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Table 2 Summary of the French guidelines to deal with critical MDR organisms

From: Antimicrobial resistance: one world, one fight!

Main steps Main causes of failure observed
Isolating the patient, at best cohorting and dedicated staff – Delayed measures (e.g., patients admitted over the week-end or medical staff not reacting quickly)
  – Lack of dedicated healthcare workers to implement isolation or cohorting
  – Missing readmission /admission screening of a patient known to carry a MDR organism
  – Missing information on a previous stay of the patient in another hospital, particularly in a foreign country
Alerting hospital management – Mistakes in the hospital management system
  – Loose relationship between the infection control team and hospital management
Stopping transfers of patients to other hospitals – Continuation of patient transfers to other hospitals
Screening any people who may have been in contact with the patient – Uncompleted list of contacts
  – Not sampling identified contact patients
  – Missing admission of a patient transferred from a ward or hospital where outbreak is ongoing
  – Inadequate lab facilities
Reinforcing hand hygiene – Poor hand hygiene at baseline
  – Insufficient input of infection control team
Identifying antibiotics that could be used in case of critically-resistant infections – Delayed identification by the laboratory