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Health care  –  Interventions

Pathogen specific interventions

When patients are known or suspected to be infected or colonized with certain bacteria, additional precautions may be needed.

In these cases, for example screening for colonization with multidrug-resistant strains, cohorting and isolation can be implemented alongside basic guidelines. Here you find supporting tools and guidance to help prevent and reduce occurrence of infections caused by specific bacteria, with special focus on resistant strains.

The tables below provide a selection of resources to support interventions to prevent and control the spread of:

  • Resistant Gram-negative bacteria
  • Mycobacterium tuberculosis
  • Methicillin-resistant Staphylococcus aureus (MRSA)
  • Clostridioides difficile

In addition, many countries have their own guidelines that are adapted to local circumstances. For additional information and resources to help determine the impact of pathogen-specific interventions, go to MEASURE. See also: Basic interventions and Infection specific interventions.

Selected Resources

Gram-negative bacteria

Resource Description
Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities Guidelines. Global WHO guidelines for preventing and controlling three types of carbapenem-resistant gram-negative bacteria:

  • Enterobacteriaceae (CRE)
  • Acintobacter baumannii (CRAB)
  • Pseudomonas aeruginosa (CRPsA)

Includes eight recommendations, condensed by leading experts from a review of the latest evidence.

Implementation manual to prevent and control the spread of carbapenem-resistant organisms at the national and health care facility level Manual that describes a stepwise approach to support implementation of the recommendations of the WHO guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities. Also relates to the general, core, IPC components that need to be in place in all health care facilities.
ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients Guidelines. These evidence-based guidelines are stratified by type of infection prevention and control intervention and species of multidrug-resistant Gram-negative bacteria and are presented in the form of ‘basic’ practices, recommended for all acute care facilities, and ‘additional special approaches’ to be considered when there is still clinical and/or epidemiological and/or molecular evidence of ongoing transmission, despite the application of the basic measures.
Carbapenem-resistant Enterobacteriaceae (CRE) Directory Directory of guidance on prevention and control of carbapenem-resistant Enterobacteriaceae, published by ECDC, EU/EEA Member States, international and national agencies and professional societies.
Gram-negative bacteria Infections in Healthcare Settings Information portal. CDC’s guidance on reducing infections caused by drug-resistant bacteria, including gram negatives.
Healthcare Facilities: Information about CRE Information portal. CDC’s resources for prevention of carbapenem-resistant Enterobacteriaceae. See for example Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (PDF).

Mycobacterium tuberculosis

Resource Description
WHO Guidelines on tuberculosis infection prevention and control, 2019 update Guidelines for infection prevention and control of tuberculosis. Provides practical and evidence-based approaches for minimizing the risk of Mycobacterium tuberculosis transmission.
TB Infection Control Information portal. Infection control program developed by CDC for tuberculosis including administrative measures, environmental controls and respiratory protective equipment. Also available in Spanish.

Methicillin-resistant Staphylococcus aureus (MRSA)

Resource Description
Meticillin-resistant Staphylococcus aureus (MRSA) Directory Directory of guidance on prevention and control of MRSA, published by ECDC, EU/EEA Member States, international and national agencies and professional societies.
Methicillin-resistant Staphylococcus aureus (MRSA) Infection in Healthcare Settings Guidelines. CDC’s resources for prevention of MRSA infections.
Rapid screening tests for meticillin-resistant Staphylococcus aureus at hospital admission: systematic review and meta-analysis Review article with a meta-analysis of randomized, non-randomized, and observational studies to summarize the available evidence on the effect of MRSA detection by rapid screening tests on hospital-acquired MRSA infections and acquisition rate.

Clostridioides difficile

Resource Description
Prevention of Clostridioides difficile in hospitals: A position paper of the International Society for Infectious Diseases Position paper. Review focusing on how to prevent C. difficile infection at hospitals in low- and middle-income countries. Discusses bottlenecks such as insufficient diagnostic capacity and overcrowding.
Clostridium difficile infection (CDI) Directory Directory of guidance on prevention and control of C. difficile infection (CDI), published by ECDC, EU/EEA Member States, international and national agencies and professional societies.
Clostridioides difficile Infection Guidelines. CDC’s resources for prevention of C. difficile (C. diff) infections.
Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) Guidelines on the epidemiology, diagnosis, treatment, and infection control and environmental management of Clostridium difficile.

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