76 / 150
surface was performed to assess the extent of surface colonisation and
biofilm formation.
Results:
Following two bacterial challenges (48 hrs incubation) with
both strains, CSHA-G and CSCC-G were showing extensive bacterial
colonization while SCS-VT remained clear (Poster Figure 1). With
MRSA SCS-VT maintained a 5 log and 4 log reduction after days 3 and 7
respectively. For
S. epidermidis
CSC-VT maintained a 6 and 1 log
reduction on days 7 and 14 respectively.
Discussion and/or Conclusion(s):
The presence of the broad
spectrum combination of vancomycin and tobramycin in high purity
calcium sulfate bone void filler is superior to gentamicin alone in both
CSHA-G and CSCC-G with respect to biofilm prevention and bacterial
colonisation in this challenging
in-vitro
model.
ID: 4722
Wipe out catheter-related bloodstream infections in neonates: the
bundle & beyond
Kavita Sethi, Liz McKechnie.
Leeds Teaching Hospitals NHS Trust
Background:
Catheter-related bloodstream infections (CRBSI) remain
the leading cause of health care associated infections (HCAI) in
neonates. CRBSI reduction is a significant patient safety challenge in
neonatal units and lack of paediatric focused researchmakes it difficult
to adapt the adult evidence-based strategies in critically ill neonates.
Aim(s)/Objective(s):
Leeds Centre for Newborn Care is one of the
largest neonatal services in the UK caring for about 1800 babies/year,
approx. 5% being extremely premature. In 2008
–
09, there were 8
MRSA bacteremia on the unit, the highest numbers reported from any
neonatal service in UK. We used a multifaceted approach to address
vascular access and on-going care.
Method(s):
A neonatal CRBSI surveillance service was introduced by
the IPC team in Nov 2011. The data was reviewed by a multi-
disciplinary team (MDT) and a vascular care bundlewas developed and
implemented in August 2014. The Line Team led by advanced neonatal
nurse practitioners was the key element. The intervention was
reinforced with nursing staff initiating changes to handover, education
and communication.
Results:
Implementation of care bundle has led to a noticeable
reduction in CRBSI (>10/1000 catheter days to 1.69/1000 catheter
days). No MRSA bacteremia has been reported to date. MDT review &
feedback of CRBSI rates to clinical staff was an excellent motivator for
change. Nursing empowerment made the difference and Leeds service
has achieved one of the best results as reported in neonatal Specialized
Service Quality Dashboard.
Discussion and/or Conclusion(s):
A collaborative, multi-disciplinary,
multi-pronged approach to reducing HCAI can be successful in
continuous quality improvement in high risk and complex patient
population.
ID: 4904
Use of a biological tracer to investigate microbial aerosols
generated by heater-cooler units
Ginny Moore, Simon Parks, Allan Bennett.
Public Health England
Background:
Mycobacterium chimaera
infections have been attributed
to a specific make/model of heater-cooler unit (HCU) used in
cardiopulmonary bypass. To help inform local decision making, NHS
Trusts require evidence that alternative heater-cooler systems can
reduce the risk of mycobacterial infection. However, the time required
to culture
M. chimaera
and the potential for bacterial growth and/or
biofilm formation means aerobiological investigations focusing on
naturally or artificially contaminated HCUs are problematic.
Aim(s)/Objective(s):
To assess the use of a non-pathogenic, aerostable,
biological tracer (MS-2 bacteriophage) to investigate microbial
aerosols generated and released from an HCU.
Method(s):
A new make/model of HCU was filled with filtered tap
water and high numbers of MS-2 (10
10
pfu/L) added to the tanks. All-
glass impingers were used to sample the air when the HCU was
circulating and not circulating water. Samplers were operated for
5 min before the impinging fluid was transferred to a sterile container
and cultured for MS-2.
Results:
Similar numbers (p = 0.1) of MS-2 were recovered from the air
when the HCU was circulating (1.9 × 10
4
pfu/m
3
) and not circulating
(3.8 × 10
3
pfu/m
3
) water. The filler inlet was identified as the principal
area of aerosol release. Aerosol releasewas not affected by the position
of the inlet cover but could be minimised through crude modification
to the filler unit.
Discussion and/or Conclusion(s):
Specialist aerobiology using a
biological tracer can determine the level of aerosol release from an
HCU and its location. Results are obtained rapidly and could be used by
manufacturers and NHS Trusts to inform design and purchasing
decisions alike.
ID: 4910
Impact of a multi-faceted intervention strategy on device
associated infections at an Indian Trauma Center
Alphina Karoung, Purva Mathur, Neha Rastogi, Jacinta Gunjiyal.
Jai
Prakash Narayan Apex Trauma Centre, AIIMS
Background:
The majority of infections in ICUs are device-associated
infections (DAIs). Appropriate surveillance and its effective imple-
mentation is need of an hour and a challenging task in developing
countries.
Aim(s)/Objective(s):
To ascertain rates of DAIs in critically ill trauma
patients and to monitor the compliance rates of hand hygiene
and preventive bundles using an indigenously developed automated
surveillance system.
Method(s):
The study was conducted from January, 2013 to March,
2016. Indigenous software for algorithmic detection of DAIs in
accordance with CDC
’
s NHSN definitions was developed. The DAI
rates, compliance to hand hygiene and preventive bundles were
regularly reported as feedbacks. The impact of this automated
surveillance was assessed on the rates of DAIs, compliance to
preventive bundles and hand hygiene.
Results:
A total of 6,517 patients were included amounting to 35,748
patient days. The rates of VAP, CLABSI and CA-UTI were respectively 8.4,
3.6 and 3.1/1,000 device days. There was significant correlation
between device days and the propensity to develop infections.
Infections were the cause of death in 168(38%) of fatal cases. A
significantly higher rate of VAP, CLA-BSI and CA-UTIs was noted in fatal
cases.
Acinetobacter baumanni
and
Klebsiella pneumoniae
were the
most common pathogens causing VAP, CLABSI and CA-UTI. A high rate
of multi-resistance was observed. Gross reduction in the DAI rates and
increased compliance to hand hygiene and preventive bundles were
observed. The software was developed at a cost of $1,580.
Discussion and/or Conclusion(s):
The automated surveillance is a
cost effective and an essential prerequisite leading to significant
reduction in DAIs and mortality.
ID: 4928
A team approach to successful reduction of haemodialysis
catheter-related
Staphylococcus aureus
bloodstream infections
Mairead Skally
1
, Maria Greene
2
, Sheila Donlon
3
, Veronica Francis
4
,
Colm Magee
4
, Peter Conlonl
4
, Conall O
’
Seaghdha
4
, Declan DeFreitas
4
,
Edmond Smyth
4
, Fidelma Fitzpatrick
5
, Hilary Humphreys
5
,
Mark Denton
4
, Margaret Fitzpatrick
6
, Lillian Rajan
4
, Binu Dineesh
4
,
Karen Burns
7
.
1
Department of Microbiology, Beaumont Hospital,
2
Renal
Clinical Support, Beaumont Hospital,
3
Infection Control, Beaumont
Hospital,
4
Beaumont Hospital,
5
Beaumont Hospital and Royal College
Surgeons Ireland,
6
Department of Microbiology, Beaumont Hospital,
7
Beaumont Hospital and Health Protection Surveillance Centre
Background:
Staphylococcus aureus
is awell recognised cause of blood
stream infections (BSIs) in haemodialysis patients. We previously
reported that 83% of
S. aureus
BSI in this cohort were haemodialysis
catheter-associated. Since 2013, a multi-disciplinary quality improve-
ment programme for prevention of haemodialysis catheter-associated
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S71