EMC (Netherlands) | KSK (Austria) | VGS (Austria) | ERU (Turkey) | INMI (Italy) | TGH (Greece) | |
---|---|---|---|---|---|---|
Prevalence according to ECDC maps 2015 and CAESAR 2016 (13, 14) | 0.2% | 0.8% | 0.8% | 30% | 33.5% | 62% |
Low | Low | Low | High | High | High | |
Median self-reported prevalence of HRMO per hospital per year, regardless of sample site (range 2014–2016) | 4 (2–5) | 0 (0–0) | 3 (2–17) | 382 (190–399) | 66 (34–69) | 178 (156–191) |
Targeted screening§ | ||||||
Primary case¥ - targeted screening on hospitalized patients | Yes (> 90%)* | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (50–90%) | Yes (10–49%) |
Primary case - targeted screening on discharged patients | Yes (> 90%) | No | No | Yes (50–90%) | No | No |
Secondary case – targeted screening on hospitalized patients | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (50–90%) | Yes (> 90%) | Yes (50–90%) |
Secondary case – targeted screening on discharged patients | Yes (> 90%) | No | No | Yes (50–90%) | No | No |
Outbreak – targeted screening on hospitalized patients | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (50–90%) | Yes (> 90%) | Yes (50–90%) |
Outbreak – targeted screening on discharged patients | Yes (> 90%) | No | No | Yes (50–90%) | Yes (50–90%) | No |
Labelling | ||||||
Isolation label for CPK-positive patients | Yes (> 90%) | Yes, but without HRMO specification (50–90%) | Yes (50–90%) | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) |
Number of negative cultures before lifting label | 6, during one year | N.D. | Upon discharge (but stays archived digitally) | 3, one week apart | 3 | 3 |
Isolation measures | ||||||
Isolation in multi-bedroom with blocking of the beds | No | No | Yes (50–90%) | Yes (50–90%) | Yes (> 90%) | No |
Isolation in single bedroom without anteroom | Yes (> 90%) | No | Yes (> 90%) | Yes (50–90%) | No | Yes (50–90%) |
Isolation in single bedroom with anteroom | No | No | No | Yes (10–49%) | Yes (> 90%) | No |
Personal protective equipment | ||||||
Non-sterile gloves | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (50–90%) |
Disposable gowns | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (50–90%) |
Caps | No | No | Yes (> 90%) | Yes (10–49%) | No | No |
(Surgical) masks | No | No | Yes (> 90%) | Yes (< 10%) | No | Yes (10–49%) |
Laboratory (2017) | ||||||
Screening technique CPK | Culture/PCR, after broth enrichment | Culture/PCR, directly on clinical sample & Culture, after broth enrichment | Culture, directly from clinical sample | Culture, directly from clinical sample | Culture, directly from clinical sample & phenotypic confirmatory test | Culture, directly from clinical sample |
Starting molecular typing of CPK | N = 2 | Always | N > 2 | N.A. | In case of clinical or epidemiological need (cluster/ outbreak) | N > 2 |
Molecular typing method of CPK | MLVA | Molecular typing is outsourced | RAPD, NGS | N.A. | Molecular typing is outsourced (RAPD, NGS/WGS, MLST) | NGS/WGS, MLST |
Cleaning and disinfection | ||||||
Replacing separation curtains after discharge | Yes | No | Yes | Yes | N.A. | No |
Disposables in the isolation room are discarded after discharge | Yes | Yes | Yes | Yes | Yes | Yes |