Table 2 Summary of health care and research recommendations

Feeling dirty and unworthy

 Be mindful of language usage when describing MDRO to carriers

 Ensure that patients do not feel like lepers and outcasts by avoiding them, or serving them last

 Mitigate loneliness by ensuring regular contacts between staff and patients

 Ensure that patients do not feel imprisoned in isolation rooms

 Take into account that MDRO carriage is an additional affliction often compounding other serious medical conditions, and that carriers may need all the support they can get

MDROs are invisible, but impact is visible

 Acknowledge the fears that patients have and provide support and advice

 Minimize the disruptive effects that MDRO status can have on people’s lives, for example by facilitating efforts to remove the status of MDRO carriage from their dossiers

Carrying burden on one’s own shoulder

 Provide clear information (written and verbal) to carriers on what is currently known and unknown about MDRO carriage, including what to tell their network of family, friends and acquaintances regarding their infectiousness

 Acknowledge the confusion due to discrepancies in behaviours/ policies and align these behaviours and policies where possible

 Improve the general knowledge of staff dealing with MDROs, so that everyone is on the same page

 Provide follow-up care for patients beyond the hospital doors into their further lives

 Consider that negative experiences associated with MDRO carriage may lead to less transparency by MDRO carriers and hesitance in being tested for resistant microbes

Further research

 Conduct qualitative research with MDRO carriers in the general population representing a younger and healthier population

 Conduct qualitative research with HCPs who treat MDRO carriers to discuss the perspectives expressed by MDRO carriers and possible solutions

 To enable more targeted support, investigate the associations of MDRO characteristics (including demographics, other medical conditions and types of MDRO) with experiences and perceptions, including fear and shame

 Examine the impact of COVID-19 on the prevalence of MDRO carriers as well as on perceptions of precautionary measures and of being a carrier