Infection prevention and control without borders: comparison of guidelines on multidrug-resistant organisms in the northern Dutch-German cross-border region

Bibliographic Details
Title: Infection prevention and control without borders: comparison of guidelines on multidrug-resistant organisms in the northern Dutch-German cross-border region
Authors: Cansu Cimen, Matthijs S. Berends, Mariëtte Lokate, Corinna Glasner, Jörg Herrmann, Erik Bathoorn, Axel Hamprecht, Andreas Voss
Source: Antimicrobial Resistance and Infection Control, Vol 14, Iss 1, Pp 1-12 (2025)
Publisher Information: BMC, 2025.
Publication Year: 2025
Collection: LCC:Infectious and parasitic diseases
Subject Terms: Vancomycin-resistant enterococci (VRE), Extended-spectrum β-lactamase Enterobacterales (ESBL-E), carbapenem-resistant Enterobacterales (CRE), Carbapenem-producing enterobacterales (CPE), Infection control, Guideline, Dutch-german cross-border region, Infectious and parasitic diseases, RC109-216
More Details: Abstract Infections due to multidrug-resistant organisms (MDROs) are a health threat due to increasing patient morbidity and mortality and the burden on healthcare systems. Robust infection prevention and control (IPC) measures are needed to minimize their emergence in hospitals. Therefore, various international and national IPC guidelines exist, yet the lack of harmonized IPC guidelines complicates the management of patients seeking healthcare across European borders. This study explores the similarities and differences in IPC measures for vancomycin-resistant enterococci (VRE) and multidrug-resistant (MDR) Enterobacterales both on local and national levels within the northern Dutch-German cross-border region. In Germany, IPC efforts are often led by hospital hygiene doctors, whereas in the Netherlands, they involve a collaboration between infection preventionists and clinical microbiologists, with local variations. The local guidelines in both countries, as expected, are based on national recommendations, yet introduce specific regulations in various aspects. The Dutch guidelines are more stringent for VRE management compared to the German guidelines, often imposing additional local measures beyond national requirements. The Dutch and German guidelines largely diverge in definitions of MDR Gram-negative bacteria. Unlike the Dutch guidelines, the German guidelines do not currently recommend screening or isolation for extended-spectrum beta-lactamase-producing Enterobacterales. For carbapenem-resistant and carbapenemase-producing Enterobacterales, there is no notable distinction between the countries’ guidelines, with both sharing the objective of maintaining a low prevalence and actively working towards containment. Inconsistencies in guidelines can lead to inefficient information exchange and inconsistent hygienic measures during patient transfers. Despite common commitments, differences in focus may reflect evolving understanding of MDRO transmission and ongoing debates on their management. Our findings highlight the divergence of IPC guidelines for the management of MDROs across two countries and call for collaboration in cross-border regions to increase the effectiveness of MDRO management in these regions and improve patient care.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2047-2994
Relation: https://doaj.org/toc/2047-2994
DOI: 10.1186/s13756-025-01528-3
Access URL: https://doaj.org/article/c3c7a4f7c9c8441f8262f2465829c0ec
Accession Number: edsdoj.3c7a4f7c9c8441f8262f2465829c0ec
Database: Directory of Open Access Journals
More Details
ISSN:20472994
DOI:10.1186/s13756-025-01528-3
Published in:Antimicrobial Resistance and Infection Control
Language:English