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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


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


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.


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




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


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



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.


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


Topic: Education and training

ID: 4429

Prospective analysis of patient safety in operation room

Fatemeh Mousavi


, Ali Vahdani




Iranian Hospital,


Iranian Hospital


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



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



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.


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


Stephane Talbit Ndjonya


, Enow Ashuntantang Gloria



Hortense Gonsu Kamga


, Sinata Koulla Shiro



Sylvain Raoul Simeni Njonnou


, Aime Timnou Tiodoung



Anne Ongmemb Boli




Erasmus University Teaching Hospital,


Department of Internal Medicine, Faculty of Medicine and Biomedical



Department of Microbiology, Faculty of Medicine and

Biomedical Sciences


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



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.


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.


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