The Journal of Hospital Infection - Supplement 1

intensive care units followed by surgical patients and haematology/

oncology patients.

Most isolates grew in both aerobic and anaerobic blood culture bottles.

The predominant species was

C albicans

(51%) followed by

C glabrata

(25%) and

C parapsilosis

(14%). 74% of the isolates were sensitive to

fluconazole. Resistance to fluconazole was common in

C glabrata

. A

third of the CBSI had evidence of candida colonisation in one or more

sites.

Discussion and/or Conclusion(s):

Over the 10 year period, there has

not been a significant difference in the incidence of CBSI in UHL.

Majority of the isolates are

C albicans

and are susceptible to

fluconazole.

ID: 4893

Uniform susceptibility of non-albicans Candida spp. from blood

stream infections to the echinocandin class of antifungals at a

geriatric hospital

Saugata Choudhury.

Tan Tock Seng Hospital

Background:

C. albicans

is deemed uniformly susceptible to the

commonly used antifungals while echinocandin resistance is emer-

ging among non-

albicans Candida spp

(NACS).

Aim(s)/Objective(s):

We aimed to evaluate the level of resistance

among NACS from blood stream infections to the echinocandins at our

institution.

Method(s):

At our 1500 bedded tertiary care hospital, susceptibility is

performed employing the Sensititre

YeastOne

on index isolates

from positive blood culture broths (BACTEC FX

Becton Dickinson).

The LIS was interrogated to characterize the susceptibility profile for all

strains of NACS isolated from the bloodstream between January 2014

and June 2016.

Results:

Seventy two isolates {

C.glabrata

(41),

C.tropicalis

(23) and

parapsilosis

(8)} had a susceptibility test performed on them.

Remarkably, all strains of

C. glabrata

tested uniformly susceptible to

the three echinocandins. Uniform susceptibility was also noted for

tropicalis,

a species for which non susceptibility to the triazoles hovers

in the vicinity of 20% locally.

Discussion and/or Conclusion(s):

Nephrotoxic agents including

amphotericin B may not find favour in a geriatric population like

ours with liposomal formulations being several folds more expensive

than the echinocandins.

The uniform susceptibility maybe attributable to our centre being a

predominantly geriatric centre which does not share the vulnerable

group of transplant patients where empirical/prophylactic echinocan-

din usage is rampant. Increasing echinocandin consumption serves as

a harbinger of

C.parapsilosis

infections. Lack of resistance to the

candins in our study was temporally associated with only 10 episodes

of candidemia due to this species.

In this era of multidrug resistance, our virgin population could help

elucidate the epidemiology of echinocandin resistance.

ID: 4990

Use of B-D-Glucan to aid diagnosis of Pneumocystis Jiroveci

Pneumonia (PCP)

Juliette Mutuyimana

, Juliette Mutuyimana

, Nelun Perera

Aashima Saibudeen

Leicester Royal Infirmary

Background:

Pneumocystis Jiroveci Pneumonia (PCP) causes serious

infection in the immunocompromised patients, with mortality

remaining high. Non-invasive diagnostic techniques including 1,3

Beta D-Glucan can be used for the presumptive diagnosis of PCP.

Aim(s)/Objective(s):

To evaluate and compare the levels of serum 1,3,

B-D-Glucan in patients with positive and negative PCP Polymerase

Chain Reaction (PCR) at University Hospitals of Leicester over a 2.5 year

period (2014

–

2016).

Method(s):

Laboratory and clinical data of patients who had suspected

PCP and had a bronchoalveolar lavage (BAL) or sputum for PCP PCR

were reviewed. Data for all patients was analysed to determine

whether or not they had B-D-Glucans tested and the serum levels were

compared.

Results:

A total of 304 patients with suspected PCP had PCP PCR tested

in BAL or sputum. 65 patients tested positive and 239 patients tested

negative.

Of the patients with positive PCP PCRs and B-D-Glucan tested, 11

patients (52%) tested positive, 9 patients (43%) tested negative, 1

patient (5%) was equivocal. 7 patients (64%) had levels in the upper

range (300

–

500 pg/mL), and 4 patients (36%) in the lower range (80

–

299 pg/mL).

Of the patients with negative PCP PCRs and B-D-Glucan tested,

58 patients (72%) tested negative, 20 patients (25%) tested positive,

3 patients (4%) were equivocal. Of the patients with positive

B-D-Glucans, 9 patients (45%) had levels in the upper range

(300

–

500 pg/mL). However, all 9 patients had either candida in

sputum/BAL and/or were already on treatment for PCP.

Discussion and/or Conclusion(s):

1,3-B-D-Glucan can help in the

presumptive diagnosis of PCP and high levels appear to correlate with

the diagnosis.

ID: 5004

Chronic pulmonary aspergillosis

–

are we referring patients to the

national referral centre?

Alessandro Gerada, Liam Bailey, Mike Beadsworth.

Royal Liverpool

University Hospitals

Background:

Chronic pulmonary aspergillosis (CPA) consists of a

heterogenous group of conditions including aspergilloma, aspergillus

nodule and cavitatory pulmonary aspergillosis. Treatment requiring

posaconazole or voriconazole is prolonged and carries a high cost

burden.

Aim(s)/Objective(s):

We reviewed all patients in our Trust who have

been prescribed voriconazole or posaconazole. In particular, we

reviewed those with CPA, and whether they had been referred to the

National Aspergillosis Centre at the University Hospital of South

Manchester (Wythenshawe, Manchester).

Method(s):

Patients dispensed voriconazole or posaconazole between

2013 and 2015 were included. Patients were identified by searching

through inpatient and outpatient prescription records. We noted the

following data:

•

presence of immunosuppression,

•

diagnosis,

•

indication for antifungals

•

radiology reports,

•

microbiology results.

Results:

97 patients were dispensed voriconazole/posaconazole. Of

these, 78 (80%) were immunosuppressed and were therefore not

suitable for referral to the National Aspergillosis Centre. From the

remaining 19, 8 (42%) patients fulfilled the referral criteria for the

National Aspergillosis Centre, of which only one (12.5%) had been

referred.

Discussion and/or Conclusion(s):

Patients with CPA should be

considered for referral to the National Aspergillosis Centre as this

could lead lead to improved clinical care and improved antifungal

stewardship. We aim to develop a care pathway to identify patients

with CPA and collaborate with clinicians to arrange referral.

ID: 5027

Candidaemia in a London teaching hospital 2010

–

2015

Marcella Vaselli, Charlie Williams.

SGUL

Background:

Candidaemia is widely recognized as a major cause of

mortality and morbidity in the healthcare environment. Guidelines

published by the IDSA address diagnosis, investigation and

management.

Aim(s)/Objective(s):

To describe the epidemiology of adult candidae-

mia and adherence to published standards in a large teaching hospital.

Method(s):

The microbiology Apex computer system identified blood

cultures positive for Candida species between 2010 and 2015.

Abstracts of FIS/HIS 2016

–

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

–

S134

S91