Als „multiresistente Erreger“ (MRE) werden Erreger bezeichnet, die Resistenzen
gegenüber einer Vielzahl von Antibiotika besitzen, welche üblicherweise zur Therapie
bei
diesen Pathogenen eingesetzt werden können. Die Prävention von Infektionen mit MRE
umfasst
Antibiotic-Stewardship-Strategien ebenso wie hygienische Ansätze, um Entstehung
und
Ausbreitung dieser Erreger im klinischen Setting zu verhindern.
Abstract
The increasing prevalence of multidrug-resistant organisms (MDRO) poses a major threat
to healthcare systems. Critically ill patients are at heightened risk to acquire
MDRO
infections resulting in longer hospital stays and higher mortality rates. This
article
provides an overview of preventive measures, divided into Infection Prevention
and
Control (IPC) and Antimicrobial Stewardship (AMS) approaches. IPC measures focus
on the
prevention of MDRO spread by applying basic and extended hygiene strategies. While
basic
hygiene such as hand and surface disinfection are effective in stopping any pathogen
transmission, extended hygiene strategies including screening approaches, patient
isolation and contact precautions are essential to identify MDRO patients and separate
them from other susceptible patients. On the one hand, AMS aims at reducing the
development of resistances under selective pressure by rational use of antimicrobials.
On the other hand, interdisciplinary AMS-teams provide recommendations to optimize
targeted MDRO therapy, including the rational use of “new” antibiotics. By pursuing
different starting points, both IPC- and AMS-strategies are necessary in the prevention
of MDRO development and transmission.
Schlüsselwörter
Antibiotic Stewardship - Infektionsprävention - Krankenhaushygiene - MRE
Keywords
Antimicrobial Stewardship - Infection Prevention and Control - MDRO
