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This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

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ESBL carriage, implementation variations of Dutch guidelines

G Terlaak-Harbers*, F Loeffen, L Ummels and J Hopman

  • * Corresponding author: G Terlaak-Harbers

Author Affiliations

Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

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BMC Proceedings 2011, 5(Suppl 6):P137  doi:10.1186/1753-6561-5-S6-P137

The electronic version of this article is the complete one and can be found online at:

Published:29 June 2011

© 2011 Terlaak-Harbers et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

In 2005, the Dutch Working party Infection Prevention (WIP) published, its “Measures to prevent transmission of highly resistant microorganisms (HRMO)” guidelines. These guidelines provide strict definitions for the indications and measures that have to be taken in patients with HRMO, including for cases of ESBL carriage. In this study we aim to evaluate the implementation of these guidelines with regard to ESBL.


In September 2010 a questionnaire with 10 items has been sent to 90 Dutch hospitals (8 teaching hospitals, 82 non-teaching hospitals). Matters addressed were: origin of culture site, notification of infection control professionals, type and duration of isolation at (re-) admittance and type of department (ICU and non-ICU).


Response rate to the questionnaire was 69% (7 teaching hospitals, 55 non-teaching hospitals). In 26/62 hospitals, Dutch culture recommendations for detection of ESBL carriage, namely throat and anal swab/faeces cultures, were not followed. Notification of infection control professional after ESBL detection occurred in 59/62 hospitals, at re-admittance in 31/62 hospitals. In 3/62 hospitals infection control measures were carried out based on individual risk assessment in every subsequent patient. Sixty percent of the non-teaching hospitals (33/55) used droplet isolation in case of respiratory ESBL isolates. In teaching hospitals this is the case in 2/7 institutes. At re-admittance the duration of isolation ranges from 2 months until the end of admittance.


In spite of clear ESBL carriage guidelines, major differences exist between hospitals concerning the implementation of these guidelines.

The main differences were: origin of culture site, notification after re-admittance and type of isolation measures.

Disclosure of interest

None declared.