{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:49:39Z","timestamp":1762004979669,"version":"build-2065373602"},"reference-count":12,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T00:00:00Z","timestamp":1516924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"INTERREG V A (202085) project EurHealth-1Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Preventing the spread of multidrug-resistant Gram-negative bacteria (MDRGNB) is a public health priority. However, the definition of MDRGNB applied for planning infection prevention measures such as barrier precautions differs depending on national guidelines. This is particularly relevant in the Dutch\u2013German border region, where patients are transferred between healthcare facilities located in the two different countries, because clinicians and infection control personnel must understand antibiograms indicating MDRGNB from both sides of the border and using both national guidelines. This retrospective study aimed to compare antibiograms of Gram-negative bacteria and classify them using the Dutch and German national standards for MDRGNB definition. A total of 31,787 antibiograms from six Dutch and four German hospitals were classified. Overall, 73.7% were no MDRGNB according to both guidelines. According to the Dutch and German guideline, 7772\/31,787 (24.5%) and 4586\/31,787 (12.9%) were MDRGNB, respectively (p &lt; 0.0001). Major divergent classifications were observed for extended-spectrum \u03b2-lactamase (ESBL) -producing Enterobacteriaceae, non-carbapenemase-producing carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa and Stenotrophomonas maltophilia. The observed differences show that medical staff must carefully check previous diagnostic findings when patients are transferred across the Dutch\u2013German border, as it cannot be assumed that MDRGNB requiring special hygiene precautions are marked in the transferred antibiograms in accordance with both national guidelines.<\/jats:p>","DOI":"10.3390\/microorganisms6010011","type":"journal-article","created":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T04:11:48Z","timestamp":1516939908000},"page":"11","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch\u2013German Border Region\u2014Impact of National Guidelines"],"prefix":"10.3390","volume":"6","author":[{"given":"Robin","family":"K\u00f6ck","sequence":"first","affiliation":[{"name":"Institute of Hospital Hygiene Oldenburg, 26133 Oldenburg, Germany"},{"name":"Institute of Hygiene, University Hospital M\u00fcnster, 48149 M\u00fcnster, Germany"},{"name":"Institute of Medical Microbiology, University Hospital M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Siemer","sequence":"additional","affiliation":[{"name":"European Medical School Oldenburg-Groningen, 26129 Oldenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jutta","family":"Esser","sequence":"additional","affiliation":[{"name":"Laborarztpraxis Osnabr\u00fcck, 49124 Georgsmarienh\u00fctte, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5013-159X","authenticated-orcid":false,"given":"Stefanie","family":"Kampmeier","sequence":"additional","affiliation":[{"name":"Institute of Hygiene, University Hospital M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7620-1800","authenticated-orcid":false,"given":"Matthijs","family":"Berends","sequence":"additional","affiliation":[{"name":"Certe Medical Diagnostics &amp; Advice, 9700 AX Groningen, The Netherlands"},{"name":"University of Groningen, University Medical Center Groningen (UMCG), Department of Medical Microbiology, 9713 GZ Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinna","family":"Glasner","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen (UMCG), Department of Medical Microbiology, 9713 GZ Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Arends","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen (UMCG), Department of Medical Microbiology, 9713 GZ Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6391-1341","authenticated-orcid":false,"given":"Karsten","family":"Becker","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, University Hospital M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Friedrich","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen (UMCG), Department of Medical Microbiology, 9713 GZ Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/s13756-017-0259-z","article-title":"Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: Guidance from the European Centre for Disease Prevention and Control","volume":"6","author":"Magiorakos","year":"2017","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_2","unstructured":"European Centre for Disease Prevention and Control (2017, December 15). EARS-Net Resistance Data for 2016. Available online: http:\/\/atlas.ecdc.europa.eu\/public\/index.aspx."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"30062","DOI":"10.2807\/1560-7917.ES.2015.20.45.30062","article-title":"European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group. Carbapenemase-producing Enterobacteriaceae in Europe: Assessment by national experts from 38 countries, May 2015","volume":"20","author":"Albiger","year":"2015","journal-title":"Euro Surveill."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13756-015-0047-6","article-title":"Cross-border comparison of the Dutch and German guidelines on multidrug-resistant Gram-negative microorganisms","volume":"4","author":"Voss","year":"2015","journal-title":"Antimicrob. Resist. Infect. 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Bull."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/6\/1\/11\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T14:52:38Z","timestamp":1760194358000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/6\/1\/11"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,26]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,3]]}},"alternative-id":["microorganisms6010011"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms6010011","relation":{},"ISSN":["2076-2607"],"issn-type":[{"type":"electronic","value":"2076-2607"}],"subject":[],"published":{"date-parts":[[2018,1,26]]}}}