75 / 150
developed. DAB review has been continued as part of our routine IPCT
surveillance programme.
ID: 4579
Incidence of peripheral intravenous catheter-related
complications in a U.S. hospital discharge database
Sangtaeck Lim
1
, Erica Adams
1
, Michael S. Broder
2
, Eunice Chang
2
,
Sheila R. Reddy
2
, Marian Tarbox
2
, Tanya Bentley
2
, Liza Ovington
1
.
1
Ethicon, Inc.,
2
Partnership for Health Analytic Research, LLC
Background:
The burden of peripheral IV (PIV) related bloodstream
infections (BSI) is underevaluated. Identifying PIV-related com-
plications in real world data is challenging due to the broad use,
inconsistent coding, and voluntary reporting for these devices.
Aim(s)/Objective(s):
To estimate the incidence of PIV-related
complications.
Method(s):
In this retrospective analysis of Premier Perspective
Database
®
US hospital discharge records, we studied hospital admis-
sions between 7/1/2013 and 6/30/2015 with 7 primary diagnoses
unlikely to cause a complication of interest: pneumonia, chronic
obstructive pulmonary disease (COPD), myocardial infarction, con-
gestive heart failure, chronic kidney disease (CKD), diabetes, or
major trauma. Based on expert input, all admissions were assumed
to include a PIV. We excluded admissions with evidence of potential
non-PIV causes of complications (e.g., dialysis, surgery, central line
use). We reported rates of selected PIV-related complications: BSI,
cellulitis, phlebitis, infections not elsewhere classified (NEC), and
extravasation.
Results:
We identified 588,375 qualifying admissions (N = 15,637
–
187,904). Mean (SD) age was 66.1 years (20.6), 52.4% were females,
and admissions were mainly non-elective (95.2%). Overall 1.8% of
patients (n = 10,354) had a complication, and rates varied by pri-
mary diagnosis: 0.98% (COPD) to 2.67% (pneumonia). BSI was most
common (82.2% of all complications), overall ranging from 0.67%
(CKD) to 2.46% (pneumonia). Rates of cellulitis, phlebitis, infections
NEC, and extravasation were lower than BSI and varied by primary
diagnosis.
Discussion and/or Conclusion(s):
Incidence rates of PIV-related
complications were uncovered in hospital data and were consistent
with research citing PIV complications regardless of dwell time.
Further study of hospital discharge records may provide insight into
the clinical and economic impact of these complications.
ID: 4688
Pseudomonas aeruginosa
: contamination of tap outlet fittings and
consequential contamination of tap water
Chloe Hutchins
1
, Jimmy Walker
2
, Jeremy Webb
3
, Ginny Moore
2
,
Katy-Anne Thompson
2
.
1
University of Southampton and Public Health
England,
2
Public Health England,
3
University of Southampton
Background:
In 2011/12, the deaths of 4 neonates were linked to
Pseudomonas aeruginosa
and the contamination of hospital tap water.
Investigations demonstrated that the tap outlet fittings (OFs) were
heavily colonised by
P. aeruginosa
. OFs may become contaminated
during cleaning.
Aim(s)/Objective(s):
To investigate the contamination of OFs via
contaminated cleaning cloths and the consequential contamination of
water delivered from both frequently and infrequently used taps.
Method(s):
Microfibre cloths contaminated with
P. aeruginosa
(10
8
CFU/mL) were used to wipe three different types of OF (A, B
and C). OFs were inserted into an experimental tap rig for up to 24-
hours. Survival over time was assessed by culture. Taps were used at
high-and low-frequencies by subjecting taps to single-, and multiple
flushes. Water was sampled via membrane filtration.
Results:
The median number of
P. aeruginosa
transferred from cloths to
OFs was 1.4 × 10
5
CFU.
P. aeruginosa
persisted on all OFs for 24-hours.
However, in comparison to OFA, significantly fewer organisms were
recovered from OFB and C after 8- and 12 h respectively.
P. aeruginosa
was recovered from water delivered from OFA at levels above the
augmented care alert level (i.e.
≥
10 CFU/100 mL). Contamination
persisted despite continued flushing. In contrast, water delivered
from OFB did not contain
P. aeruginosa
beyond the first flush.
Discussion and/or Conclusion(s):
Contamination of OFs via cleaning
cloths can occur. OF design, whilst not removing the potential for
retrograde contamination may, in combination with a flushing
regimen, prevent these waterborne pathogens from contaminating
the water delivered from the outlet.
ID: 4714
In vitro studies into biofilm prevention using antibiotic-loaded
beads: implications for prosthetic infection management
Robert Howlin
1
, John Cooper
2
, Sean Aiken
2
, Paul Stoodley
3
.
1
University
of Southampton and University Hospital Southampton NHS Foundation
Trust,
2
Biocomposites Ltd,
3
The Ohio State University
Background:
Bacterial biofilms play a key role in prosthetic infection
(PI) pathogenesis. Establishment of the biofilm phenotype confers
the bacteria with significant tolerance to systemic antibiotics and the
host immune system meaning the twin strategy of thorough joint
debridement and prosthesis removal often remain the only possible
course of therapeutic intervention. Protection of the prosthesis and
dead space management may be achieved through the use antibiotic
loaded cements and beads which aim to release high localised
concentrations of antibiotics to the surgical site.
Aim(s)/Objective(s):
The antibacterial and antibiofilm efficacy of these
materials is poorly understood. We have performed an array of
in vitro
studies against a selection of important gram negative and gram
positive pathogens involved in PIs to better understand their potential
clinical benefit.
Method(s):
Acrylic cement and various non-acrylic materials prepared
as beads loaded with antibiotics were evaluated for their capacity to
both inhibit biofilm formation and kill preformed biofilms using agar
diffusion assays, viable cell counts, confocal and scanning electron
microscopy. Studies to model the release of antibiotics from mineral
based cements permitted an understanding of antibiotic elution
kinetics and the bacterial response.
Results:
Agar diffusion assays demonstrated antibacterial concentra-
tions of eluting antibiotics lasting for up to 111 days, dependent on the
cement type, antibiotic and bacterial strain. Antibiotic-loaded beads
attenuated early bacterial colonisation and reduced biofilm formation
for multiple days post inoculation. Established biofilms were harder to
clear.
Discussion and/or Conclusion(s):
Synthetic antibiotic-loaded CS
beads have potential to reduce or eliminate biofilm formation on
implant material to aid in the management of PIs.
ID: 4715
Study to evaluate the biofilm prevention capability of three bone
void fillers combined with antibiotics
Robert Howlin
1
, John Cooper
2
, Sean Aiken
2
, Paul Stoodley
3
.
1
University
of Southampton and University Hospital Southampton NHS Foundation
Trust,
2
Biocomposites Ltd,
3
The Ohio State University
Background:
An increasing number of biomaterials combined
with antibiotics are being used in the surgical management of
osteomyelitis.
Aim(s)/Objective(s):
This study evaluated biofilm prevention capabil-
ity of three commercially available materials combined with anti-
biotics against
S. epidermidis
and
MRSA
, and their susceptibility to
surface colonization under repeated bacterial challenges.
Method(s):
Three materials were evaluated: high purity synthetic
calcium sulfate combined with vancomycin and tobramycin
A
(SCS-VT),
calcium sulfate/hydroxyapatite containing gentamicin
B
(CSHA-G) and
calcium sulfate/calcium carbonate containing gentamicin
C
(CSCC-G).
Beads of each were placed into 6 well plates (10 beads/well) and 4 mL
of each bacterial strain (10
6
cells/mL) added to the wells. At days 1
(24 h post-inoculation), 2, 3, 7 and 14, viable cell counts, confocal laser
scanning microscopy and scanning electron microscopy of the bead
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S70