{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T10:20:15Z","timestamp":1787998815583,"version":"build-2784847793"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rehabilitation (Stuttg)"],"published-print":{"date-parts":[[2020,12]]},"abstract":"Zusammenfassung<\/jats:title>\n Hintergrund Nach einer ersten gro\u00dfen Untersuchung zu\n multiresistenten Erregern (MRE) in Rehabilitationseinrichtungen im Jahr 2014\n f\u00fchrte das MRE-Netz Rhein-Main im Jahr 2019 erneut eine Untersuchung\n durch, diesmal wurde vor dem Hintergrund der KRINKO-Empfehlung zu\n multiresistenten Enterokokken auf das Vorkommen Vancomycin-resistenter\n Enterokokken (VRE) und multiresistenter gramnegative Erreger (3MRGN und 4MRGN)\n untersucht.<\/jats:p>\n Material und Methoden Insgesamt 16 Kliniken nahmen teil, darunter eine\n Klinik f\u00fcr neurologische Fr\u00fchrehabilitation (FR). Die Teilnahme\n der Patienten war freiwillig. Die Rektalabstriche wurden in einem nach DIN ISO\n 15189-akkreditierten medizinisch-mikrobiologischen Labor mittels etablierten\n Standard-Methoden (u.\u2009a. via mittels MALDI\u2013TOF-MS und VITEK\n 2-Resistenztestung gem. EUCAST) analysiert. Mit dem standardisierten Fragebogen\n der europaweiten HALT-Untersuchung (Healthcare associated infections in\n long-term care facilities) wurden Patientencharakteristika (Alter,\n Geschlecht, Krankenhaus, OP- und MRE-Anamnese, Medical devices, aktuelle\n Antibiotikatherapie etc.) erhoben.<\/jats:p>\n Ergebnisse 928 Patienten nahmen an der Untersuchung teil, 895 aus\n allgemeinen Reha-Einrichtungen (AR) und 33 aus einer neurologischen\n Fr\u00fchrehabilitation (FR). 65% der AR-Patienten (FR 100%)\n gaben einen Klinikaufenthalt in den letzten 6 Monaten an, 29% (FR\n 100%) der Patienten wurden direkt aus einer Klinik aufgenommen,\n 22% (FR 64%) hatten eine Antibiotika-Therapie in den letzten 3\n Monaten erhalten. Medical devices waren bei AR-Patienten mit 1%\n insgesamt selten, in der FR mit 61% Harnwegskathetern und 36%\n Gef\u00e4\u00dfkathetern jedoch h\u00e4ufig. 2,2% (FR\n 33,3%) der AR-Patienten waren mit VRE und 6,7% (FR\n 18,2%) mit 3MRGN besiedelt. Ein Patient wies einen 4MRGN-Erreger auf (FR\n 0).<\/jats:p>\n Diskussion Im Vergleich zur fr\u00fcheren Untersuchung ergaben sich\n bei den erhobenen Patientencharakteristika keine wesentlichen\n \u00c4nderungen. Die VRE-Pr\u00e4valenz war mit 3,3% niedrig, die\n Pr\u00e4valenz an 3MRGN war mit 7,1% im Vergleich zu 2014\n (3,6%) h\u00f6her. Risikofaktoren f\u00fcr eine VRE- und eine\n 3MRGN-Besiedelung (sign. erh\u00f6hte Odds-Ratio) waren:\n Krankenhausbehandlung in der Anamnese sowie ein erh\u00f6hter Pflegebedarf\n aufgrund von Bewegungseinschr\u00e4nkung, Stuhlinkontinenz und\n Desorientiertheit. Dar\u00fcber hinaus wurden eine vorausgegangene\n Antibiotikabehandlung sowie Hautbarriereverletzungen bedingt durch Medical\n devices oder Wunden als weitere Risikofaktoren f\u00fcr eine\n VRE-Besiedelung gefunden.<\/jats:p>","DOI":"10.1055\/a-1199-9083","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:18:48Z","timestamp":1598919528000},"page":"366-375","source":"Crossref","is-referenced-by-count":7,"title":["Multiresistente Erreger (MRE) in der Rehabilitation:\n Pr\u00e4valenz und Risikofaktoren f\u00fcr MRGN und VRE"],"prefix":"10.1055","volume":"59","author":[{"given":"Katrin","family":"Steul","sequence":"additional","affiliation":[{"name":"MRE-Netz Rhein-Main, Frankfurt am Main"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cleo","family":"Schmehl","sequence":"additional","affiliation":[{"name":"MRE-Netz Rhein-Main, Frankfurt am Main"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Berres","sequence":"additional","affiliation":[{"name":"MRE-Netz Rhein-Main, Frankfurt am Main"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Hofmann","sequence":"additional","affiliation":[{"name":"MEDIAN Kliniken Hessen GmbH & Co. KG, Bad Nauheim"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Klaus-Altschuck","sequence":"additional","affiliation":[{"name":"MEDIAN Kliniken Hessen GmbH & Co. KG, Bad Nauheim"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hogardt","sequence":"additional","affiliation":[{"name":"Goethe Universit\u00e4t, Universit\u00e4tsklinikum Frankfurt,\n Institut f\u00fcr Medizinische Mikrobiologie und Krankenhaushygiene,\n Frankfurt am Main"},{"name":"University Center of Competence for Infection Control, Frankfurt am\n Main"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkhard AJ","family":"Kempf","sequence":"additional","affiliation":[{"name":"Goethe Universit\u00e4t, Universit\u00e4tsklinikum Frankfurt,\n Institut f\u00fcr Medizinische Mikrobiologie und Krankenhaushygiene,\n Frankfurt am Main"},{"name":"University Center of Competence for Infection Control, Frankfurt am\n Main"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Pohl","sequence":"additional","affiliation":[{"name":"VAMED Klinik Schloss Pulsnitz GmbH, Fachklinik f\u00fcr\n Neurologisch-Neurochirurgische Rehabilitation, Pulsnitz"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursel","family":"Heudorf","sequence":"additional","affiliation":[{"name":"MRE-Netz Rhein-Main, Frankfurt am Main"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,8,31]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/S1473-3099(17)30753-3","article-title":"Discovery, research, and development of new antibiotics: the WHO priority list\n of antibiotic-resistant bacteria and tuberculosis","volume":"18","author":"E Tacconelli","year":"2018","journal-title":"Lancet Infect Dis Internat"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1007\/s00103- 018-2811-2","volume":"61","year":"2018","journal-title":"Bundesgesundheitsbl"},{"key":"ref4","first-page":"696","volume":"57","year":"2014","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung\n Gesundheitsschutz"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1007\/s00103-012-1549-5","volume":"55","year":"2012","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung\n Gesundheitsschutz"},{"key":"ref7","first-page":"31","article-title":"Integrieren statt isolieren","author":"A Klaus-Altschuck","year":"2013","journal-title":"Healthcare Journal"},{"key":"ref8","first-page":"410","article-title":"Multiresistente Erreger in der Rehabilitation \u2013 Ergebnisse einer\n Pilotstudie des MRE-Netz Rhein-Main, 2013","volume":"19","author":"U Heudorf","year":"2014","journal-title":"Umweltmedizin, Hygiene Arbeitsmedizin"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1055\/s-0035-1559642","article-title":"Multiresistente Erreger in Rehabilitationseinrichtungen im Rhein-Main-Gebiet,\n Deutschland, 2014: I Pr\u00e4valenz und Risikofaktoren","volume":"54","author":"U Heudorf","year":"2015","journal-title":"Rehabilitation"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1055\/a-0638-9226","article-title":"Multiresistente Erreger in der onkologischen und kardiologischen Rehabilitation\n \u2013 Ergebnisse einer Surveillancestudie in Brandenburg","volume":"58","author":"T Kiefer","year":"2019","journal-title":"Rehabilitation"},{"key":"ref11","first-page":"999","article-title":"Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in patients in\n longterm care in hospitals, rehabilitation centers and nursing homes of a rural\n district in Germany","volume":"133","author":"R Woltering","year":"2008","journal-title":"Dtsch Med Wochenschr"},{"key":"ref12","first-page":"163","article-title":"Fl\u00e4chendeckendes einmonatiges MRSA Pr\u00e4valenz-screening in Akut-\n und Rehakliniken in Siegen- Wittgenstein","volume":"18","author":"C Grabe","year":"2010","journal-title":"Epidemiol Bull"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jhin.2014.02.007","article-title":"Admission prevalence and acquisition of nasal carriage of meticillin-resistant\n Staphylococcus aureus (MRSA) in German rehabilitation centres","volume":"87","author":"R K\u00f6ck","year":"2014","journal-title":"J Hosp Infect"},{"key":"ref14","first-page":"Doc21","article-title":"Long term observation of MRSA prevalence in a German rehabilitation center: risk\n factors and variability of colonization rate","volume":"11","author":"J Geffers","year":"2016","journal-title":"GMS Hyg Infect Control"},{"key":"ref15","first-page":"519","article-title":"Eigenschaften, H\u00e4ufigkeit und Verbreitung von Vancomycin- resistenten\n Enterokokken (VRE) in Deutschland \u2013 Update 2015\/2016","author":"I Klare","year":"2017","journal-title":"Epidemiol Bull"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1186\/s13756-019-0573-8 eCollection 2019","article-title":"Near-ubiquitous presence of a vancomycin-resistant Enterococcus faecium\n ST117\/CT71\/vanB -clone in the Rhine-Main metropolitan area of\n Germany","volume":"8","author":"L Falgenhauer","year":"2019","journal-title":"Antimicrob Resist Infect Control"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1055\/s-0034-1375640","article-title":"Multiresistente Erreger in der neurologisch-neurochirurgischen\n Fr\u00fchrehabilitation (2004-2013)","volume":"53","author":"J D Rollnik","year":"2014","journal-title":"Rehabilitation"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s12883-017-0833-2","article-title":"Outcome of neurological early rehabilitation patients carrying multi-drug\n resistant bacteria: results from a German multi-center study","volume":"17","author":"J D Rollnik","year":"2017","journal-title":"BMC Neurol"},{"key":"ref20","first-page":"634","article-title":"Rehabilitationsverlauf von Patienten in der neurologisch-neurochirurgischen\n Fr\u00fchrehabilitation. Ergebnisse der multizentrischen Erfassung im Jahr\n 2014 in Deutschland","volume":"87","author":"M Pohl","year":"2016","journal-title":"Nervenarzt"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.jhin.2017.08.002 Epub 2017 Aug 8. 2015","article-title":"Infection Prevention (AGIP). Infection control measures and prevalence of\n multidrug-resistant organisms in non-hospital care settings in northeastern\n Germany: results from a one-day point prevalence study","volume":"97","author":"N O H\u00fcbner","year":"2017","journal-title":"J Hosp Infect"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1128\/AAC.01993-13 Epub 2013 Dec 2","article-title":"Extended-spectrum-\u03b2-lactamase-producing Escherichia coli as intestinal\n colonizers in the German community","volume":"58","author":"G Valenza","year":"2014","journal-title":"Antimicrob Agents Chemother"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1055\/s-0035-1564099","article-title":"Multiresistente Erreger in Rehabilitationseinrichtungen im Rhein-Main-Gebiet,\n Deutschland, 2014: II. \u00c4rztliche Risikoanalyse und\n Hygienema\u00dfnahmen","volume":"54","author":"U Heudorf","year":"2015","journal-title":"Rehabilitation"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1055\/a-0936-2193","article-title":"Praktisches Hygienemanagement in der station\u00e4ren Rehabilitation\n \u2013 Umgang mit Multiresistenten Erregern (MRE) am Beispiel einer\n orthop\u00e4dischen Klinik","volume":"58","author":"A Schr\u00f6der","year":"2019","journal-title":"Rehabilitation"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/1471-2377-14-34","article-title":"Outcome of MRSA carriers in neurological early rehabilitation","volume":"14","author":"J D Rollnik","year":"2014","journal-title":"BMC Neurol"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4236\/ojtr.2015.31001","article-title":"Outcome of Early Neurological Rehabilitation Patients Colonized with Extended-\n Spectrum Beta-Lactamase (ESBL) Producing Bacteria","volume":"3","author":"J D Rollnik","year":"2015","journal-title":"Open Journal of Therapy and Rehabilitation"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"939","DOI":"10.23736\/S1973-9087.18.05100-6 Epub 2018 Jun 11","article-title":"Factors influencing weaning from mechanical ventilation in neurological and\n neurosurgical early rehabilitation patients","volume":"54","author":"S B Schmidt","year":"2018","journal-title":"Eur J Phys Rehabil Med"},{"key":"ref28","first-page":"285","article-title":"Evidenzbasierte Hygiene in der Neurorehabilitation: Was ist sinnvoll, was ist\n n\u00f6tig?","volume":"24","author":"M Borg","year":"2018","journal-title":"Neurol Rehabil"},{"key":"ref29","first-page":"273","article-title":"Hygiene in der Neurorehabilitation","volume":"24","author":"M Pohl","year":"2018","journal-title":"Neurol Rehabil"},{"key":"ref30","first-page":"301","article-title":"Verg\u00fctungsrelevanz von Mehrkosten durch Multiresistente Erreger in der\n Neurorehabilitation","volume":"24","author":"S Knecht","year":"2018","journal-title":"Neurol Rehabil"}],"container-title":["Die Rehabilitation"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1199-9083.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T23:46:48Z","timestamp":1607384808000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1199-9083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,31]]},"references-count":27,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2020,12,7]]},"published-print":{"date-parts":[[2020,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1199-9083","relation":{},"ISSN":["0034-3536","1439-1309"],"issn-type":[{"value":"0034-3536","type":"print"},{"value":"1439-1309","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,31]]}}}