risk assessment of the exposure of people to methicillin resistant staphylococcus aureus mrsa from dogs

52 Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163 Methods & Materials: A retrospective analysis of case histories of patients with a clinical diagnosis of ARIs complicated with community-acquired pneumonia in children Age of children ranged from one month to five years Patients were treated in viral diseases branch of municipal children’s infectious diseases hospital in Astana Patient’s data of antibacterial records were analyzed in outpatient stage in order to monitor antibiotic therapy We developed an antibiotic map which includes the data on antibiotics obtained before entering the hospital for the last months, indicating the dose and duration of outpatient treatment, as well as antibiotics that the patient received in the hospital, the dose and duration This card was put into practice in the hospital from 2009 This allows us to track the quantitative and qualitative characterization of antibacterial therapy in hospital Statistical data calculation was performed using Excel 2010 software and SPSS Statistics 20.0 Results: We analyzed 395 cases patients in the viral disease branch with a clinical diagnosis of ARIs complicated with community-acquired pneumonia The average age of studied patients was - 20.48 +- 13.95 months The antibacterial card was revealed that 57 (14.4%) patients out of 395 got antibiotics before hospitalization At the time of admission, the period from the beginning of illness averaged - 3.2+2.1 days Among the antibiotics the most commonly used were semi-synthetic aminopenicillin (40.3%), inhibitor protected semi-synthetic aminopenicillin (17.5%), macrolides (15.6%) 2-generation cephalosporins (12.3%), 3rd-generation cephalosporins (8.7%) During the appointment of antibacterial therapy, physician will base on the obtained data in order to avoid irrational use of antibiotics Conclusion: The use of antibacterial cards, with the aim of monitoring of used antibiotics in the hospital, allowed to improve the quality of the causal treatment, to reduce significantly the time of the patient’s stay in hospital and to reduce drug polypharmacy http://dx.doi.org/10.1016/j.ijid.2016.11.133 19.054 Pefloxacin as a surrogate marker to determine susceptibility to quinolones drugs in Salmonella enterica Serovar Typhi: Structural and molecular analysis P Sharm a,∗ , M Kumar b , S Dahiya c , P Kaur d , S Sood c , B.K Das c , A Kapil c a All India Institute of Medical Sciences, Microbiology, Delhi, DELHI/IN b All India Institute of Medical Sciences, Biophysics, NEW DELHI/IN c All India Institute of Medical Sciences, Microbiology, NEW DELHI/IN d All India Institute of Medical Sciences, Biophysics, New Delhi, DELHI/IN Purpose: Quinolones remain the mainstay for enteric fever treatment since past four decades after the emergence of MDR strains of S Typhi CLSI recommends the pefloxacin susceptibility as a surrogate marker for ciprofloxacin, ofloxacin and levofloxacin susceptibility for treatment of enteric fever susceptibility We analyzed the sensitivity and specificity of pefloxacin as a surrogate marker for all quinolones by using susceptibility analysis with current CLSI guidelines, detection of molecular mechanisms of resistance and drug target interactions by molecular docking Methods & Materials: Antibiotic susceptibility to ciprofloxacin, ofloxacin and levofloxacin were determined in 321 isolates of S Typhi as per CLSI guidelines The correlational analysis was done for pefloxacin zone of inhibition and MIC of ciprofloxacin, ofloxacin and levofloxacin Temporal analysis was done by ChiSquare test for trend using SPSS ver 17.0 DNA sequencing was done for quinolone resistance determining region (QRDR) of gyrA, gyrB, parC and parE genes of target enzymes and mutations were compared to pefloxacin susceptibility Drug target interaction was studies by molecular docking Homology model of DNA gyraseDNA complex was determined using templates 1AB4 and 2XCT in prime modeling software Molecular docking of ciprofloxacin, ofloxacin, levofloxacin and pefloxacin drug molecules was done Binding mode and docking score were determined for each drug Results: Pefloxacin susceptibility and resistance showed a predictive value of 0.99 and respectively Most common mutations were Ser83 and Asp87 of gyrA gene No mutation was found in QRDR of pefloxacin susceptible strains Docking confirmation was same for all quinolones studied The binding was stabilized by stacking interaction of quinolone ring and aromatic base pairs of DNA and carboxylate group interacts with the ser83 residue of GyrA subunit Docking score for ciprofloxacin, ofloxacin, levofloxacin and pefloxacin were -11.666, -11.349, -11.348 and -8.269 respectively Conclusion: The mode of binding and conformation of pefloxacin is same as ciprofloxacin, levofloxacin and ofloxacin but binding affinity is less than all these three antibiotics as confirmed by docking score It is concordant with the CLSI criteria that an isolate susceptible with pefloxacin is automatically susceptible to all fluoroquinolones, hence it is a good surrogate marker for fluoroquinolones susceptibility http://dx.doi.org/10.1016/j.ijid.2016.11.134 19.056 Risk assessment of the exposure of people to methicillin-resistant Staphylococcus aureus (MRSA) from dogs M.I Neves, J Pinto Ferreira, K Stärk ∗ SAFOSO, Liebefeld/CH Purpose: The purpose of this study was to assess the risk of exposure of people to MRSA from dogs, via direct and indirect pathways, with special emphasis on companion animal veterinarians This scenario was used as an example of cross-species spread of antimicrobial resistance genes Methods & Materials: We conducted a risk assessment to quantify the probability of exposure of people, specifically veterinarians to MRSA Risk pathways included both direct and indirect (e.g environment) transmission A 24h-time period was considered to estimate the probability of potential exposure Input data was collected through a literature review When information was not available, expert opinion was considered Palisade decision tools (@Risk 7.0.1 Pro edition) were used to construct the risk simulation model The outcome was the probability of exposure within the defined time window Repeated exposure and exposure load were not considered Sensitivity analysis was performed to quantify the relative significance of each of the model input parameters Results: The risk of exposure to MRSA from dogs appears to be low, for individuals with no occupational exposure (2.4x10-8 ) and one order of magnitude higher for companion animal veterinarians Most of the available literature focused on reporting cases where similar isolates of MRSA were found in dogs and humans, but there are important data gaps for parameters including exposure load It is therefore currently not possible to reliably quantify the significance of the different transmission pathways or even to rank them Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163 Conclusion: No significant exposure to MRSA and therefore no indication of related adverse health effects from dog ownership or occupational exposure of small animal veterinarians were identified However, we only considered a 24h-time period of potential exposure In a scenario of prolonged colonization of an animal the repeated daily contact will result in cumulative exposure Also, exposure does not necessarily mean risk More work is needed to understand the health consequences of exposure to resistance genes, particularly MRSA http://dx.doi.org/10.1016/j.ijid.2016.11.135 19.058 Uropathogens and antimicrobial susceptibility patterns in urinary tract infections diagnosed in the primary care setting in Singapore M.X Tan a,∗ , K Mannath b , L.P Ng b , P.L Hu b , K.S.P Moey b , K.T Tan b , Y.L.A Koong b , T.Y Tan c , C.S Wong a , N.C Tan b a Tan Tock Seng Hospital, Institute of Infectious Diseases and Epidemiology, Singapore/SG b SingHealth Polyclinics, Singapore/SG c Changi General Hospital, Singapore/SG Purpose: Urinary tract infection (UTI) is a frequent condition encountered in primary care Treatment is usually empirical without urine culture or susceptibility testing because the causative uropathogens and their antimicrobial susceptibility profiles are considered to be predictable However, there is increasing evidence of antimicrobial resistance in community-acquired uropathogens This cross-sectional study aims to describe the distribution of uropathogens and their antibiotic susceptibilities amongst patients who were diagnosed with UTI in primary care clinics in Singapore Methods & Materials: Patients with UTI diagnoses (by their primary care physicians) were recruited from two public sector primary care clinics under the SingHealth Polyclinics in Singapore Upon enrolment, data on diagnosis, symptoms, risk factors for antimicrobial resistance and antibiotics prescribed for this UTI episode were collected Each patient provided a clean-catch midstream sample for urine culture at the routine diagnostic laboratory of Changi General Hospital in Singapore A positive urine culture was defined as isolation of ≥103 colony forming units (cfu)/ml of primary urinary pathogens (Escherichia coli, Klebsiella spp or Staphylococcus saprophyticus) in pure culture, or isolation of ≥105 cfu/ml of these organisms as predominant growth The significance cut-off for culture of other potential urinary pathogens were ≥105 cfu/ml Susceptibility to antibiotics commonly used for UTI was assessed using disc diffusion methods using standard cut-offs Descriptive statistics on the prevalence of different uropathogens and their antibiotic susceptibilities are presented, with Pearson’s chi-square test used to assess differences between subgroups Results: Of 380 urine samples collected, 177 (46.2%) yielded positive cultures There were no significant associations between the urine cultures result and ethnicity or age group E.coli (n=135, 76.3%) and Klebsiella ssp (n=14, 7.9%) were the two most common pathogens isolated, for all gender and age groups The E.coli strains demonstrated high non-susceptibility to Amoxicillin (46.7%), Cephalexin (60.7%), Ciprofloxacin (30.4%), Trimethoprim(29.6%) and Trimethoprim-sulphamethoxazole (28.9%), while the Klebsiella ssp strains showed 42.9% non-susceptibility to Nitrofurantoin Susceptibility to Augmentin and Fosfomycin remain high (at least 90%) for both E Coli and Klebsiella ssp 53 Conclusion: While oral Amoxicillin, Cephalexin, Ciprofloxacin, Trimethoprim-sulphamethoxazole and Nitrofurantoin are commonly used for UTI treatment, increasing community-acquired resistance to these antibiotics in Singapore may complicate the efficacy of empirical treatment http://dx.doi.org/10.1016/j.ijid.2016.11.136 19.059 Canine leishmaniosis: Serological comparison of a commercial rapid test with a quantitative enzyme-linked immunosorbent assay test for detection of anti-Leishmania infantum antibodies S Villanueva-Saz ∗ , M.T Verde-Arribas, D Ripolles-Lopez Zaragoza University, Saragossa/ES Purpose: The aim of this study was to evaluate a serological immunochromatographic test for the detection of anti-Leishmania infantum canine antibodies Methods & Materials: The rapid test was compared to a reference quantitative serological technique: ELISA in-house (Enzyme-Linked Immunosorbent Assay) This quantitative ELISA inhouse was used to define the sera as positive or negative One hundred canine serum samples were evaluated, 41 were considered negative and 59 were considered seropositive with different levels of anti-Leishmania antibodies: low levels (n=7), medium levels (n=28) and high levels (n= 24) Based on these results, the FASTest® LEISH (Diagsnostik Megacor, Austria) was evaluated: sensitivity, specificity, positive predictive value, negative predictive value, Kappa index and accuracy were calculated Results: The sensitivity and specificity were 0.97 and 0.98, respectively In an endemic area to Leishmania infantum infection with a low seroprevalence (10%), the positive predictive value was 0.82 and the negative predictive value was 1.00 By contrast, for a high seroprevalence area (25%), the positive predictive value was 0.93 and the negative predictive value was 0.99 For the Kappa index, FASTest® LEISH obtained 0.95 and the accuracy for this qualitative test was 0.97 Conclusion: The study showed that FASTest® LEISH is a reliable diagnostic test that complies with all requirements for a sensitive (relative sensitivity 97%) and specific (relative specificity 98%) rapid test Compared to other commercial tests the FASTest® LEISH is a commercial rapid test with high sensitivity and specificity for early detection infected dog with a reasonable cost-benefit balance http://dx.doi.org/10.1016/j.ijid.2016.11.137 19.060 Scenario-based assessment of decontamination methodology for biosafety and biosecurity applications B Crook ∗ , J Farrant, C Makison-Booth, A Beswick Health and Safety Executive, Science Division, Buxton/UK Purpose: In laboratory biosafety and in public biosecurity, there is the requirement to call upon effective methods to decontaminate occupied spaces following a biological release Not all methods will be suitable for a specific environment or against a specific bioagent