olver.
NHS Tayside
Background:
Mycobacterium mucogenicum
belongs to the rapid-
growing non-tuberculous mycobacteria. It is commonly found in
contaminated water. As pathogen it seems to mainly cause line-
associated infections. Only a few cases of skin infections caused by
M.
mucogenicum
have been published.
Aim(s)/Objective(s):
Here we would like to present a case of a
persistent rash with
M. mucogenicum
repeatedly grown from tissue
samples.
Method(s):
The patient
’
s consent was obtained.
Results:
A patient in her mid-sixties was seen by dermatology because
of venous eczema and bilateral lower limb oedema. She is known
to have rheumatoid arthritis. On physical examination a papular
voilaceous rash on the left lower leg was noted. She reports slow
progression of the rash over a two year period. The patient had been
immunosuppressed due to methotrexate treatment when the rash
first developed.
Histopathologically, tissue taken from the rash appeared as non-
caseating granulomatous inflammation. Further samples from two
biopsies of the rash were sent to the reference laboratory.
M.
mucogenicum
grew after 8 days incubation from each sample. The
organism tested susceptible to amikacin, clarithromycin, doxycycline,
imipenem and linezolid.
Discussion and/or Conclusion(s):
This finding was interpreted as
clinically relevant.
M. mucogenicum
was found in two biopsies with a
concurring clinical and histopathological picture. A prolonged course
of doxycycline is planned and follow up of the patient will be under
the care of the dermatology team.
Non-tuberculous mycobacteria such as
M. mucogenicum
can cause a
wide range of infections. Due to their acid-fast nature, appropriate
diagnostic methods should be chosen if an infection with these
organisms is a possibility.
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S63