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Carbapenem-resistant Enterobacteriaceae (CRE) pose a significant threat to global public health as these organisms have the potential to cause infections which are easily spread and are associated with high mortality rates.

The aim of this study was to establish which screening strategies acute NHS trusts in England have chosen to adopt and whether or not that strategy has prevented or is likely to prevent the cross-border spread of CRE.

All acute NHS trusts in England were invited to participate in a multicentre quantitative study. Participants were asked to complete a questionnaire relating to their local CRE screening protocol.

Of the 91 participating trusts, 83 (91.2%) adhere to Public Health England (2013) guidance. However, only 22 (24.2%) trusts have adopted the European Centre for Disease Prevention and Control (2016) recommendations. In total, 31 (34.1%) trusts reported incidences of person-to-person transmission, of which 45.2% were related to foreign travel. Furthermore, 31 (34.1%) trusts reported that patients who have had an admission to a hospital in the UK not known to have a high prevalence of healthcare-associated CRE in the last 12 months had screened positive.

This study has demonstrated that inter-hospital transmission is as much of a concern as cross-border spread. Mandatory participation in enhanced surveillance could provide PHE with the epidemiological evidence required to support this stance and help to develop new national guidance.

This study has demonstrated that inter-hospital transmission is as much of a concern as cross-border spread. Mandatory participation in enhanced surveillance could provide PHE with the epidemiological evidence required to support this stance and help to develop new national guidance.

From September 2014, a tertiary care hospital in Karachi, Pakistan, started diagnosing 3-5 cases/month of a yeast locally identified as

spp. resistant to fluconazole. US Centers for Disease Control and Prevention identified the isolates as

. The Pakistan Field Epidemiology and Laboratory Training Program (FELTP) and the hospital investigated the outbreak from April 2015 to January 2016.

The aim of the outbreak investigation was to determine the risk factors and to inform measures to limit the spread of the organism in the hospital.

Medical records, nursing schedules and infection control practices were reviewed. Sixty-two age- and sex-matched hospital controls from the same wards were identified.

Thirty cases (17 males) were identified (mean age = 51.6 years, age range = 2-91 years), case fatality was 53%. Multivariate logistic regression showed that a history of surgery within 90 days of diagnosis, admission to the emergency department and history of chronic kidney disease were significantly associated with

infection.

This is the report of the outbreak investigation that triggered a global exploration of

as a newly identified multidrug-resistant nosocomial organism, spreading within the hospital, especially among patients with invasive procedures. Unfortunately, we could not identify any specific source of the outbreak nor stop the transmission of the organism.

This is the report of the outbreak investigation that triggered a global exploration of C. auris as a newly identified multidrug-resistant nosocomial organism, spreading within the hospital, especially among patients with invasive procedures. dBET6 Unfortunately, we could not identify any specific source of the outbreak nor stop the transmission of the organism.

Urinary tract infections (UTIs) are one of the most frequently reported infections in older adults and the most common reason for antimicrobial prescribing in nursing homes (NHs). In this vulnerable population, both a good diagnosis and prevention of these infections are crucial as overuse of antibiotics can lead to a variety of negative consequences including the development of multidrug-resistant organisms.

To determine infection prevention and control (IPC) and diagnostic practices for UTIs in Belgian NHs.

Local staff members had to complete an institution-level questionnaire exploring the availability of IPC practices and resources and procedures for UTI surveillance, diagnosis, and urinary catheter and incontinence care.

UTIs were the second most common infections in the 87 participating NHs (prevalence 1.0%). Dipstick tests and urine cultures were routinely performed in 30.2% and 44.6% of the facilities, respectively. In non-catheterised residents, voided or midstream urine sampling was most frequently applied. Protocols/guidelines for urine sampling, urinary catheter care and incontinence care were available in 43.7%, 45.9% and 31.0% of the NHs, respectively. Indwelling catheters were uncommon (2.3% of the residents) and urinary retention (84.9%) and wound management (48.8%) were the most commonly reported indications. Only surveillance was found to significantly impact the UTI prevalence 2.2% versus 0.8% in NHs with or without surveillance, respectively (

< 0.001).

This survey identified key areas for improving the diagnosis and prevention of UTIs, such as education and training regarding the basics of urine collection and catheter care.

This survey identified key areas for improving the diagnosis and prevention of UTIs, such as education and training regarding the basics of urine collection and catheter care.

National point prevalence surveys (PPS) of healthcare-associated infection (HAI) and antimicrobial prescribing in hospitals were conducted in 2011 and 2016 in Scotland. When comparing results of PPS, it is important to adjust for any differences in patient case-mix that may confound the comparison.

To describe the methodology used to compare prevalence for the two surveys and illustrate the importance of taking case-mix (patient and hospital stay characteristics) into account.

Multivariate models (clustered logistic regression) that adjusted for differences in patient case-mix were used to describe the difference in prevalence of six outcomes (HAI, antimicrobial prescribing and four devices central vascular catheter, peripheral vascular catheter, urinary catheterisation and intubation) between the 2011 and 2016 PPS. Univariate models that did not adjust for these differences were also developed for comparison to show the importance of adjusting for confounders.

Without adjustment for case-mix, HAI and intubation prevalence estimates were not significantly different in 2016 compared with 2011 although with adjustment, the prevalence of both was significantly lower (

=0.