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