Prävention und Diagnostik multiresistenter Erreger

Abstract

Patients colonized or infected by multidrug-resistant bacteria (MDR) are entitled to the same medical treatment as other patients and infection control measures based on the current evidence are not in conflict with this aim. Recent studies indicate that the correct sampling technique is of utmost importance when screening for MRSA and usage of certain swabs might reduce the sensitivity considerably. Despite improvements in diagnostic strategies for direct MRSA detection by PCR, false positive results cannot be totally excluded. With regard to multidrug-resistant gramnegative bacteria differences between species should be emphasized to tailor infection control measures. E. g. easier transmissibility has been shown for K. pneumoniae compared to E. coli. Hospitals in Germany should strictly employ screening for carbapenemase-producing Enterobacterales as well as A. baumannii in all patients hospitalized abroad within the previous year. To avoid unnecessary social exclusion of MDR patients it must be emphasized that contact precautions are recommended for hospitals and not for long-time care facilities.

Die Besiedlung eines Patienten mit multiresistenten Erregern, die sogenannte Kolonisation, ist nicht offensichtlich erkennbar, bis die ersten Symptome auftreten. Jedoch besteht immer die Gefahr, dass die Keime auf andere Kontaktpersonen übertragen werden und diese infizieren. Um eine Verbreitung multiresistenter Keime in Krankenhäusern zu verhindern, ist eine moderne Krankenhaushygiene notwendig. Diese umfasst eine adäquate Diagnostik sowie Prävention.

Schlüsselwörter

multiresistente Erreger - MRSA - VRE - Carbapenemase-produzierende Enterobacterales

Key words

multidrug-resistant bacteria - MRSA - VRE - carbapenemase-producing Enterobacterales

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