92 / 150
Results:
Typing of the blood culture and water isolates revealed the
same strain of
C. pauculus
. Little used outlets were removed. Taps were
cleaned and descaled. Dosing of thewater supply was undertakenwith
silver hydrogen peroxide (Sanosil). Review of procedures in the unit
and infection control education to unit staff was undertaken.
Discussion and/or Conclusion(s):
C. pauculus
is an environmental
organism which can contaminate hospital water supplies and lead to
infections in patients. Investigations should include identification of
little used outlets, dead legs and identification of practice issues.
Control measures include cleaning and descaling of taps and dosing
with silver hydrogen peroxide.
ID: 4764
Air microbial sampling in operating theatres by active and passive
methods: comparison with EU GGMP recommendation
Cesira Pasquarella
1
, Francesco Auxilia
2
, Martina Barchitta
3
,
Maria Luisa Cristina
4
, Daniela D
’
Alessandro
5
, Ida Mura
6
, Marta Nobile
2
,
Antonella Agodi
3
, Italian Study Group of Hospital Hygiene (GISIO)
7
.
1
University of Parma,
2
University of Milan,
3
University of Catania,
4
University of Genoa,
5
Sapienza University of Rome,
6
University of Sassari,
7
Italian Society of Hygiene, Preventive Medicine and Public Health (SItI)
Background:
Within the GISIO-ISChIA study of surgical operations
(Agodi et al., 2015) a significant correlation (
P
< 0.001) was found
between airborne microbial contamination measured by active
sampling (colony-forming units per cubic metre, cfu/m
3
) and passive
settle plate sampling (Index of Microbial Air Contamination, IMA).
Aim(s)/Objective(s):
This was to obtain an equation that correlates the
microbial air contamination values of cfu/m
3
and IMA, and compare
the values obtained with the recommended limits defined by the EU
Guidelines to Good Manufacturing Practice (EU GGMP, 2008) for
clean areas used to manufacture sterile medicinal products. The EU
GGMP values were: Grade B: 10 cfu/m
3
, 5 cfu/settle plates 90 mm in
diameter/4 h; Grade C: 100 cfu/m
3
, 50 cfu/4 h; Grade D: 200 cfu/m
3
,
100 cfu/4 h.
Method(s):
The cfu/m
3
was measured during surgical operations by an
air sampler and the IMA values obtained from the number of cfu that
settled on 9 cm diameter settle plates during a one hour period.
Results:
The following correlation equation was obtained: y = 1.86 +
0.12x, where
“
x
”
= cfu/m
3
value and
“
y
”
= IMA value. Using this
equation, when cfu/m
3
values were 10, 100 and 200, gave IMA values
of 3.06, 13.86, and 25.86, respectively, which compared well to EU
GGMP values of 1.25, 12.5, and 25.
Discussion and/or Conclusion(s):
The relationship between cfu/m
3
and IMAvalues obtained from active and passive sampling during the
GISIO-ISChIA study are similar to those suggested by the EU GGMP for
pharmaceutical manufacturing, and the EU GGMP relationship could
be applied in operating theatres.
ID: 4816
The nasal carriage of MRSA among tobacco smokers
Galina Kuznecova, Sergejs Kuznecovs, Klara Jegina.
Preventive Medicine
Institute
Background:
Smoking tobacco is known to suppress the immune
system and disturbe normal nasal flora. Hypothetically tobacco
smoking could be associated with
methicillin-resistant Staphylococcus
aureus
(MRSA) formation in the upper respiratory tract.
Aim(s)/Objective(s):
The aim of the present investigation was to
detect the amount of MRSA carriers among tobacco smokers.
Method(s):
Nasopharyngeal swabs MRSA and nasal tissue samples
were taken from 4690 smokers and 4500 non-smokers enrolled for
long-term study from1998 through 2014. Person
’
s smoking behaviour,
age, gender, morbidity and use of antibiotics was recorded.
Results:
MRSAnasal carriagewas found in1% of non-smokers and in4%
of tobacco smokers in 1998, in 1,5% of non-smokers and in 6% of
smokers in 2000, 1,7% and 8,4% in 2001, 1,7% and 9,2% in 2002, 1,5%
and 9% in 2003, and 1,2% and 10% in 2004, 1,3% and 12,1% in 2008, 2%
and 13,6% in 2014. Male smokers ages 50
–
65 years (p < 0.001),
antibiotic use (p < 0.02), rate of hospitalization (p = 0.005), and specific
local IgE level (p < 0.001) were significantly associated with MRSA
colonization.
Discussion and/or Conclusion(s):
The nasal carriage of MRSA among
tobacco smokers is high, undetectable, and growing. It is possible that
tobacco smoking maybe the cause of nasal carriage of MRSA. From
other risk factors for MRSA nasal carriage including antibiotics, rate of
hospitalization, contact with health-care workers, previous MRSA
infection, older age, diabetes and obesity, smoking is most significant
because of its effect on immune system. Smokers becoming increas-
ingly more contagious.
ID: 4847
Impact on incidence rates of multidrug-resistant
Pseudomonas
aeruginosa
and
Klebsiella pneumoniae
after eliminating hand
washing sinks in an intensive care unit
Evelyn Shaw, Pilar Ciercoles, Sara Grillo, Laura Gavaldà,
Carmen Gutierrez, Dolors Garcia, Fe Tubau, Jordi Camara,
Rosa Granada, Ariadna Padulles, Jordi Carratala, Miquel Pujol.
Hospital
Universitari de Bellvitge-IDIBELL
Background:
Hand washing sinks have been recognised as reservoirs
in long-term outbreaks of multidrug-resistant (MDR) Gram-negative
bacteria (GNB). In our hospital, intensive care unit (ICU) had high rates
of MDR
Pseudomonas aeruginosa
(MDR-PA) and
Klebsiella pneumoniae
(MDR-KP) despite implementing a standardised programme for
controlling MDR-GNB since 2012. In August 2014, sinks from all
patient rooms were removed and patient hygiene procedure was also
changed.
Aim(s)/Objective(s):
To assess the impact of removing hand washing
sinks on incidence of clinical samples with MDR-PA and MDR-KP in a
24-bed ICU one year after the intervention.
Method(s):
Patients with positive clinical samples with MDR-PA or
MDR-KP were prospectively collected from January 2012 to December
2015. New cases are shown as number of cases and rates per 1,000
patient-days.
Results:
A total of 152 patients with a first clinical sample were
identified, 78 (51%) hadMDR-PA [59 (40%) only susceptible to amikacin
and colistin, and 19 (12%) carbapenemase-producing]; 74 (49%) had
MDR-KP [64 (42%) Extended spectrum
β
-lactamase-producing and 10
(6%) carbapenemase-producing]. Incidence rates in 2012 and 2015
were respectively 5.7 and 1.3 per 1000 patient-days (p < 0.001) for
MDR-PA and 4 and 0.9 per 1000 patient-days (p < 0.001) for MDR-KP.
Discussion and/or Conclusion(s):
Removing hand washing sinks from
patient rooms and changing hygiene procedure contributed in a
significant reduction of MDR-GNB in this endemic ICU, although did
not reach total eradication.
ID: 4971
Methodological approach of assessing present state of technical
processes in hospitals regarding risk management of Legionella in
UK, GER and CH
Thomas Leiblein
1
, Matthew Tucker
2
, Mal Ashall
2
, Susanne Lee
3
,
Carsten Gollnisch
4
, Susanne Hofer
5
.
1
Liverpool John Moores University
(PhD candidate) Zurich University of Applied Sciences (work),
2
Liverpool
John Moores University,
3
Leegionella Ltd.,
4
Hygieneinspektionsstelle für
Trinkwassersysteme,
5
Zurich University of Applied Sciences (ZHAW),
Institute of Facility Management
Background:
The complexity of hospitals is made up of the
organisational structure as well as the technical systems within the
building. Process owners act within a highly interdisciplinary field,
recognising regulations and organisational barriers. Activities regard-
ing risk management require interdisciplinary work. Literature merely
reports on
Legionella
prevention seen from a clinical perspective
rather than from a technical one. But technical services operate
systems. They may have deeper knowledge of the system itself.
Potential threats coming from the system are to be considered.
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S87