Clinical outcomes in OPAT patients treated with ceftriaxone 4 g and ceftazidime 6 g extended interval dosing regimens.

Background: New dosing regimens for ceftriaxone 4 g/24 hours and ceftazidime 3 g/12 hours are convenient for patients receiving OPAT. To date, these have not been clinically validated.

Aim: To assess the tolerability, toxicity and effectiveness of once daily ceftriaxone (4 g) and 12 hourly ceftazidime regimens (3 g twice a day) in the OPAT setting.

Clinical, microbiological characteristics and predictors of mortality in patients with carbapenemase-producing Enterobacterales bloodstream infections: a multicentre study.

Objectives: To investigate the clinical, microbiological characteristics and outcomes of patients with bloodstream infections (BSI) due to carbapenemase-producing Enterobacterales (CPE).

Methods: A multicentre retrospective observational study of patients with BSIs due to CPE admitted to six UK hospitals was conducted between 2011 and 2021. Multivariate analysis was used to identify factors predicting 30-day case fatality rate (CFR).

Hospital-acquired bacteraemia at a large UK NHS Trust. A return towards baseline following implementation of a 5-year quality improvement programme.

Introduction: Until recently, healthcare-associated bacteraemia was a neglected area of infection prevention and control (IPC), despite a 30-day mortality of 15-20%. Recently, the UK Department of Health (DH) introduced a target to reduce hospital-acquired bacteraemias by 50% over a five-year period. Following implementation of multifaceted and multidisciplinary interventions, the aim of this study was to determine its impact on achieving this target.

Utility of EBUS-TBNA in diagnosing mediastinal tuberculous lymphadenitis in East London.

Objectives: To characterise and describe the diagnostic utility of Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) in intrathoracic tuberculosis in a cohort of patients with mediastinal lymphadenopathy of unknown aetiology.

Methods: Consecutive patients with intrathoracic lymphadenopathy undergoing EBUS-TBNA between 2012 and 2016 were identified. Demographic data, biopsy cytopathology and mycobacteriology results, HIV and vitamin D status, susceptibility results and final diagnoses were recorded.

The difference in mortality between adult patients with laboratory documented influenza A and B, a single centre retrospective observational study.

Background: Seasonal influenza is an annual occurrence that leads to large community outbreaks and increased hospitalization. A number of studies have suggested that influenza A (FLUAV) is associated with increased rates of hospitalization and mortality compared with influenza B (FLUBV). This study compared demographic and clinical variables in patients diagnosed with FLUAV or FLUBV during the 2017-2018 UK Influenza season.

Missed opportunities to use rapid influenza testing and severity assessment to avoid hospital admission: A cohort study from an East London District General Hospital.

Annual outbreaks of seasonal influenza cause a substantial health burden. The aim of this study was to compare patient demographic/clinical data in two influenza patient groups presenting to hospital; those requiring O or critical care admission and those requiring less intensive treatment. The study was conducted from 1 December 2017 until 1 April 2019 at a district general hospital in East London.

Clinical Value of Screening Peritoneal Dialysis Patients for Bacterial Colonization or Contamination.

Introduction: The adoption of the International Society for Peritoneal Dialysis guideline of using mupirocin ointment has been limited by fear of developing mupirocin-resistant organisms. We performed a surveillance program of a large peritoneal dialysis (PD) unit.

Methods: We performed 1,175 surveillance swabs from anterior nares, PD catheter exit site, groin, and axilla, from 240 patients.

Shigellosis and toxic megacolon secondary to Shigella flexneri serotype 3a: The challenges of laboratory diagnosis.

We present a rare case of Shigella flexneri bacteraemia and toxic megacolon, and discuss the challenges of conventional laboratory techniques versus molecular PCR platforms in differentiating between Shigella species and Escherichia coli.

Strategy to reduce bacteraemia based on cohort data from a London teaching hospital.

Background And Aim: In 2017, National Health Service Improvement set a 10% reduction target for bacteraemia by 2018, followed by a 50% reduction in healthcare-associated Gram-negative bacteraemias by 2022. We analysed consecutive cases of bacteraemia and devised a strategy to achieve these targets.

Methods: From December 2012 to November 2013, demographic, clinical and microbiological data were prospectively collected on all patients with bacteraemia at the Royal London Hospital in East London, UK.

The utility of a blood culture database to identify patients suitable for outpatient parenteral antibiotic treatment.

Background: The clinical and cost-effectiveness of outpatient parenteral antimicrobial therapy (OPAT) services are well described. We used a blood culture database as a novel approach to case finding and determined its utility in identifying inpatients suitable for OPAT.

Methods: From December 2012 to November 2013, consecutive adult inpatients with bacteraemia, and those recruited to OPAT, were prospectively studied.

The characteristics and outcome of bacteraemia in renal transplant recipients and non-transplant renal patients.

Background: There is lack of outcome data for bacteraemic patients on specialist renal units. We described demographic, clinical, microbiological data and outcomes for bacteraemic adult renal transplant and non-transplant patients at a London Teaching Hospital. We also assessed the appropriateness of empirical antibiotic policy.

Rapid Whole-Genome Sequencing of Mycobacterium tuberculosis Isolates Directly from Clinical Samples.

The rapid identification of antimicrobial resistance is essential for effective treatment of highly resistant Mycobacterium tuberculosis. Whole-genome sequencing provides comprehensive data on resistance mutations and strain typing for monitoring transmission, but unlike for conventional molecular tests, this has previously been achievable only from cultures of M. tuberculosis.

Outcomes in UK patients with hospital-acquired bacteraemia and the risk of catheter-associated urinary tract infections.

Purpose: There is lack of contemporary outcome data on patients with hospital-acquired infections that cause bacteraemia. We determined the risk factors for 7-day mortality and investigated the hypothesis that, compared with central venous catheter (CVC)-associated bacteraemic infections, catheter-associated bacteraemic urinary tract infections (UTIs) were significantly associated with 7-day mortality.

Methods: From October 2007 to September 2008, demographical, clinical and microbiological data were collected on patients with hospital-acquired bacteraemia.

Mortality and associated risk factors in consecutive patients admitted to a UK NHS trust with community acquired bacteraemia.

Purpose: Within the UK, there is lack of contemporary data on clinical outcomes in patients admitted to hospital with severe community acquired infection. The purpose of this study was to determine outcomes and risk factors associated with mortality in consecutive patients admitted to a UK NHS trust with community acquired infections that cause bacteraemia.

Methods: From September 2007 to August 2008, demographic, clinical and microbiological data were collected on patients with laboratory confirmed bacteraemia.

Previous treatment in predicting drug-resistant tuberculosis in an area bordering East London, UK.

Objectives: To determine the utility of 'risk assessment' in selecting Mycobacterium tuberculosis isolates for rifampin resistance or rpoB genotyping compared to 'non-selectively' genotyping all isolates. Secondly, we examined the association between past treatment and drug resistance.

Methods: From January 2003 to December 2006, demographic, clinical, and laboratory data were prospectively collected on patients with laboratory-confirmed tuberculosis (TB).

The case for outpatient treatment of Plasmodium falciparum malaria in a selected UK immigrant population.

UK guidance recommends that all patients with falciparum malaria be admitted to hospital, although a number of cohort studies in the developed world demonstrate that outpatient treatment of falciparum malaria is feasible and safe in selected patients. We review the literature on outpatient treatment in developed countries and present local data from East London where a selected immigrant population were successfully treated as outpatients. Although it is premature to claim that outpatient treatment of falciparum malaria is safe in all selected patients, we conclude it is time for a large UK-based safety study or randomised trial to dispel the belief that all patients with uncomplicated Plasmodium falciparum must be admitted to hospital.

Hospital-based study of viridans streptococcal bacteraemia in children and adults.

Objectives: To assess the proportion and clinical significance of bacteraemia caused by viridans streptococci (VS) in immunocompetent adults and children.

Methods: Over a 25-month period, we collected data on all patients with VS bacteraemia at a UK district general hospital.

Results: VS caused 50/723 (6.

Community-acquired Klebsiella pneumoniae meningitis in an alcoholic patient with an infected pancreatic pseudocyst; a case report and review of literature.

We report a case of a 49-year-old male with a history of chronic alcoholism and evidence of a pancreatic pseudocyst on CT scanning. He presented with a 3-days history of fever, loss of appetite and upper abdominal pain. Blood cultures grew Klebsiella pneumoniae and he improved clinically with a seven-day course of intravenous co-amoxiclav and metronidazole.

Mortality following bacteraemic infection caused by extended spectrum beta-lactamase (ESBL) producing E. coli compared to non-ESBL producing E. coli.

Objectives: To determine the differences in mortality and length of hospital stay in patients with bacteraemic infection caused by ESBL and non-ESBL producing Escherichia coli. Main outcome measures were mortality, time from bacteraemia to death and length of inpatient stay.

Methods: From June 2003 to November 2005, we prospectively collected clinical and microbiological data on all adult patients with E.