ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients

Clin Microbiol Infect. 2014 Jan:20 Suppl 1:1-55. doi: 10.1111/1469-0691.12427.


Healthcare-associated infections due to multidrug-resistant Gram-negative bacteria (MDR-GNB) are a leading cause of morbidity and mortality worldwide. These evidence-based guidelines have been produced after a systematic review of published studies on infection prevention and control interventions aimed at reducing the transmission of MDR-GNB. The recommendations are stratified by type of infection prevention and control intervention and species of MDR-GNB 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. The level of evidence for and strength of each recommendation, were defined according to the GRADE approach.

Keywords: Acinetobacter; Burkholderia; Enterobacteriaceae; Pseudomonas; Stenotrophomonas; extended-spectrum β-lactamase; guideline; infection control; multidrug-resistant Gram-negative; outbreak.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Anti-Infective Agents, Local
  • Bacterial Typing Techniques
  • Chlorhexidine
  • Cross Infection / prevention & control*
  • Cross Infection / transmission*
  • Disease Outbreaks / prevention & control*
  • Drug Resistance, Multiple, Bacterial
  • Gram-Negative Bacteria / isolation & purification*
  • Gram-Negative Bacterial Infections / prevention & control*
  • Gram-Negative Bacterial Infections / transmission*
  • Hand Hygiene
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infection Control / methods*
  • Risk Factors


  • Anti-Infective Agents, Local
  • Chlorhexidine