345 Managing community exercise referrals: does cross infection occur?

Introduction: We have previously reported the controversies of exercise referral to community gyms and the risks of cross infection for patients with different microbiological groups (MG) [1]. As per MACFU guidelines each individual is informed if another patient attends the same gym and specific attendance times arranged to avoid direct contact. The aim of the study was to determine if cross infection occurred between patients with different MG referred to the same gym. Methods: We surveyed the records of 41 referrals made over a 3 year period (2003 2005). Data was collected for MG and groups of patients attending the same gym. Attendance ratings and changes to microbiological grouping including strain typing were recorded. Results: 23 females and 18 males were referred. Mean (range) BMI 22.4 (14 38.3), FEV1 2.38 (0.85 4.4)l/rain. The MG consisted of 16 sporadic Pseudomonas aeruginosa (Pa), 13 transmissible Pa, 9 non-Pa, 2 Burkholderia cenocepacia, and 1 Burkholderia gladioli. Three pairs (6 patients), mean (range) BMI 21.95 (19.4 29.2) FEV12.3 (1.65 3.3) were referred with different MG's to 3 different venues. Pair 1: sporadic Pa and transmissible Pa. Pair 2: non-Pa and transmissible Pa; and pair 3: non-Pa and sporadic Pa. 5 of the 6 were classed as regular attenders (>1 visit per week) and 1 a poor attender. All patients reported lapses in attendance related to ill health or busy social/work spells for periods up to 2 months. None of the pairs attending the same venue changed microbiological group as a result of attendance at their exercise facility. Conclusion: Routine microbiological surveillance and negotiation of attendance times have prevented cross infection in patients with different MG's attending the same gym.