86 / 150
This case demonstrates both the utility of PET scan, a new test, to
localise disease and provided a target for biopsy, but also an old test,
stool culture for mycobacteria, to reach the diagnosis of cryptic
Mycobacterium bovis
lymphadenopathy.
ID: 5161
Direct identification of blood culture isolates
–
a key to improved
antibiotic stewardship?
Emily Goldstein, Aleksandra Marek, Mairi Macleod.
NHS Greater
Glasgow and Clyde
Background:
Identification of isolates directly from blood culture fluid
using MALDI-TOF permits preliminary result reporting of pathogens in
around 30 minutes. This rapid turnaround time allows targeted
antibiotic therapy resulting in improved patient management and
antibiotic stewardship.
Results:
In this study we performed direct identification of isolates
from 102 blood culture bottles which flagged positive, using a
centrifugation method and compared these results to identifications
obtained using traditional culture and identification methods. Correct
identification was achieved in 65% of monomicrobial infections
compared to traditional methods, with a greater proportion of Gram
negative organisms being correctly identified (69%) than Grampositive
organisms (63%). Ten blood culture bottles investigated in this study
were polymicrobial, the direct identification method correctly identi-
fied one organismin7of these samples, in each case the likelypathogen
was identified (e.g.
Staphylococcus aureus
or
Enterococcus
spp.)whereas
probable contaminants were not. We also performed a retrospective
analysis of antibiotic prescribing for patients included in this study to
determine whether the correct identification of blood culture isolates
using direct identificationmethods, improving the turnaround time by
at least one day, would improve antibiotic prescribing practice and
could in turn improve patient outcome.
ID: 5165
A retrospective analysis of the investigation of suspected
meningitis in an Acute Medical Unit
Katharine Relph, Jenni Crane.
NHS Lothian
Aim(s)/Objective(s):
To assess current practice in the investigation of
suspected meningitis in view of the newly published UK joint
specialist guidelines, and to establish areas of practice that require
improvement.
Method(s):
A retrospective audit of all patients presenting with
suspected meningitis who had lumbar puncture (LP) for suspected
meningitis over an eighteen month period was performed. Case
identification was undertaken by reviewing all CSF samples received
by laboratories. Data was collected from case notes using a pro-forma
adapted from the recent guidelines.
Results:
75 patients were included. 2 patients had their LP in <1 hour.
Mean time to LP was 13 hours (range 1
–
107) from presentation. 57
patients had neuro-imaging prior to LP. In 22 of these patients there
was no indication for this. Other reasons for delayed LP included
uncontrolled seizures, deteriorating GCS, agitation, patient refusal, and
technically challenging LPs. 54 patients had blood cultures sent and 18
patients had blood sent for bacterial PCR.
Discussion and/or Conclusion(s):
A significant majority of patients
waited >1 hour for a LP. The most common factor for delay was waiting
for neuro-imaging.
To improve the investigation of these patients the following interven-
tions have been implemented:
•
Reduce unnecessary requests for intracranial imaging through
education of medical staff
•
Simulated LP teaching for medical trainees
•
Improved accessibility to equipment (e.g. LP packs) to facilitate
timely LP
•
The use of electronic ordering bundles for blood cultures and
bacterial PCR.
Further prospective analysis will be undertaken to assess the above
proposals.
Topic: Education and training
ID: 4429
Prospective analysis of patient safety in operation room
Fatemeh Mousavi
1
, Ali Vahdani
2
.
1
Iranian Hospital,
2
Iranian Hospital
Background:
In order to find out strength and weaknesses in
our health system, we point out to patient safety as a whole and its
details such as many helping factors, likewise any failure in
communication.
Aim(s)/Objective(s):
We performed a research about patient care
using Prospective Observational Technique. Considering any failure
that is critical for patient
’
s life and by resolving them before
they happen, we can create a safer environment for ongoing
surgery in operation rooms and drawing attention of staff to potential
faults.
Method(s):
First of all, one survey was created to evaluate staffs
’
knowledge about patient safety and considered methods to prevent
any errors and then a one-page formwas prepared to collect faults and
near miss cases errors in the duration of research. The preferred
research method was correlational method because of different
aspects of research.
The duration was only one month as a start point and main
participants were staff of the operation room in Iranian hospital
Dubai. In next step analyzing was done based on LOTICs score and as a
result we recommended some solutions to remove problems like wise.
Results:
Based on collected data, we found out there are many
important negotiable problems about patient safety in operation
room. First of all, miscommunication is important issue, also we found
out some gaps on training and education in OT.
Discussion and/or Conclusion(s):
Improving communication among
staff, arranging training course in hospital, managing work load
…
, can
help to create safer place for doing surgeries.
ID: 4435
Knowledge, attitude and practices of health care workers on
preventive measures of hospital acquired infections are poor in
Yaounde
Stephane Talbit Ndjonya
1
, Enow Ashuntantang Gloria
2
,
Hortense Gonsu Kamga
3
, Sinata Koulla Shiro
3
,
Sylvain Raoul Simeni Njonnou
2
, Aime Timnou Tiodoung
2
,
Anne Ongmemb Boli
2
.
1
Erasmus University Teaching Hospital,
2
Department of Internal Medicine, Faculty of Medicine and Biomedical
Sciences,
3
Department of Microbiology, Faculty of Medicine and
Biomedical Sciences
Background:
In Cameroon, isolation of resistant bacterial strains at
the Yaounde Central Hospital (YCH), closure of Intensive care unit
(ICU) of YCH and Yaoundé University Teaching Hospital (YUTH)
for disinfection as a result of nosocomial infection, make hospital
acquired infections a major problem in our environment. There is no
sensitization, and specific control program for this health issue in
Cameroon.
Aim(s)/Objective(s):
The aim of our study was to evaluate knowledge,
attitudes and practices of health care workers of YGH, YUTH and YCH
on preventive measures towards nosocomial infections.
Method(s):
We carried out a descriptive cross-sectional study in the
above mentioned health institutions from May to September 2015. It
was a consecutive sampling. Data were collected via a self-adminis-
tered and anonymous questionnaire.
Results:
Our study population was made of 63 health care workers.
Most of the health care workers had less than 5 years experience
(n = 28). None of the professional had good knowledge. 80 to 87.5% had
poor knowledge. Hand hygiene was the least known preventive
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S81