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Microorganisms 2018, 6(1), 11; https://doi.org/10.3390/microorganisms6010011

Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch–German Border Region—Impact of National Guidelines

1
Institute of Hospital Hygiene Oldenburg, 26133 Oldenburg, Germany
2
Institute of Hygiene, University Hospital Münster, 48149 Münster, Germany
3
Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany
4
European Medical School Oldenburg-Groningen, 26129 Oldenburg, Germany
5
Laborarztpraxis Osnabrück, 49124 Georgsmarienhütte, Germany
6
Certe Medical Diagnostics & Advice, 9700 AX Groningen, The Netherlands
7
University of Groningen, University Medical Center Groningen (UMCG), Department of Medical Microbiology, 9713 GZ Groningen, The Netherlands
*
Author to whom correspondence should be addressed.
Received: 29 December 2017 / Revised: 23 January 2018 / Accepted: 25 January 2018 / Published: 26 January 2018
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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. View Full-Text
Keywords: ESBL; carbapenemase; Euregio; multidrug resistance; Klebsiella; Escherichia coli; Acinetobacter baumannii; Stenotrophomonas maltophilia; Enterobacteriaceae ESBL; carbapenemase; Euregio; multidrug resistance; Klebsiella; Escherichia coli; Acinetobacter baumannii; Stenotrophomonas maltophilia; Enterobacteriaceae
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Köck, R.; Siemer, P.; Esser, J.; Kampmeier, S.; Berends, M.S.; Glasner, C.; Arends, J.P.; Becker, K.; Friedrich, A.W. Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch–German Border Region—Impact of National Guidelines. Microorganisms 2018, 6, 11.

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