Table 3 Overview of national and local IPC measures for multidrug-resistant Gram-negative bacteria in the Netherlands
IPC measures | SRI-NL | UMCG |
|---|---|---|
screening criteria | patients • 1with recent healthcare facility stays abroad • who had invasive procedures abroad • come from another Dutch healthcare facility with an ongoing uncontrolled outbreak • lived in a refugee shelter < 2 months ago. | • stricter with Dutch hospital rules (screening regardless of an ongoing outbreak) • additional recommendations for refugees/asylum seekers, adopted child, long-stay and dialyzed patients. • known / contact of ESBL-E/CPE/CRE carrier. |
sampling site | rectum/perirectum/faeces sample | 2rectum |
management of carriers | ESBL-E • contact isolation • contact precautions in multiple rooms allowed if no single room is available, with a 1.5 m bed clearance CRE/CPE contact isolation | ESBL-E • contact isolation • ESBL-producing E. coli: island nursing CRE/CPE 3contact-plus isolation |
lifting the isolation | ESBL-E 2 negative results starting 3 months after the last positive culture CRE/CPE • 2 negatives starting 1 year after the last positive culture • Follow-up cultures for admissions in the first year after carrier status termination | ESBL-E 4same as SRI CRE/CPE same as SRI |
readmission of a known MDRGN patient | No recommendation | ESBL-E procedures differ between ESBL-producing E. coli and the other Enterobacterales for declaring negative, lifting isolation based on the number of known negatives and the time since the last positive culture CRE/CPE • uptake screening and isolation • no difference among different microorganisms • conditions for lifting the isolation are stricter |
recommended PPE for HCWs | gloves, long-sleeved apron | same as SRI |