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7. How to deal with multidrug-resistant Gram-negative microorganisms in cross-border healthcare? Comparison of Dutch and German guidelines

Author

Müller, J., Voss, A., Köck, R., Sinha, B., Rossen, J.W., Kaase, M., Mielke, M., Daniels-Haardt, I., Jurke, A., Hendrix, R., Kluytmans, J.A., Klytmans-van den Bergh, M.F., Pulz, M., Herrmann, J., and Friedrich, A.W.

Subjects
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries)
Abstract

Contains fulltext : 153014.pdf (Publisher’s version ) (Open Access)

Published
2015

12. Cross-border comparison of the Dutch and German guidelines on multidrug-resistant Gram-negative microorganisms

Author

Muller, J., Voss, A., Kock, R., Sinha, B., Rossen, J.W., Kaase, M., Mielke, M., Daniels-Haardt, I., Jurke, A., Hendrix, R., Kluytmans, J.A., Kluytmans-Vandenbergh, M.F., Pulz, M., Herrmann, J., Kern, W.V., Wendt, C., Friedrich, A.W., Muller, J., Voss, A., Kock, R., Sinha, B., Rossen, J.W., Kaase, M., Mielke, M., Daniels-Haardt, I., Jurke, A., Hendrix, R., Kluytmans, J.A., Kluytmans-Vandenbergh, M.F., Pulz, M., Herrmann, J., Kern, W.V., Wendt, C., and Friedrich, A.W.

Abstract

Contains fulltext : 154905.pdf (publisher's version ) (Open Access), BACKGROUND: In all European countries, hospital-acquired infections caused by Gram-negative multidrug-resistant microorganisms (GN-MDRO) are a major health threat, as these pathogens cannot be adequately treated anymore, or the start of effective antibiotic treatment is delayed. The efforts to limit the selection and spread of GN-MDRO remains a problem in cross-border healthcare, as the national guidelines on hygiene standards applicable for patients colonized or infected with GN-MDRO in hospitals are not harmonized between European countries. METHODS: In order to point out the similarities and differences in the national guidelines of Germany and The Netherlands regarding GN-MDRO, guidelines were compared and an expert workshop was organized by the INTERREG IVa project EurSafety Health-net. RESULTS: Both guidelines divide the Gram-negative organisms into subgroups based on bacterial species and antibiotic susceptibility patterns in order to define multidrug-resistant variants of these bacteria. However, the Dutch guideline defines that GN-MDRO Enterobacteriaceae requires testing for certain mechanisms causing antibiotic resistance, whereas the German guideline makes use of a newly created classification scheme, based on phenotypic characterization. Besides diagnostic issues, the main difference between the Dutch and German guideline is the divergent evaluation of ESBL-producing Enterobacteriaceae. Special hygiene measures are required for all patients with ESBL-producing Enterobacteriaceae in The Netherlands, whereas the German guideline recommends special precautions only for those cases in which patients are colonized or infected with strains showing co-resistance to ciprofloxacin ("3MRGN"). CONCLUSIONS: The usage of consistent terminology and harmonized diagnostic procedures would improve the possibilities for infection prevention, treatment and patient safety. Prevention of severe non-treatable infections and outbreaks due to MDRO, caused by an increased popula

Published
2015

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