e8 Abstracts

ASSESSING THE IMPACT OF AN E-MAIL ONSIGNIFICANT BLOOD CULTURES AT CITYHOSPITALS SUNDERLANDCATEGORY: LESSON INMICROBIOLOGY & INFECTION CONTROL

Clare Hamson, Giuseppe Bignardi, Chris SettleSunderland Royal Hospital, Sunderland, Tyne and Wear,United Kingdom

Introduction

Having reached the Trust year end target for MRSAbacteraemias by the end of month 11, an e-mail was senton behalf of the Chief Executive, Director of InfectionPrevention and Control and the Infection Control Doctor, toall users reiterating infection control principles and in-structing clinical staff not to take unnecessary bloodcultures. Key messages in relation to blood cultures were:

� Only take if really necessary and it will alter patientcare

� Avoid taking from any central access device (CVAD) orarterial line

� Avoid taking from patients on an end of life pathway� Consultants take personal responsibility to ensure

blood cultures are only being done for reasons that ifpositive will alter patient management

The year end target was subsequently met owing to nopositive blood cultures with MRSA in the following 28 days(as opposed to four during the preceding 28 days). Wespeculated that fewer blood cultures were taken as a resultof the directive. Did this deficit mostly reflect eliminationof unnecessary blood cultures, or was there an impact onclinically significant and useful bacteraemia diagnoses? Wesearched hospital records during the periods 28 days beforeand after the e-mail to quantify differences in bloodcultures and to address the above question.

Scientific findings

Compared to before the e-mail, 14.6% fewer blood cultureswere taken during the 28 days afterwards, with a corre-sponding 10.5% drop in the total number of positives (810vs. 692 and 86 vs. 77 respectively). The difference appearsto reflect a reduction in blood culture contaminants sincethere was no decrease in the absolute number of significantblood cultures, including those which led to an alteration intreatment (49 vs. 54 and 27 vs. 28 respectively). Thenumber of positive blood cultures from CVAD was smallduring both periods (7 vs. 4); the clinical significance ofthese is often uncertain.

Discussion

Although there may be other reasons for the drop in bloodculture contaminants during the review period, it seemslikely that the e-mail directive had a significant impact onthe blood culture taking practices within the trust. Clinicalstaff clearly engaged during this period with the impor-tance of taking appropriate blood cultures. Measures to

minimise blood culture contaminants already well estab-lished in the trust include 24 hour dedicated technicians fortaking the majority of blood cultures and the use of 2%chlorhexidine sponge applicators for skin preparation.

Conclusions

Our findings support the premise that encouraging staff totake blood cultures only for reasons that if positive willalter patient management does not compromise diagnosisand management of significant bacteraemias. Trust widepractices can be significantly influenced by timely re-inforcement of good infection control principles by seniorclinicians.

METAL ION / PYRIDINEDICARBOXYLATE POLYMERCOMPOSITES AS INHIBITORS OF BACTERIALBIOFILM FORMATIONCATEGORY: SCIENTIFIC FREEPAPER

suhair saleh 1, Bassam Sweileh 2, Sami Taha 2,Mutasem Taha 3

1Department of Pharmaceutical Sciences andPharmaceutics/school of pharmacy/applied scienceuniversity, amman, Jordan2Department of Chemistry, Faculty of Sciences, Universityof Jordan, Amman, Jordan3Department of Pharmaceutical Sciences, Faculty ofPharmacy, University of Jordan, amman, Jordan

Introduction

Bacterial biofilms are extremely resistant forms of bacterialcolonization and have serious health and economicimplications.

One significant consequence of bacteria growing as bio-films is their resistance to medical and industrial controlstrategies compared to their single cell forms, which renderbiofilms of enormous impact on medicine and economyBiofilms can exist on many medical implants such as cathe-ters, artificial hips, contact lenses, etc. and owing to theirincreased resistance to antimicrobial agents, they can oftenonly be treated by removal of the implant, which increasesthe trauma to the patient and the cost of treatment

Our growing understanding of bacterial biofilms hasprompted continuous efforts towards designing new mate-rials capable of resisting biofilm formation at their surfaces.Approaches to biofilm-resistant materials can be confined tofew basic methods, namely, surface modification to reducebacterial attachment and subsequent biofilm development,and impregnation of polymers with antimicrobials to preventbacterial colonization. Several approaches were used torelease antimicrobials (eg: ciprofloxacin) from device sur-faces or to drive antimicrobials through the biofilm overa sustained period of time. Many carrier systems have beenproposed, including biodegradable polymers such as poly(-lactide-co-glycolide) and thermoreversible hydrogels ormetallic surfaces (particularly copper and silver) that re-lease antibacterial ions over prolonged periods of time.