Table of Contents Table of Contents
Previous Page  78 / 150 Next Page
Show Menu
Previous Page 78 / 150 Next Page
Page Background

ID: 5148

Non-surgical CVC inserted in Pediatric Intensive Care Unit is at high

risk for infection

Achille Yepmo


, David Faraoni


, Chantal Lerminiaux



Philippe Van Der Linden




CHU Brugmann- Queen Fabiola University

Hospital Children,


CHU Brugmann - Queen Fabiola University Children



Queen Fabiola University Children Hospital


Central line infection is a serious complication.


To determine the rate of central venous catheter

(CVC) infection and the predictive factors of CVC infection in Queen

Fabiola University Children Hospital (QFUCH, Brussels, Belgium).


Prospective monocentric observational study that

included all inserted CVC from November 2013 to May 2016.

Outcome variable was CVC infection. Determinants of CVC infection

were analyzed through multivariate logistic regression model that

included the following variables: age of children, surgical vs non-

surgical insertion, place and site of insertion, indication and duration

of CVC.


577 CVC were inserted. Only 475 CVC were analyzed,

including 91 surgical and 384 non-surgical CVC. The crude rate of

CVC infection was 0.03 and 8.9 per 1000 CVC days respectively for

surgical and non-surgical CVC. There were no difference among

the insertion sites (p = 0.075). The only factor associated with

outcome was non-surgical CVC insertion in PICU (OR 2.02, 95% CI


3.85), p = 0.032). In contrast, no difference between CVC

inserted in NICU and operating room was observed (OR 0.64, 95% CI


1.21), p = 0.17).

Discussion and/or Conclusion(s):

CVC insertion in PICU was a risk

factor of infection. Our results are in accordance with the available

literature. CVC inserted in PICU cumulates many risk factors

for infection such as severe medical conditions, multilumen CVC,

many CVC, long duration of CVC, prolonged mechanical ventilation,

parenteral nutrition, blood transfusion. To reduce the overall rate of

CVC infection in QFCUH, a multimodal strategy including education,

training of the staff and implementation of checklist should be set up.

ID: 5164

Modelling catheter-related

Staphylococcus aureus

infections in


Rasmus Birkholm Grønnemose, Hans Jørn Kolmos,

Thomas Emil Andersen.

University of Southern Denmark


Recent studies revealing the elaborate interactions


Staphylococcus aureus

and the human coagulation system

during vascular infections have prompted the need for more

in vivo



in vitro



In this study we aimed to develop a new

in vitro

model for vascular catheter-related infections with

S. aureus


human plasma in a flow system.


The model allowed for continuous monitoring of the

bacteria-coagulation build-up during adhesion and biofilm formation

in a flow chamber by using fluorescent microscopy with GFP-


S. aureus

and human plasma supplemented with fluores-

cent fibrinogen.


Using the model, we show that

S. aureus

creates an elaborate

biofilm on medical grade silicone containing both human fibrin(ogen)

and bacterial poly-N-acetylglucosamine (PNAG).

Discussion and/or Conclusion(s):

A new catheter biofilmmethod was

established and shown to model the bacteria-coagulation interplay



. This model will allow for future studies of novel catheter loading

agents targeting bacteria-induced thrombosis.

ID: 5181

Access to bladder scanners and specialist urology nurses in NHS

Trusts: room for improvement

Ammar Yusuf, Susan Hopkins.

Royal Free London NHS Foundation Trust


In England, there are >500,000 hospital onset urinary

tract infections (UTI) each year; 50% associated with a urinary catheter

(UC). At least 1% progress to bloodstream infections (BSI). The overall

effectiveness of bladder scanners in reduction of UTI is 75%. A quality

improvement programme for UC, including clinical nurse specialists

(CNS), reduced UTI by 75%.


To assess uptake of bladder scanners and access

to urology CNS in the NHS.


A freedom of information was sent to all NHS acute and

community/care (CC) trusts requesting the number of bladder

scanners registered in their equipment library, recent purchases of

bladder scanners in 2015/2016, number of urology CNS and hospital

training and policy records for bladder scanners.


A response was returned from 111 Trusts (21 CC; 89 Acute).

There was wide variation in the number of registered bladder

scanners in organisations (mean 17; range 0

74); this was not

significantly different between organisation type. In 2015/16, 63

trusts purchased new scanners. Bladder scanner training records

were more frequently available in Acute compared to CC trusts (72%

V 47%) but similar proportions had a policy for scanner use (36%

Acute V 38% CC). CC Trusts reported significantly less urology CNS

than Acute trusts (mean 0.4 V 4.2 whole time equivalent per


Discussion and/or Conclusion(s):

Bladder scanners and urology CNS

have proven clinical and cost-effectiveness in reducing UTI but are not

embedded in all NHS organisations. These will be important measures

for organisations to implement to achieve reductions in UTI and Gram-

negative BSI.

Topic: Diagnostics

ID: 4423

Klebsiella pneumonia New Delhi Metallo-beta-lactamase-1

outbreak in a Surgical Ward at Mater Dei Hospital

Noel Abela, Claire Marantidis Cordina, Elizabeth Scicluna,

Andrea Falzon Parascandalo, Michael Borg, Geraldine Borg,

Samuel Tanti.

Mater Dei Hospital


New Delhi metal-


-lactamase (NDM)-producing Gram-

negative bacteria have spread globally and pose a threat to all

healthcare institutions. We reported was the first of NDM outbreak

detected in Malta.


A highly resistant NDM-1

Klebsiella pneumoniae

(KP) was

reported from the rectal swab of a patient in a surgical ward at Mater

Dei Hospital in January, 2016; this was followed by a further case

within the same week. Cross-transmission was suspected; it was

decided to screen all patients rectally for CRE. A third case was

identified after the initial screening and ward was closed to further

admissions. Full contact precautions were implemented with a

dedicated nurse to the 3 confirmed cases. Furthermore all patients

that remained in the ward were screened from wounds, rectal and

those with a urinary catheter inserted for CRE twice weekly and a 4th

case was identified.


A retrospectively exercise was performed and another 2

patients were traced and identified in the same ward. VNTR typing

confirmed that these isolates were all of the same clone. No further

cases were reported.

Discussion and/or Conclusion(s):

We suspect that that NDM-1

KP was introduced to our hospital in 2011 when Libyan patients

were admitted for treatment during the Libyan crisis. This was not

detected before the outbreak because the PCR was not available at

the time.

Abstracts of FIS/HIS 2016

Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24