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Page Background

Outbreak management focused on a two stage decontamination

process: 1. NaDCC solution; 2. hydrogen peroxide (H2O2) vapour



Evaluate association of patient bed placement

with acquisition of

C. auris.


Retrospective audit.


217 patients who met cr69%iteria for sharing an environ-

mental with a positive

C. auris

patient. 14% (30/217) of patents were

subsequently found to be

C. auris


16 of the 30 positive patients had sequential bed occupancy that was

previously occupied by a positive

C. auris


14 of 30 patients had direct

C. auris

patient exposure suggesting a 20%

(16/82) risk with sequential admission into a bed space previously

occupied by a

C. auris

+ patient, 10% (14/135) risk (if a direct positive

patient exposure took place).

11/16 69% cases acquired

C. auris

despite the fact that the room

environment had been decontamination prior to occupancy. Including

three patients who were placed directly into single rooms.

Discussion and/or Conclusion(s):

Environment poses risk of trans-

mission of

C. auris


69% of patients acquired

C. auris

despite decontamination with 2

disinfectant process.

Further studies needed to demonstrate the efficacy of specific

decontamination process used in controlling the risk of transmission

from the environment. Finding may suggest that routes of transmis-

sion may be multifactorial not solely due to environmental contam-

ination. No particular source including mobile medical equipment has

been identified.

Topic: Fungal infections

ID: 4433

Mucocutaneous candidiasis in neonates and infants

Adnan Bajraktarevic


, Amra Junuzovic Kaljic


, Amra Dzinovic



Alisa Abduzaimovic


, Aida Djulepa Djurdjevic


, Faruk Alendar



Almir Masala


, Marela Spahovic


, Alija Drnda




Public Health

Institution of Canton Sarajevo-Health Center Vrazova Sarajevo-

Department for Preschool Children,


Pediatrics Clinic Sarajevo,


Biochemistry and Microbiology laboratory,


General Hospital Sarajevo,


Dermatology Clinic Sarajevo,


Cantonal Government Sarajevo- Ministry

for Education and Health,


Pharmacology Faculty-Department for Clinical



Infectious Clinic Sarajevo-Department for Children

Infectious Diseases


Candida infections are rarely serious in otherwise

healthy children. Systemic candidiasis is the most serious Candida

infection. It affects many parts of the body and is usually caused by an

immune deficiency. Chronic mucocutaneouscandidiasisis a cluster of

disorders of cell-mediated immunity that presents as chronic severe

candidal infections of the skin and mucous membranes. The clinical

manifestations of infection with


species range from local

mucous membrane infections to widespread dissemination with

multisystem organ fail.


The clinical manifestations of



in the neonate and infants vary, ranging from localized infections of

the skin andmucous membranes to life-threatening systemic infection

with multisystem organ failure.


The questions on test of dr Brian Martin help identify the

severity level of Candida overgrowth condition. Scoring this children


Candida questionnaire should help us to evaluate the role Candida

albicans contributes to child

s health problems.


There were 786 cases of mucocutaneous candidiasis during

last twenty years in dispansery for preschool children Center Sarajevo.

From that total number of children there were 502 (63,87%) cases in

neonates or infants until 12 months.

Discussion and/or Conclusion(s):

Symptomatic infections such as

thrush and


diaper dermatitis may develop at any age

thereafter, particularly following broad-spectrum antibiotic treat-

ment. Systemic candidiasis is rare, but is a particular risk for premature


ID: 4540

An unusual case of disseminated yeast infection

Tara Moshiri, Nikunj Mahida, Tim Boswell.

Department of Microbiology,

Nottingham University Hospitals


Trichosporon Mycotoxinivoras is a yeast that was first

isolated in 2004 from a termite hindgut. It has the ability to detoxify

mycotoxins and was given the above name meaning



in Latin. It was first described as a human pathogen, in

2009, causing pneumonia in a patient with cystic fibrosis. In 2012, the

first disseminated case was identified, in a patient with cystic fibrosis

who had received a double-lung transplant.


To the best of our knowledge, this is the first case

of disseminated Trichsoporon Mycotoxinivorans infection in a cystic

fibrosis patient, diagnosed outside North America and in the absence

of lung transplantation.


The patient was transferred from a peripheral hospital

with severe, non-resolving pneumonia, to the intensive care unit for

specialist cystic fibrosis management. Yeast was cultured from

sputum, broncho-alveolar lavage and blood cultures. The organism

could not be identified using chromogenic media or Vitek-2

(bioMérieux). Ambisome was started for broad-spectrum antifungal

coverage whilst identification was pending.


Reference laboratory techniques using Maldi-Tof provided the

identification but the patient unfortunately had significantly deterio-

rated and a decision was made for palliative treatment.

Discussion and/or Conclusion(s):

This case highlights an important

pathogen for cystic fibrosis patients that hereto has not been seen in

the UK. The recommended treatment option is a combination of

Voriconazole and Ambisome. This combination of antifungal agents is

not commonly used but could be considered in cystic fibrosis patients

with suspected disseminated yeast infection until the organism is


ID: 4552

An audit of the management of invasive candidiasis

Faiha Eltayeb, Vivienne Weston.

Nottingham University Hospitals


Candidaemia is associated with significant morbidity

and mortality. National and international standards of care advocate

specific measures regarding appropriate management.


To evaluate management of invasive candidae-

mia against practice guidelines. A compliance of 85% is set as

acceptable recognizing complexity of case and presentations.


A retrospective study identifying twenty positive blood

cultures together with recorded final identification and sensitivities.

Administered antifungals, duration of management and outcomes

were recorded from clinical notes. Audit templates has been driven

from referenced guidelines, extracted data were examined against

recommended standards.


Of the 20 cases identified, 100% had final identifications and

sensitivities. 80% of cases had central lines removal within 48 hours of

positive cultures, 81% were started on appropriate antifungals, ocular

involvement was sought and evaluated only in 36% of the cases. In 70%

of cases treatment was not deescalated as recommended and only 40%

of cases received 14 days of treatment after clearance blood culture as


Discussion and/or Conclusion(s):

All isolates were identified and

had appropriate sensitivities. There was timely removal of central

lines with explanation documented in cases where lines weren


removed, escalation /de-escalation of management was less evident

particularly in Candida albicans infection. Ocular involvement was

recommended/sought in less than half of the cases. There need to be

emphasis on advising 2 weeks of treatment following clearance blood


Abstracts of FIS/HIS 2016

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