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BACKGROUND: Nursing homes and long-term care facilities (LTCF) caring for elderly and chronically ill residents are at high risk to experience severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) outbreaks. We report an outbreak of coronavirus disease 2019 (COVID-19) in 3 LTCFs of the Geriatric Health Centres of Graz, Austria lasting from March 22 to April 14, 2020. AIM: The objectives of our study were: (1) to elucidate contributing factors and transmission pathways of SARS-CoV-2, (2) to analyze symptoms of COVID-19 in the residents and health care workers. METHODS: We carried out a retrospective outbreak analysis. FINDINGS: Thirty-six of /277 residents of 3 LTCFs were infected with SARS-CoV-2. Only a quarter of COVID-19 cases among residents had fever ≥38.1°C and 19% suffered from cough. Six of 36 residents remained asymptomatic. Hospitalization rate was 58% in residents. Overall, 33% (12/36) residents infected with SARS-CoV-2 died. Nineteen of 214 health care workers were tested positive for SARS-CoV-2. Universal rt-PCR testing for SARS-CoV-2 of all residents and health care workers as well as infection control measures contributed to ending the outbreaks. CONCLUSIONS: Delayed recognition of possible COVID-19 cases due to either mild symptoms or symptoms that were perceived as atypical early in the pandemic contributed to the transmission of SARS-CoV-2 in LTCFs. This emphasizes the importance of low-threshold testing in LTCF residents.

Background We aimed to determine the prevalence of asymptomatic colonization by C. difficile in stool of residents in four long-term care facilities (LTCFs) in Graz, Austria and to identify factors associated with colonization. Methods We conducted a point-prevalence study in March 2018. Stool samples were examined by GDH enzyme immunoassay and when positive a toxin A/B-enzyme immunoassay was carried out. Additionally, all samples were tested by toxin A and B PCR and were plated manually as well as in automated fashion onto selective C. difficile agar. Results In 4/144 (2.8%) residents the GDH assay was positive. Each resident was colonized by a different C. difficile ribotype. C. difficile was not detected in any of the environmental samples. Significantly more colonized residents (60%) had stayed at a hospital in the 3 months previous to the study compared to 10% of non-colonized patients (p=0.01). Conclusions The prevalence of colonization by toxigenic C. difficile was 2.8% in patients in LTCFs in Graz, Austria.

Healthcare-associated infections (HCAI) are a common cause for residents’ mortality and morbidity associated with a significant socio-economic burden. Data on HCAIs in Austrian long-term care facilities are scare. Therefore, we evaluated the incidence rate of HCAIs per 1000 resident days in four LTC facilities in Graz, Austria, characterized the spectrum of HCAIs and the use of antimicrobial substances. We conducted a prospective surveillance study from 1 January to 31 December 2018 in four LTCFs of the Geriatric Health Centre of the City of Graz (total of 388 beds). Nursing staff collected data on HCAIs once a week using an electronic reporting system. During the 12-month surveillance period, 252 infections of 165 residents were recorded. The overall incidence rate of HCAIs was 2.1 per 1000 resident days. Urinary tract infections were the most commonly recorded HCAIs (49%, 124/252, 1.03 per 1000 resident days), followed by skin and soft tissue infections and respiratory tract infections. Beta-lactams (ATC class J01C) were prescribed most frequently (63/212), followed by fluoroquinolones (J01M, 54/212). In conclusion, the overall incidence rate for HCAIs was relatively low at 2.1 per 1000 resident days. Our real-life data can serve as a basis for future antimicrobial stewardship and infection prevention interventions.

Background Residents in long-term care facilities (LTCFs) are increasingly found to be an important reservoir of multidrug-resistant gram-negative (MRGN) bacteria. Aims We aimed to determine colonization by MRGN bacteria over 6 months in LTCFs and geriatric wards in Graz, Austria, and to evaluate risk factors for such colonization. Methods During August 2015, we conducted a point-prevalence survey at LTCFs and geriatric wards of the Geriatric Health Centers of the City of Graz. Inguinal and perianal swabs were taken from 137 patients and screened for MRGN using standard procedures. Six months after the initial investigation all colonized patients were sampled again and use of antibiotics, hospital admissions, and mortality was registered. Genetic relatedness of MRGN bacteria was evaluated. Results We detected 12 patients harboring MRGN isolates (prevalence, 8.7%). Overall inguinal colonization was 5.1%. After 6 months, only 2 out of 12 patients were still colonized. Presence of a urinary catheter was associated with a higher risk of MRGN colonization (odds ratio [OR], 17.5; 95% CI, 1.6-192). Chronic wounds and gastrostomy were also risk factors of MRGN colonization (OR, 10.7; 95% CI, 1.6-69.3 and OR, 18.3; 95% CI, 2.4-139.4, respectively). There was no difference in mortality between colonized and noncolonized patients. Conclusions Prevalence of colonization with MRGN bacteria was low in patients in LTCFs and geriatric wards in Graz, Austria.

Residents in long-term care facilities (LTCFs) are frequently colonized by multidrug-resistant Gram-negative bacteria, putting them at risk for subsequent infections. We aimed to evaluate the effect of the multispecies probiotic Omnibiotic10AAD&reg, on the intestinal and inguinal skin colonization of patients by multidrug-resistant Gram-negative bacteria in LTCFs. Patients colonized by multidrug-resistant Gram-negative bacteria received a 12 week oral course of Omnibiotic10AAD&reg, Inguinal swabs and stool samples were collected during and after treatment for microbiological and microbiome analysis. The median age of patients was 76 years. Twelve patients completed the pilot study. Intestinal colonization was reduced to 42% of patients 8 weeks after the end of treatment, but increased to 66% 24 weeks after the end of probiotic treatment. Colonization of inguinal skin was lowest during probiotic treatment and increased thereafter. Fecal microbiome analysis revealed statistically significant increases of the genus Enterococcus comparing start and end of probiotic treatment. In conclusion, a 12 week course of a multispecies probiotic led to a transient reduction of intestinal colonization 8 weeks after the end of treatment. The findings of our pilot study warrant further research in the area of probiotics and intestinal colonization by multidrug-resistant bacteria.

Methicillin-resistant Staphylococcus aureus (MRSA) decontamination regimens predominantly use chlorhexidine bathing in combination with mupirocin nasal ointment. However, resistances in Staphylococcus aureus strains are increasingly common and there is a need of alternative, safe and feasible protocols. This interventional cohort study performed at the Albert Schweitzer Hospital in Graz, Austria, aimed to (1) determine MRSA prevalence at different body sites and (2) assess the efficacy of the decontamination using octenidine-based leave-on products added to existing robust infection control measures. All inpatients of this tertiary care hospital being treated in geriatric medical wards (GWs) and apallic care units (ACUs) were screened for MRSA and decontamination rates were determined after one, two or three decontamination cycles, respectively. At baseline, MRSA was detected in 25 of the 126 patients screened (19.8%). We found MRSA in 13/126 (10.3%) swabs from nasal vestibules, in 12/126 (9.5%) skin swabs, in 11/51 (21.6%) swabs from PEG-stomata or suprapubic catheters and in 8/13 (61.5%) tracheostomata swabs. A maximum of three 5-day decontamination cycles reduced the number of MRSA positive patients by 68.0%. Excluding non-compliant and deceased patients, decontamination reduced MRSA carriage by 93.3% (n = 15). No adverse events related to the applied decontamination regimen occurred. Exclusive screening of the nose might underreport MRSA prevalence rates. In this study, decontamination with octenidine-based leave-on products was safe and effective in a critical patient population.

A1 Meet the needs: Important questions for ICU relatives Magdalena M. Hoffmann1,2, Anna K. Holl3, Harald Burgsteiner4, Thomas Pieber1,5, Philipp Eller6, Karin Amrein1 A2 Daily use of the Surgical Safety Checklist: results of a real-time audit Gerald Sendlhofer1,2,3, Karina Leitgeb1, Veronika Gombotz1, Peter Tiefenbacher1, Lars-Peter Kamolz2,3 A3 Best-practice projects concerning patient safety in Austria Gerald Sendlhofer1,2,3,4, , Karina Leitgeb1,4, Magdalena Hoffmann1,4, Sabine Papst1,4, Susanne Gasteiner1,4, Lars Peter Kamolz2,3,4 A4 Comprehensive Cancer Center Graz: evaluation of availability of mandatory healthcare professionals in tumorboards Peter Tiefenbacher1,2, Yvonne Muller1,2, Gerald Sendlhofer1,2,3,4 A5 Comprehensive Cancer Center Graz: protocol to evaluate communication and recommendation finding in tumorboards Marlies Hart1, Peter Tiefenbacher1,2, Yvonne Muller1,2, Gerald Sendlhofer1,2,3,4 A6 Generating a new insulin prescription chart at a university hospital Julia Kopanz1, Katharina M. Neubauer1, Gerald Sendlhofer2,3,4, Barbara Semlitsch1, Andres Pak5, Gerald Cuder1, Thomas R. Pieber1, Johannes Plank6 A7 The Speech and Language Therapy teaching practice at the Institute for Speech and Language Therapy at FH JOANNEUM in Graz Annemarie Schinko1, Angelika Rother1 A8 Development and implementation of a progress test in undergraduate dental education: a prospective Austrian pilot project Barbara Kirnbauer1, Petra Rugani1, Norbert Jakse1, Johannes Bernhardt-Melischnig2, Rudolf Egger3 A9 What they need and what they get: protocol to identify the needs of information of patients and what they receive so far Magdalena M. Hoffmann1,2, Karina Leitgeb1,3, Esther Trampusch4,5, Angelika Hofer4, Regina Riedl6, Karin Amrein2, Christa Tax7, Gernot Brunner7, Gerald Sendlhofer,1,3,8 A 10 Medication-related problems resolved and money saved: results of a clinical pharmacy service evaluation in the surgical setting Emilie Tudela-Lopez1, Petra Polzleitner1, Klara Jadrna1, Christina Labut1, Maria Kundracikova1, Helga Fend1, Gunar Stemer1 A 11 Intercultural communication management in radiology Jutta Maria Lorenz1 A 12 Spotlight on data quality: comparison of data input by physicians vs. non-physicians in the German Resuscitation Registry Gerhard Prause1, Paul Zajic1, Philipp Zoidl1, Geza Gemes1 A 13 MRSA prevalence and eradication with octenidine Gerald Pichler1, Christian Pux1, Rita Babeluk2, Brigitte Hermann3, Eric Stoiser3, Antonella De Campo4, Andrea Grisold5, Ines Zollner-Schwetz6, Robert Krause6, Walter Schippinger4 A 14 QUIPS: a pain registry with impact in science and daily routine work Alexander Avian1,2, Brigitte Messerer3, Claudia Weinmann2, Winfried Meisner2 A 15 Patient empowerment for the youngest Karina Leitgeb1, Magdalena Hoffmann1, Gerald Sendlhofer1,2,3 A 16 Development of a pocket guide for parenteral nutrition in hospitalized adults Anna Maria Eisenberger1, Siegrid Fuchs2 A 17 Safety and efficacy of a clinical decision support system for blood glucose management in patients with diabetes mellitus type 2 at a plastic-surgical ward Alexandru-C. Tuca1, Katharina M. Neubauer2, Julia K. Mader2, Felix Aberer2 , David B. Lumenta1, Birgit Bauer1 ,Klaus Donsa3 , Thomas Augustin3 , Bernhard Holl3 , Lukas Schaupp2, Peter Beck4, Johannes Plank2 , Thomas R. Pieber2,3, Lars-P. Kamolz1,5 A 18 Urban dwellers show higher readiness in participating actively in the shaping of the healthcare system in Austria Christian Smolle1, Frederike Reischies2, Gudrun Pregartner3, Daryousch Parvizi2, Gerald Sendlhofer1,4, Lars-Peter Kamolz1,4