The increasing prevalence of gram-negative Enterobacteriaceae being resistant to antibiotics poses new challenges to healthcare facilities around the globe. Enterobacteriaceae that are able to form enzymes with extended beta-lactamase spectrum – also referred to as – extended-spectrum beta-lactamases – or ESBL-producing organisms – are most relevant here. ESBL can additionally result in an extended resistance to third-generation cephalosporins. Hence, it is also called cephalosporin-resistant Enterobacteriaceae (CRE).
In Germany, the incidence of ESBL-associated infections on intensive care units has tripled between 2006 and 2010. 34 per cent of these infections have been acquired in hospitals and probably could have been prevented by good infection control measures1.
In case of ESBL, experts2 recommend a differentiated, risk-related hygiene management.
Grading criteria are:
- Resistance pattern.
To which antibiotics is the respective germ resistant and what are the remaining treatment options?
- Risks for fellow patients or co-residents.
The hygiene regime should be stricter, the more the fellow patients are vulnerable to infections.
These criteria determine if it is sufficient to carry out basic hygiene or if additional measures such as barrier nursing and isolation precautions need to be taken.