Köck, Robin and Siemer, Philipp and Esser, Jutta and Kampmeier, Stefanie and Berends, Matthijs and Glasner, Corinna and Arends, Jan and Becker, Karsten and Friedrich, Alexander (2018) Defining multidrug resistance of Gram-negative bacteria in the Dutch–German border region: impact of national guidelines. Microorganisms, 6 (1:11). ISSN 2076-2607

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Abstract

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 β-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.

Item Type:	Article
Additional Information:	Publiziert mit Hilfe des DFG-geförderten Open Access-Publikationsfonds der Carl von Ossietzky Universität Oldenburg.
Uncontrolled Keywords:	ESBL, carbapenemase, Euregio, multidrug resistance, Klebsiella, Escherichia coli, Acinetobacter baumannii, Stenotrophomonas maltophilia, Enterobacteriaceae
Subjects:	Technology, medicine, applied sciences > Medicine and health
Divisions:	Faculty of Medicine and Health Sciences > Department of Human Medicine
Date Deposited:	03 Aug 2018 09:16
Last Modified:	16 Oct 2018 08:19
URI:	https://oops.uni-oldenburg.de/id/eprint/3682
URN:	urn:nbn:de:gbv:715-oops-37637
DOI:	10.3390/microorganisms6010011
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