TY - JOUR
T1 - Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch-German Border Region-Impact of National Guidelines
AU - Koeck, Robin
AU - Siemer, Philipp
AU - Esser, Jutta
AU - Kampmeier, Stefanie
AU - Berends, Matthijs S.
AU - Glasner, Corinna
AU - Arends, Jan P.
AU - Becker, Karsten
AU - Friedrich, Alexander W.
PY - 2018/3
Y1 - 2018/3
N2 - Preventing the spread of multidrug-resistant Gram-negative bacteria (MDRGNB) is a public health priority. However, the definition of MDRGNB applied for planning infection prevention measures such as barrier precautions differs depending on national guidelines. This is particularly relevant in the Dutch-German border region, where patients are transferred between healthcare facilities located in the two different countries, because clinicians and infection control personnel must understand antibiograms indicating MDRGNB from both sides of the border and using both national guidelines. This retrospective study aimed to compare antibiograms of Gram-negative bacteria and classify them using the Dutch and German national standards for MDRGNB definition. A total of 31,787 antibiograms from six Dutch and four German hospitals were classified. Overall, 73.7% were no MDRGNB according to both guidelines. According to the Dutch and German guideline, 7772/31,787 (24.5%) and 4586/31,787 (12.9%) were MDRGNB, respectively (p <0.0001). Major divergent classifications were observed for extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, non-carbapenemase-producing carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa and Stenotrophomonas maltophilia. The observed differences show that medical staff must carefully check previous diagnostic findings when patients are transferred across the Dutch-German border, as it cannot be assumed that MDRGNB requiring special hygiene precautions are marked in the transferred antibiograms in accordance with both national guidelines.
AB - Preventing the spread of multidrug-resistant Gram-negative bacteria (MDRGNB) is a public health priority. However, the definition of MDRGNB applied for planning infection prevention measures such as barrier precautions differs depending on national guidelines. This is particularly relevant in the Dutch-German border region, where patients are transferred between healthcare facilities located in the two different countries, because clinicians and infection control personnel must understand antibiograms indicating MDRGNB from both sides of the border and using both national guidelines. This retrospective study aimed to compare antibiograms of Gram-negative bacteria and classify them using the Dutch and German national standards for MDRGNB definition. A total of 31,787 antibiograms from six Dutch and four German hospitals were classified. Overall, 73.7% were no MDRGNB according to both guidelines. According to the Dutch and German guideline, 7772/31,787 (24.5%) and 4586/31,787 (12.9%) were MDRGNB, respectively (p <0.0001). Major divergent classifications were observed for extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, non-carbapenemase-producing carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa and Stenotrophomonas maltophilia. The observed differences show that medical staff must carefully check previous diagnostic findings when patients are transferred across the Dutch-German border, as it cannot be assumed that MDRGNB requiring special hygiene precautions are marked in the transferred antibiograms in accordance with both national guidelines.
KW - ESBL
KW - carbapenemase
KW - Euregio
KW - multidrug resistance
KW - Klebsiella
KW - Escherichia coli
KW - Acinetobacter baumannii
KW - Stenotrophomonas maltophilia
KW - Enterobacteriaceae
U2 - 10.3390/microorganisms6010011
DO - 10.3390/microorganisms6010011
M3 - Article
C2 - 29373498
SN - 2076-2607
VL - 6
JO - Microorganisms
JF - Microorganisms
IS - 1
M1 - 11
ER -