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antimicrobial susceptibility patterns of

Streptococcus bovis

group blood

culture isolates in NHS Greater Glasgow and Clyde.


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-



Streptococcus pasteurianus

from blood cultures.


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



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


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



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.


To explore AMR trends among bacterial isolates

from a tertiary eye hospital in west London.


Interrogation of the laboratory information management

system enabled retrospective identification of all bacterial isolates

from ophthalmic samples in fiscal years 2012 to 2015.


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



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


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




. 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


Sexual health clinics in Barts Health currently perform

direct near-patient inoculation of selective plates for

Neisseria gonor-


(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.


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.


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.


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


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



have been published.


Here we would like to present a case of a

persistent rash with

M. mucogenicum

repeatedly grown from tissue



The patient

s consent was obtained.


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.



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