Prevention and control of multi-drug-resistant Gram-negative bacteria: recommendations from a Joint Working Party

Multi-drug-resistant (MDR) Gram-negative bacterial infections have become prevalent in some European countries. Moreover, increased use of broad-spectrum antimicrobial agents selects organisms with resistance and, by increasing their numbers, increases their chance of spread. This report describes measures that are clinically effective for preventing transmission when used by healthcare workers in acute and primary healthcare premises. Methods for systematic review 1946–2014 were in accordance with SIGN 501 and the Cochrane Collaboration;2 critical appraisal was applied using AGREEII.3 Accepted guidelines were used as part of the evidence base and to support expert consensus. Questions for review were derived from the Working Party Group, which included patient representatives in accordance with the Patient Intervention Comparison Outcome (PICO) process. Recommendations are made in the following areas: screening, diagnosis and infection control precautions including hand hygiene, single-room accommodation, and environmental screening and cleaning. Recommendations for specific organisms are given where there are species differences. Antibiotic stewardship is covered in a separate publication

Multidrug-resistant (MDR) Gram-negative bacteria information leaflets

The Working Party recommends (section 9.5) that clear information on the standards of infection prevention and control should be available to promote confidence in the quality of care provided.1 To assist, the following four information leaflets have been created. The purpose of these leaflets is to explain the meaning of multidrug-resistant Gram-negative organisms and, more specifically, carbapenem-resistant organisms; to assist healthcare workers, patients, relatives, and visitors in understanding why these bacteria are a problem; and to explain what precautions can be taken to help prevent the spread of these bacteria