Skip to main content

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)