Nick Cortes

Hampshire Hospitals NHS Foundation Trust | NHS · Infection

Mitigation of SARS-CoV-2 transmission from international travel is a priority. We evaluated the effectiveness of travellers being required to quarantine for 14-days on return to England in Summer 2020. We identified 4,207 travel-related SARS-CoV-2 cases and their contacts, and identified 827 associated SARS-CoV-2 genomes. Overall, quarantine was as...

Background SARS-CoV-2 variants of concern (VOCs) have been associated with higher rate of transmission, and evasion of immunisation and antibody therapeutics. Variant sequencing is widely utilized in the UK. However, only 0.5% (~650k) of the 133 million cumulative positive cases worldwide were sequenced (in GISAID) on 08 April 2021 with 97% from Eu...

Background The SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility. Methods We did an ecological study to examine the associatio...

Background The management of the COVID-19 pandemic is hampered by the long delays associated with laboratory PCR testing. In hospitals this leads to poor patient flow and nosocomial transmission and so rapid, accurate diagnostic tests are urgently required. The aim of this study was to evaluate the clinical impact and real-world diagnostic accuracy...

We describe the optimisation of a simplified sample preparation method which permits rapid and direct detection of SARS-CoV-2 RNA within saliva, using reverse-transcription loop-mediated isothermal amplification (RT-LAMP). Treatment of saliva samples prior to RT-LAMP by dilution 1:1 in Mucolyse™, followed by dilution in 10 % (w/v) Chelex© 100 Resin...

Background Diagnosis of influenza in patients admitted to hospital is delayed due to long turnaround times with laboratory testing, leading to inappropriate and late antiviral treatment and isolation facility use. Molecular point-of-care tests (mPOCTs) are highly accurate, easy to use, and generate results in less than 1 h, but high-quality evidenc...

p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph; line-height:200%"> Background The management of the COVID-19pandemic is hampered by the long delays associated with centralised laboratoryPCR testing. In hospitals this leads to poor patient flow and nosocomial transmission.Rapid, accurate tests are therefore urgently neede...

Vertebral osteomyelitis (VO), also known as spondylodiscitis, describes infections of the vertebrae and intervertebral discs. Discitis describes infection limited to the intervertebral discs; in clinical practice both discitis and VO can be regarded as different stages of a single entity. VO can be caused by bacteria, fungi and parasites The incide...

A prospective study was designed to investigate the clinical impact of the rapid ID and AST generated by the Accelerate Pheno™ System versus our standard of care (SoC) of direct disc susceptibility and VITEK2. We processed signal positive blood cultures from 172 septic patients in ITU and on admission to ED and determined the clinical impact of the...

Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, a...

Abstract Background: In Hampshire Hospitals NHS Foundation Trust, in addition to an on-the-spot investigation into hospital-onset Clostridium difficile infection (CDI) by the infection prevention team, a multidisciplinary team root cause analysis (MDT-RCA) forum has been developed. The MDT-RCA aims to deliver a more thorough investigation into indi...

Whole genome sequencing (WGS) makes it possible to determine the relatedness of bacterial isolates at high resolution, helping to characterise outbreaks. However, for Staphylococcus aureus , accumulation of within-host diversity during carriage might limit interpretation of sequencing data. In this study, we hypothesised the converse: that within-h...

Influenza virus and RSV can cause serious respiratory infections. The patients most at risk are those at both extremes of life, the immunocompromised and those with underlying medical conditions. Having a rapid diagnosis for these infections can enable infection prevention and control (IPC) procedures +/- treatment to be implemented appropriately h...

Evaluating usefulness of URINE procalcitonin levels to assist the diagnosis or exclusion of UTI

An evaluation of the PhenoTestTM BC kit on the novel Accelerate phenoTM System has been completed. Rapid pathogen identification (ID) and antimicrobial susceptibility testing (AST) results produced via fluorescent in situ hybridisation and morphokinetic cellular analysis on positive blood cultures was compared to current standard of care (SoC) at H...

In December 2015, an outbreak of pertussis was detected among staff working in the Maternity Unit of a district general hospital in Hampshire. This occurred in the background of increased pertussis activity in the community. The outbreak occurred over the Christmas holiday period causing staff shortages at a time when the departments were already o...

Purpose Methicillin-resistant Staphylococcus aureus (MRSA) is defined as S. aureus genetically having the mecA or mecC genes or phenotypically showing minimum inhibitory concentration (MIC) of oxacillin higher than 2 mg/L. However, recently, cefoxitin/oxacillin-susceptible mecA-positive S. aureus (OS-MRSA) has been reported worldwide. Little is kn...

Introduction There is well documented evidence linking Streptococcus bovis (S bovis) bacteraemia to colonic neoplasms and polyps. As patients with S bovis bacteraemia can be found across various specialities, our aim was to audit the consistency of appropriate specialist referral for assessment of colonic pathology. Methods All cases of S bovis bac...

A 46-year-old man was admitted with confusion and lower limb weakness that had developed over 2 weeks. A history of chronic productive cough was noted. Significantly, 4 years previously he had been investigated for cough and left apical lung consolidation. No evidence of Mycobacterium tuberculosis was found at the time and this was not investigated...

Two organ recipients developed serologic evidence of syphilis infection after renal transplantation from a common deceased donor with a history of treated syphilis. Testing of donor serum for syphilis, which occurred after transplantation, gave results interpreted as consistent with past infection. However, subsequent serologic results in the recip...

Pneumonia caused by Streptococcus pneumoniae is characterized by neutrophil infiltration and variable epithelial injury. Neutrophil adhesion to alveolar epithelial pneumocytes (A549) was measured and demonstrated to be dose-dependent following preincubation of these (A549) pneumocytes with type 1 S. pneumoniae. Adhesion peaked at a bacteria-to-epit...