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Table 5a Standard and additional infection control precautions by HRMO positive residents, per HRMO in a non-outbreak setting

From: Dutch guideline for preventing nosocomial transmission of highly-resistant micro-organisms (HRMO) in long-term care facilities (LTCFs)

HRMO or indication Hand hygieneb Personal Protective Equipment Single room/apartment Sanitation Use of shared facilities such as living room
Glovesc Apron/Single use isolation gown with long sleevesc Mask Toilet/commode chair Bathroom
Enterobacteriaceae (ESBL included, not CPEa) Yes Yes Apron Nod no No sharing with other residents Sharing possiblee Yesf
CPEa Yes Yes Isolation gown Nod Yesg No sharing with other residents No sharing with other residents Depending on individual situationh
Acinetobacter species Yes Yes Isolation gown Nod Yesg No sharing with other residents No sharing with other residents Depending on individual situationh
Pseudomonas aeruginosa Yes Yes Apron Nod no No sharing with other residents Sharing possiblei Yesf
Stenotrophomonas maltophilia
Streptococcus pneumoniae (PRP) Yes Yes Apron FFP1j Yesg, k Sharing possible Sharing possiblee Yes, under conditionsf, l
Enterococcus faecium (VRE) Yes Yes Apron Nod Yes, by preferenceg No sharing with other residents No sharing with other residents Yesf
Recent admission foreign HCF Yes Yes Isolation gown Noned, m Yesg No sharing with other residents No sharing with other residents Depending on individual situation h, l
  1. aCPE: Carbapenem resistant Enterobacteriaceae
  2. bWHO 5 moments of hand hygiene (part of standard precautions)
  3. cWear only when giving physical care to residents and/or contact with material of residents. Do not wear during pure social activities
  4. dUse a surgical mask whenever there is a risk of splashing of body fluids (part of standard precautions)
  5. eWhen resident shares a bathroom: HRMO positive resident is the last one to use the bathroom, immediate cleaning procedure after use
  6. fGive resident instruction on how to perform hand hygiene. If residents have wounds or indwelling catheters, cover these with an appropriate (wound)dressing
  7. gIf HRMO positive resident shares his room or apartment with another resident (e.g. couples), the other resident is also to be considered as an HRMO positive resident
  8. hConsult the medical microbiologist and/or infection control practitioner to determine if visiting shared facilities (e.g. living room) is appropriate (taking into account the risk of transmission to other residents). If using shared facilities is permitted, see footnote f
  9. iIf resident shares bathroom facilities, ensure that after use immediate cleaning and disinfection takes place (important issue because of long survival duration of these microorganisms)
  10. jFFP: Filtering facepiece particle; Put FFP1 mask in place before entering resident’s room (only in the acute phase of a respiratory infection which means, in the first 48 hours after appropriate antibiotic treatment has started)
  11. kSingle room/apartment is only necessary in the acute phase of a respiratory infection, which means in the first 48 hours after appropriate antibiotic treatment has started
  12. lUse of shared facilities not allowed in the acute phase of a respiratory infection, in the first 48 hours after appropriate antibiotic treatment has started
  13. mSpecial note: When a resident is suspected of MRSA carriage (e.g. after recent admission in foreign HCF, use surgical mask as part of the precautions for prevention of MRSA)