Zusammenfassung
Isolationsmaßnahmen zur Prävention der Übertragung multiresistenter Erreger (MRE) gehören in Anbetracht der steigenden Resistenzentwicklung auf Intensivstationen mittlerweile zur Routine. Noch wichtiger sind allerdings Basishygiene und der verantwortungsvolle Umgang mit antiinfektiven Therapien. Dieser Beitrag widmet sich den verschiedenen Präventionsmaßnahmen, die nur in Kombination effektiv und zielführend sind.
Abstract
Isolation of patients with multidrug-resistant organisms (MRGN) has been recommended since years. Recent evidence suggests no benefit by this isolation procedure. Furthermore, isolation precautions may have potential negative effects on patient well-being and may increase therapeutic error.
Rather than blocking patients up in a room, implementing and continuous education about standard precautions as hand washing and contact awareness may decrease spread of MRGN and other resistant bacteria. In this context, evidence about mechanism of resistance transfer between bacteria is still expanding. Education about these mechanisms inside and outside the body may help to corroborate the appreciation about implementation of standard precautions. In addition, the awareness of antibiotic stewardship in this context has to be underlined. Prevention of spreading bacteria is not done by isolation in room. In fact, it is a multifactorial continuous cycle of planning, teaching, surveillance and transfer of knowledge. Combination of education, compliance to standard precautions and continuous education may be a big step forward in fighting MRGN transmission and progression.
Schlüsselwörter
räumliche Isolation - Intensivmedizin - Antibiotic Stewardship - multiresistente gramnegative Bakterien (MRGN)
Key words
isolation precautions - intensive care - antibiotic stewardship - multidrug-resistant Gram-negative bacteria (MRGN)
