title: Controversies in guidelines for the control of multidrug-resistant Gram-negative bacteria in EU countries.
abstract: The various guidelines that are available for multidrug-resistant Gram-negative bacteria are useful, and contain broad areas of agreement. However, there are also important areas of controversy between the guidelines in terms of the details of applying contact precautions, single-room isolation and active surveillance cultures, differences in the approach to environmental cleaning and disinfection, and whether or not to perform staff and patient cohorting, healthcare worker screening or patient decolonization. The evidence-base is extremely limited and further research is urgently required to inform an evidence-based approach to multidrug-resistant Gram-negative bacteria prevention and control.
authors.affiliation: Imperial College Healthcare NHS Trust, London, UK. Electronic address: jon.otter@imperial.nhs.uk.
authors.forename: J A
authors.initials: JA
authors.lastname: Otter
authors.affiliation: Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: N T
authors.initials: NT
authors.lastname: Mutters
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine I, Tübingen University Hospital, Tübingen, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Tacconelli
authors.affiliation: Department of Internal Medicine, Infectious Diseases Unit, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Gikas
authors.affiliation: Imperial College Healthcare NHS Trust, London, UK; Imperial College London, UK.
authors.forename: A H
authors.initials: AH
authors.lastname: Holmes
mesh_terms: D003428:Cross Infection / Q000382:microbiology* / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D019317:Evidence-Based Medicine; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D017053:Infection Control / Q000379:methods*; D010356:Patient Isolation; D017410:Practice Guidelines as Topic / Q000592:standards*
keywords: Acinetobacter; Klebsiella; guidelines; infection control; multidrug-resistant Gram-negative bacteria