Table 2c. Comparing national IPC policies on VRE
EMC (Netherlands) | KSK (Austria) | VGS (Austria) | INMI (Italy) | ERU (Turkey) | TGH (Greece) | |
|---|---|---|---|---|---|---|
Prevalence according to ECDC maps 2015 and CAESAR 2016 (13, 14) | 1.9% | 3.1% | 3.1% | 11.2% | 16% | 20% |
Low | Low | Low | Medium | Medium | Medium | |
Median self-reported prevalence of HRMO per hospital per year, regardless of sample site (range 2014–2016) | 33 (9–47) | 0 (0–0) | 48 (48–114) | 11 (3–23) | 48 (42–51) | 38 (31–47) |
Targeted screening§ | ||||||
Primary case¥ - targeted screening on hospitalized patients | Yes (> 90%)* | Yes (> 90%) | Yes (> 90%) | No | Yes (> 90%) | No |
Primary case - targeted screening on discharged patients | Yes (> 90%) | No | No | No | Yes (50–90%) | No |
Secondary case – targeted screening on hospitalized patients | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (50–90%) | No |
Secondary case – targeted screening on discharged patients | Yes (> 90%) | No | No | No | Yes (50–90%) | No |
Outbreak – targeted screening on hospitalized patients | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (> 90%) | Yes (50–90%) | Yes (50–90%) |
Outbreak – targeted screening on discharged patients | Yes (> 90%) | No | No | Yes (50–90%) | Yes (50–90%) | No |
Labelling | ||||||
Isolation label for VRE-positive patients | Yes (> 90%) | Yes, but without HRMO specification (50–90%) | Yes (> 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) | 2 | 3, one week apart | 2 |
Isolation measures | ||||||
Isolation in multi-bedroom with blocking of the beds | No | No | Yes (50–90%) | Yes (> 90%) | Yes (50–90%) | No |
Isolation in single bedroom without anteroom | Yes (> 90%) | No | Yes (> 90%) | No | Yes (50–90%) | No |
Isolation in single bedroom with anteroom | No | No | No | Yes (> 90%) | Yes (10–49%) | 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%) | No | Yes (> 90%) | Yes (> 90%) | Yes (50–90%) |
Caps | No | No | Yes (> 90%) | No | Yes (10–49%) | No |
(Surgical) masks | No | No | Yes (> 90%) | No | Yes (< 10%) | No |
Laboratory (2017) | ||||||
Screening technique VRE | Culture/PCR, after broth enrichment. Suspension on vancomycin screenings agar 10 ul | Culture, directly from clinical sample & culture, after broth enrichment. | Culture/PCR, directly on clinical sample. | Culture, directly from clinical sample. | Culture, directly from clinical sample | Culture, directly from clinical sample. |
Starting molecular typing of VRE | N = 2 | N > 2 | N > 2 | In case of clinical or epidemiological need (cluster/ outbreak) | N.A. | N.A. |
Molecular typing method of VRE | Molecular typing is outsourced | Molecular typing is outsourced | GeneXpert (Cepheid) | Molecular typing is outsourced (RAPD, NGS/WGS) | N.A. | N.A. |
Cleaning and disinfection | ||||||
Replacing separation curtains after discharge | Yes | No | Yes | N.A. | Yes | No |
Disposables in the isolation room are discarded after discharge | Yes | Yes | Yes | Yes | Yes | Yes |