Multidrug-resistant Germs: Prevention

To prevent multidrug-resistant germs, attention must be paid to reducing individual risk factors.

Behavioral risk factors

  • Diet
    • Malnutrition
  • Poor hand hygiene: one in four patients carried multidrug-resistant pathogens (MREs) on their hands when admitted to a U.S. rehab facility.
  • Foreign travel:
    • Of 574 travelers who were free of multidrug-resistant pathogens before traveling to tropical countries, half returned with multidrug-resistant pathogens in their intestines.
    • India returnees returned with multidrug-resistant bacterial strains in their gut 76% of the time, including colistin-resistant strains containing the mcr-1 gene.

Other risk factors

  • Iatrogenic (caused by the physician):
    • Antibiotic treatment
      • Without prior bacteriology (determination of the pathogen or its resistance).
      • With underdosing of the antibiotic
      • With rapid change of different antibiotics (antibiotic cycling).
      • With premature termination of the antibiotic
      • Not in accordance with guidelines or generous prescribing practice

Preventive measures

Nurses should wear gloves and be instructed in their proper use. Furthermore, it is necessary to protect the mouth and nose (surgical mouthguard). Especially when working where body fluids containing pathogens can be spread. Eye protection is another important measure in the event of splash hazards. The protective gown to be used must not be used for several patients!

Hand hygiene (concerning nursing staff and patients as well as people in general).

  • Hand washing (under running water with soap (for at least 15-20 seconds); while doing so, soap hands well and then thoroughly rinse off the soap scum; then hand disinfection using an alcohol-based disinfectant).
    • Always after:
      • Direct contact with other people
      • Coming home
      • Coughing and sneezing
      • Blowing the nose
      • Going to the toilet
      • Contact with animals
    • Always before:
      • Food preparation
      • The food
  • Proper hand hygiene requires that nails are cut short (< 2 mm protruding above the fingertip).
  • Avoid shaking hands and hugging to greet.
  • Keep your distance from people who are coughing or sneezing.
  • Touch as little as possible your mouth, nose or eyes with your own hands.
  • Hand disinfection again after contact with respiratory secretions!

Further notes