Differences in infection control and diagnostic measures for multidrug-resistant organisms in the tristate area of France, Germany and Switzerland in 2019 – survey results from the RH(E)IN-CARE network
BACKGROUND Multidrug-resistant organisms (MDROs) are a public health threat. Single-centre interventions, however, are likely to fail in the long term, as patients are commonly transferred between institutions given the economic integration across borders. A transnational approach target...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2021-03-01
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| Series: | Swiss Medical Weekly |
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| Online Access: | https://www.smw.ch/index.php/smw/article/view/2967 |
| _version_ | 1826995599747055617 |
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| author | Sarah Tschudin-Sutter Thierry Lavigne Hajo Grundmann Julia Rauch Vanessa M. Eichel Stéphanie Deboscker Benoit Jaulhac Nico T. Mutters |
| author_facet | Sarah Tschudin-Sutter Thierry Lavigne Hajo Grundmann Julia Rauch Vanessa M. Eichel Stéphanie Deboscker Benoit Jaulhac Nico T. Mutters |
| author_sort | Sarah Tschudin-Sutter |
| collection | DOAJ |
| description |
BACKGROUND
Multidrug-resistant organisms (MDROs) are a public health threat. Single-centre interventions, however, are likely to fail in the long term, as patients are commonly transferred between institutions given the economic integration across borders. A transnational approach targeting larger regions is needed to plan overarching sets of interventions. Here, we aim to describe differences in diagnostic and infection prevention and control (IPC) measures in the fight against MDROs.
METHODS
In 2019, we systematically assessed diagnostic algorithms and IPC measures implemented for detection and control of MDROs at three tertiary academic care centres (Freiburg; Strasbourg; Basel). Data were collected using a standardised data collection sheet to be filled in by every centre. Uncertainties were clarified by direct contact via telephone or email with the data supplier. Internal validity was checked by at least two researchers independently filling in the survey.
RESULTS
All centres have established a primarily culture-based, rather than a nucleic acid amplification-based approach for detection of MDROs (i.e., vancomycin-resistant Enterococci [VRE], methicillin-resistant Staphylococcus aureus [MRSA], extended-spectrum beta-lactamase-producing Enterobacteriaceae [ESBL], carbapenemase-producing and carbapenem-resistant Gram-negatives [CPGN/CRGN]). IPC measures differed greatly across all centres. High-risk patients are screened for most MDROs on intensive care unit (ICU) admission in all centres; only the French centre is screening all patients admitted to the ICU for VRE, MRSA and ESBL. Patients colonised/infected by MRSA, quinolone-resistant ESBL Klebsiella spp. and CPGN/CRGN are isolated everywhere, whereas patients colonised/infected by VRE and ESBL are usually not isolated in the German centre.
CONCLUSIONS
In contrast to the French and Swiss centres, the German centre no longer uses isolation measures to control VRE and quinolone-susceptible ESBL. Overall, the French centre is more focused on intercepting MDRO transmission from outside, whereas the German and Swiss centres are more focused on intercepting endemic MDRO transmission. These findings point to important challenges regarding future attempts to standardise IPC measures across borders.
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| first_indexed | 2024-04-11T04:27:40Z |
| format | Article |
| id | doaj.art-e9861aea575b4645a29795b592ddc3cd |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2025-02-18T09:35:47Z |
| publishDate | 2021-03-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-e9861aea575b4645a29795b592ddc3cd2024-11-02T17:49:22ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972021-03-01151091010.4414/smw.2021.20454Differences in infection control and diagnostic measures for multidrug-resistant organisms in the tristate area of France, Germany and Switzerland in 2019 – survey results from the RH(E)IN-CARE networkSarah Tschudin-Sutter0Thierry Lavigne1Hajo Grundmann2Julia Rauch3Vanessa M. Eichel4Stéphanie Deboscker5Benoit Jaulhac6Nico T. Mutters7Division of Infectious Diseases and Hospital Epidemiology, and Department of Clinical Research, University Hospital Basel and University of Basel, SwitzerlandService d’hygiène hospitalière, Hôpitaux Universitaires de Strasbourg, FranceMedical Centre - University of Freiburg, Institute for Infection Prevention and Hospital Epidemiology, Freiburg, GermanyMedical Centre - University of Freiburg, Institute for Infection Prevention and Hospital Epidemiology, Freiburg, GermanyHeidelberg University Hospital, Centre for Infectious Diseases, Heidelberg, GermanyService d’hygiène hospitalière, Hôpitaux Universitaires de Strasbourg, FranceUniversity of Strasbourg and CHRU Strasbourg, Laboratory of Bacteriology and UR 7290 ITI InnoVec, Fédération de Médecine Translationnelle de Strasbourg, Institute of Bacteriology, Strasbourg, FranceMedical Centre - University of Freiburg, Institute for Infection Prevention and Hospital Epidemiology, Freiburg, Germany; Bonn University Hospital, Institute for Hygiene and Public Health, Bonn, Germany BACKGROUND Multidrug-resistant organisms (MDROs) are a public health threat. Single-centre interventions, however, are likely to fail in the long term, as patients are commonly transferred between institutions given the economic integration across borders. A transnational approach targeting larger regions is needed to plan overarching sets of interventions. Here, we aim to describe differences in diagnostic and infection prevention and control (IPC) measures in the fight against MDROs. METHODS In 2019, we systematically assessed diagnostic algorithms and IPC measures implemented for detection and control of MDROs at three tertiary academic care centres (Freiburg; Strasbourg; Basel). Data were collected using a standardised data collection sheet to be filled in by every centre. Uncertainties were clarified by direct contact via telephone or email with the data supplier. Internal validity was checked by at least two researchers independently filling in the survey. RESULTS All centres have established a primarily culture-based, rather than a nucleic acid amplification-based approach for detection of MDROs (i.e., vancomycin-resistant Enterococci [VRE], methicillin-resistant Staphylococcus aureus [MRSA], extended-spectrum beta-lactamase-producing Enterobacteriaceae [ESBL], carbapenemase-producing and carbapenem-resistant Gram-negatives [CPGN/CRGN]). IPC measures differed greatly across all centres. High-risk patients are screened for most MDROs on intensive care unit (ICU) admission in all centres; only the French centre is screening all patients admitted to the ICU for VRE, MRSA and ESBL. Patients colonised/infected by MRSA, quinolone-resistant ESBL Klebsiella spp. and CPGN/CRGN are isolated everywhere, whereas patients colonised/infected by VRE and ESBL are usually not isolated in the German centre. CONCLUSIONS In contrast to the French and Swiss centres, the German centre no longer uses isolation measures to control VRE and quinolone-susceptible ESBL. Overall, the French centre is more focused on intercepting MDRO transmission from outside, whereas the German and Swiss centres are more focused on intercepting endemic MDRO transmission. These findings point to important challenges regarding future attempts to standardise IPC measures across borders. https://www.smw.ch/index.php/smw/article/view/2967multi-drug resistanceMDROinfection preventionInfection ControldiagnosisVRE |
| spellingShingle | Sarah Tschudin-Sutter Thierry Lavigne Hajo Grundmann Julia Rauch Vanessa M. Eichel Stéphanie Deboscker Benoit Jaulhac Nico T. Mutters Differences in infection control and diagnostic measures for multidrug-resistant organisms in the tristate area of France, Germany and Switzerland in 2019 – survey results from the RH(E)IN-CARE network Swiss Medical Weekly multi-drug resistance MDRO infection prevention Infection Control diagnosis VRE |
| title | Differences in infection control and diagnostic measures for multidrug-resistant organisms in the tristate area of France, Germany and Switzerland in 2019 – survey results from the RH(E)IN-CARE network |
| title_full | Differences in infection control and diagnostic measures for multidrug-resistant organisms in the tristate area of France, Germany and Switzerland in 2019 – survey results from the RH(E)IN-CARE network |
| title_fullStr | Differences in infection control and diagnostic measures for multidrug-resistant organisms in the tristate area of France, Germany and Switzerland in 2019 – survey results from the RH(E)IN-CARE network |
| title_full_unstemmed | Differences in infection control and diagnostic measures for multidrug-resistant organisms in the tristate area of France, Germany and Switzerland in 2019 – survey results from the RH(E)IN-CARE network |
| title_short | Differences in infection control and diagnostic measures for multidrug-resistant organisms in the tristate area of France, Germany and Switzerland in 2019 – survey results from the RH(E)IN-CARE network |
| title_sort | differences in infection control and diagnostic measures for multidrug resistant organisms in the tristate area of france germany and switzerland in 2019 survey results from the rh e in care network |
| topic | multi-drug resistance MDRO infection prevention Infection Control diagnosis VRE |
| url | https://www.smw.ch/index.php/smw/article/view/2967 |
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