P17.02 An outbreak Of Staphylococcus aureus after thoracoscopy

Abstract

s, 7th International Conference of the Hospital Infection Society, 10–13 October 2010, Liverpool, UK / Journal of Hospital Infection 76S1 (2010) S1–S90 S53 flagging system for at risk patients was developed and implemented in October 2005. Education was delivered through formal and informal means. HCWwere targeted at both undergraduate through links with academic bodies and postgraduate level through practice support programs and medical grand rounds etc. Specific clinical units were targeted as part of outbreak management. The audit was repeated in 2008 and 2010 using the same tool. Comparable audit reports were widely disseminated to clinicians and hospital management. Results: Between April 2005 and April 2010 a significant improvement in practice of TBP was observed. Up to 90% of patients colonised/infected with meticillin resistant Staphyloccus aureus (MRSA) were isolated/cohorted in 2010. Conclusions: Sustained education, audit and feedback, supported by protocols and risk management tools have influenced staff knowledge of IPC practices and strategies to control spread of transmissible organisms. Although practice improvement is apparent there remain deficits and challenges in the application of TBP in this hospital. P17.02 An outbreak Of Staphylococcus aureus after thoracoscopy Y. Hendriks, H. Coertjens, M. v. Rijen, J. Kluytmans. Amphia Hospital, Netherlands Background: In a period of 6 weeks there were 4 patients with a Staphylococcus aureus infection after thoracoscopy. Objective: To investigate and control an outbreak of S. aureus after thoracoscopy. Methods: The department of Infection control audited the procedures during thoracoscopy. The healthcare workers (HCW) who were present during the procedures were screened for nasal carriage of S. aureus. All isolates were typed (AFLP). Results: The audit demonstrated that the thoracoscopy took place in a standard hospital room instead of a operation room class II (as recommended by the National guidelines), multiple breaks in infection principles during the procedure e.g. no scrub suits and the lack of knowledge of universal principles of hygiene. AFLP learned that three of the four patients were infected with the same strain. Twelve out of 31 (39%) HCW were nasal carriers of S. aureus. One of the HCW had the same type as the three patients. The following corrective actions were implemented: the HCW with the outbreak strain was treated for carriage and not allowed to work until eradication was achieved, thoracoscopy procedures were performed in the operating theatre, HCW involved in the procedures were trained in the principles of infection control. Follow up during >12 months revealed no infections after thoracoscopy. Of note, the HCW who carried the outbreak strain was recolonised with the same strain 5 months after the eradication treatment. She is allowed to work with this strain under the assumption that the current control measures prevent the spread to patients. No further infections have been found. Conclusions: An outbreak of S. aureus infections after thoracoscopy was traced to a colonised HCW. The suboptimal environmental conditions and breaks in general hygienic measures during the procedures were probably the main cause of the outbreak. The outbreak was terminated by improving the environmental conditions as well as the behavior of the HCW. P17.03 Infection control measures taken during lumbar punctures: a survey of current practice S. Kelly, R. Malhotra. University Hospital Coventry and Warwickshire, United Kingdom; Weston General Hospital, United Kingdom Background: Infective complications of lumbar puncture are not common but are a significant source of morbidity and mortality. It is likely that adhering to infection control measures when carrying out a lumbar puncture will minimize the risk of iatrogenic meningitis. However there is no clear consensus in the literature as to the most appropriate methods to use. Objective: The aim of this survey was to assess what infection control measures doctors currently use when performing lumbar punctures. Methods: We constructed an anonymous, tick-box survey asking about specific infection control measures taken when performing lumbar punctures. This was distributed to doctors in all medical specialties in the West Midlands and Severn Deaneries. Results: The response rate was 63% (119/188 responses) but 12 forms were incomplete and so not included. According to grade, we surveyed 62 (58%) CT1–2 doctors, 27 (25%) ST3–5 doctors and 18 (17%) Senior Registrars. Responders had performed, on average, a total of 16 lumbar punctures (range 3–45). Results show that all doctors use hand-washing, sterile gloves and skin preparation but significant numbers never wore facemasks or caps (Table 1). CT 1–2 doctors were three times more likely than SpRs to perform all of the infection control measures stated (36% vs. 10%, Table 2). Similarly, the number of infection control measures taken by doctors decreased with the number of times the procedure had been performed. Table 1. Infection control measures taken by doctors when performing