U Heudorf

Frankfurt City Public Health Office, Frankfurt, Hesse, Germany

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Publications (107)111.28 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Endoscopy is an important part of modern medical diagnostics and therapy. The invasive procedures are however associated with a risk to transmit infections. Against this background the KRINKO has published the "Hygienic requirements for the reprocessing of flexible endoscopes and endoscopic accessories" in 2002 and has updated these recommendations in 2012. In 2003 and 2013 all gastroenterological facilities in Frankfurt am Main using flexible endoscopes were monitored for compliance with the recommendations. The inspections were performed after prior notice by a staff member of the health authority using a checklist which had been developed on the basis of the current KRINKO recommendations. In both years all institutions performing endoscopic procedures were visited: 2003 15 hospitals and 23 practices; 2013 14 clinics and 10 practices. In 2013 (data for 2003 in brackets) 100 % (93 %) of the hospitals and 60 % (22 %) of practices reprocessed their endoscopes by automated methods. The appropriate reprocessing and filling of water bottles for rinsing the scope channels with sterile water and the sterilisation of accessories were satisfactorily performed in 2003 and 2013 by all hospitals. However in 2013 only 90 % (2003: 74 %) of the practices correctly reprocessed water bottles and 80 % (52 %) used sterile water for filling the bottle. In 2013 100 % (2003: 57 %) of the practices correctly sterilised accessory instruments, while 2 practices used disposable, i. e., single-use materials. In 2013 all institutions performed microbiological tests according to KRINKO recommendations, while in 2003 all hospitals but only 43 % of the practices could present such tests. While the gastroenterological departments of Frankfurt hospitals already complied with the KRINKO recommendations in 2003, the inspection of several practices in 2003 had revealed considerable shortcomings in the implementation of these recommendations. Subsequently the practices have improved their hygiene management. © Georg Thieme Verlag KG Stuttgart · New York.
    Zeitschrift für Gastroenterologie. 12/2014; 52(12):1402-7.
  • Ursel Heudorf, R Gottschalk, M Exner
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    ABSTRACT: Antimicrobial-resistant organisms are regarded as a particular threat to the public health of the European population. In Germany the requirement for a national rollout reporting of positive laboratory test results for methicillin-resistant Staphylococcus aureus (MRSA) in blood cultures was implemented in 2009. This was followed in 2011 by the introduction of a laboratory-based, rollout reporting system for the detection of gram-negative bacteria with acquired carbapenem-resistance (carbapenem-resistant organisms, CRO) in the federal state of Hessen. This article will present the experience gained in Frankfurt am Main with the existing reporting system. Blood or cerebrospinal fluid cultures positive for MRSA were reported from all Frankfurt clinics between 2010 and 2013. The objective of preventing nosocomial infections by introducing a mandatory reporting for MRSA in blood cultures was only partially achieved by the reporting procedure on a population scale. Instead, reporting on a clinic-based scale, i.e., incidence per 1,000 patient days should be used. Moreover, mandatory reporting of clusters of nosocomial colonizations with MRSA could be an appropriate measure for the timely prevention of nosocomial infections with these organisms. CROs were reported from nearly all clinics as well as the ambulatory setting. Different reporting criteria have resulted not only in a greatly varying workload for the institutions and the health authorities but also in vastly different numbers of reported events. Regarding the importance of CRO, mandatory reporting seems reasonable. Criteria of reporting should be simple and easily comprehensible, i.e., all 4MRGN (gram-negative bacteria with resistance against four antibiotic groups such as acylureidopenicillins, third- and fourth-generation cephalosporins, fluorchinolones, and carbapenems) according to the German Commission on Hospital Hygiene and Infection Prevention (KRINKO) should be considered. Reporting and evaluation of multidrug-resistant organisms (MDRO) in a population-based system does not seem to be sufficient regarding these organisms with high importance for hospital hygiene; mandatory reporting on an anonymous clinic-based scale should be used.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 10/2014; · 0.72 Impact Factor
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    ABSTRACT: The federal state of Hesse, Germany, introduced a laboratory-based reporting scheme for carbapenem-resistant organisms (CROs).
    BMC Infectious Diseases 08/2014; 14(1):446. · 3.03 Impact Factor
  • U Heudorf, M Schade
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    ABSTRACT: Following the heat wave of August 2003 that caused over 70,000 fatalities in Western Europe, heat-health action plans (HHAP) and heat warning systems were implemented in many European countries, including Germany. The effect of these preventive measures (informing the population as well as nursing and medical personnel) on excess mortality during heat waves in Frankfurt am Main, Germany, is studied, taking into account newly published data on a modifying effect of air pollution on heat mortality. Mortality data comprising all deaths registered in the city of Frankfurt was obtained from the statistical state office; air temperature and air pollution data in Frankfurt Ost were obtained from the Hessian state office for environment and geology. SPSS Version 15 was used for statistical analysis (bivariate and partial correlations, nonparametric tests/Kruskal-Wallis, and Mann-Whitney test).
    Zeitschrift fur Gerontologie und Geriatrie. 07/2014;
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    ABSTRACT: Residents of long-term care facilities (LTCF) are at risk of healthcare associated infections (HAI) and are often treated with antibiotics. In Germany a current HAI prevalence of 1.6 % and antibiotic use in 1.15 % have been reported. However, data published on the current prevalence of multidrug-resistant organisms (MRDO) in LTCFs in Germany are scarce. Therefore, the prevalence of HAI, antibiotic use and presence of MDROs were investigated in LTCF residents in Frankfurt am Main, Germany. A point prevalence study of HAI and antibiotic use according to the European HALT protocol (health care associated infections in long-term care facilities) was carried out; swabs from the nose, throat and perineum were analyzed for methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta-lactamase producing enterobacteria (ESBL) and vancomycin-resistant enterococci (VRE). A total of 880 residents in 8 LTCFs were enrolled in the study in 2012. The study participants were 30 % male, 46.7 % were more than 85 years old, 70 % exhibitied urinary or fecal incontinence, 11.4 % had an indwelling urinary catheter and 0.1 % a vascular catheter. Prevalence rates of HAI and of antibiotic use were 2.5 % and 1.5 %, respectively. The prevalence of MDROs in 184 residents who agreed to being tested for MDROs was 9.2 % MRSA, 26.7 % ESBL and 2.7 % VRE. The HAIs and antibiotic use were comparable to the German HALT data from 2010. Compared to other German studies there is a steadily increasing MRSA problem in German LTCFs. High and increasing ESBL rates have been detected in German LTCFs. Further studies are needed to confirm this trend, preferably encompassing molecular methods to study epidemiology.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 04/2014; 57(4):414-22. · 0.72 Impact Factor
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    ABSTRACT: Multidrug-resistant organisms (MDROs) are not only a problem in the hospital but also in the community setting. The MRE-Net Rhine-Main was founded in order to decrease the rate of development and spread of MDROs in the region and to counter the stigmatisation of people with MDROs. The network attempts to achieve these goals by offering telephone support, information flyers, internet services, information events and training for health-care practitioners from hospitals (HOSP), residential and nursing homes (RNH), outpatient care services (OCS), emergency services (ES), medical practices (MP) and rehabilitation centers (RC). A first interim evaluation examined the expectations each institution had associated with its participation and how well these objectives were fulfilled. Furthermore the utilisation and acceptance of the services offered by the network were investigated.The participating institutions (n=143) received a standardised questionnaire adapted to the type of institution by mail including questions focusing on the above-mentioned issues.96 questionnaires could be evaluated (response 67.1%). More than 90% of the participants expected to participate in trainings, receive improved information, to gain more confidence in handling patients and to improve hygiene measures - with great differences between HOSP, RNH and OCS. These expectations were largely satisfied. 65.5% of the institutions participated at least once in a training, particularly RNH, OCS, whereby the usefulness of the trainings was rated high by these institutions. 14.4% of the institutions had made use of the telephone service, the gain of information was rated as high by HOSP, RNH and OCS. 81% knew of and used the flyers, but almost half of the institutions did not know the homepage of the network.Overall the expectations of the network participants were met well to very well and the benefit derived from the trainings and the print and online media was rated as high. Therefore the network will continue and further intensify its work.
    Das Gesundheitswesen 03/2014; · 0.62 Impact Factor
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    ABSTRACT: Nicht nur angesichts der sehr häufigen Infektionen bei Kindern, sondern auch wegen des entwicklungsgemäßen kindlichen Verhaltens (Krabbeln auf dem Boden, ,,mouthing“) besteht in der kinder- und jugendärztlichen Praxis ein besonderes Risiko der Erregerübertragung, obwohl dort im Vergleich mit anderen Praxen vergleichsweise wenige invasive Maßnahmen (Blutentnahmen, Infusionen, Katheter usw.) vorgenommen werden. Eine Aufbereitung kritischer Medizinprodukte findet in Kinder- und Jugendarztpraxen praktisch überhaupt nicht statt.Sachgerechte Hygiene in kinder- und jugendärztlichen Praxen (ohne Medizinprodukteaufbereitung) setzt Folgendes voraus: ein Personal, das die Infektionsrisiken und v. a. die Übertragungswege kennt und sich entsprechend verhält, insbesondere eine gute Händehygiene und Flächendesinfektion vornimmt. Diese Maßnahmen sind nicht teuer, aber wirkungsvoll, auch bei der zunehmenden Problematik der multiresistenten Erreger. Eine gute Hygiene sicherzustellen, liegt in der Verantwortung der Praxisinhaber und Mitarbeiter selbst, zum Schutz von Patienten und Personal vor Infektionen – und nicht zuletzt auch zum Schutz vor Beschwerden oder Prozessen.
    Monatsschrift Kinderheilkunde 10/2013; 161(10). · 0.19 Impact Factor
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    ABSTRACT: Since July 1st, 2009 in accord with the statuary order based on the German law for infectious diseases (Infektionsschutzgesetz), MRSA in blood and liquor have to be notified to the public health authorities. The aim of this extension of the notification to report is to improve the surveillance of nosocomial infections and the prevention of nosocomial MRSA infections. In this paper data of the notifications in the year 2011 within the MDRO-Net Rhine-Main, an association of 7 public health authorities in the region, are reported in order to investigate whether the aims of the obligation for notification could be achieved.In 2011, 138 MRSA bloodstream infections, including 1 MRSA in liquor culture, were notified to the 7 health protection authorities, resulting in an incidence rate of 5.6/100 000 inhabitants. In urban regions with more hospitals available, the incidence rate was higher than in rural districts with less medical facilities (6.9 vs. 4.4/100 000 inhabitants). Only 46 (35%) of the patients with MRSA cultured in their blood had been detected via anamnesis as patients on risk for MRSA, and 59 (45%) had been screened for MRSA on admission. The incidence rate in the different hospitals was 0.041±0.031/1 000 patient days (range 0-0.145/1 000 patient days).For the first time, data on notification of MRSA cultures in blood specimen are published from a whole MRE Network in Germany encompassing >2.1 million inhabitants. Incidence rates per 100 000 inhabitants alone do not seem adequate to cope with the aims of the obligation for notification. Instead, reference to patient days in the respective clinic enables an external comparison to other medical institutions in the region and is a better base for discussion with these institutions on improvements of surveillance, screening and hygiene.
    Das Gesundheitswesen 08/2013; · 0.62 Impact Factor
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    ABSTRACT: Colonization/infection with multidrug-resistant bacteria (MDRB) such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae, is an increasing problem not only in hospitals but also in long-term care facilities. The aim of this study was to determine the prevalence as well as the risk factors of colonization/infection with MRSA, VRE, and ESBL producing Enterobacteriaceae in geriatric clinics, nursing homes, and ambulant care in Frankfurt am Main, Germany. 288 patients from 2 geriatric clinics (n=46), 8 nursing homes (n=178), and 2 ambulant care facilities (n=64) as well as 64 staff members were screened for MDRB in the time period from October 2006 to May 2007. 58 patients (20.1%) and 4 staff members (6.2%) were colonized with MDRB. Among patients, 27 (9.4%) were colonized with MRSA, 11 (3.8%) were screened positive for VRE, and 25 (8.7%) were found to be colonized with ESBL producing Enterobacteriaceae. Prevalence of MDRB in geriatric clinics, nursing homes, and ambulant care facilities were 32.6%, 18.5%, and 15.6%, respectively. Significant risk factors for MDRB were immobility (OR: 2.7, 95% CI: 1.5-4.9; p=0.002), urinary catheter (OR: 3.1, 95% CI: 1.7-5.9; p<0.001), former hospitalization (OR: 2.1, 95% CI: 1.1-4.0; p=0.033), and wounds/decubiti (OR: 2.3, 95% CI: 1.5-4.9; p=0.03). Finally, the high level of MDRB in geriatric clinics, nursing homes, and ambulant care points to the importance of these institutions as a reservoir for dissemination.
    International journal of medical microbiology: IJMM 05/2013; · 4.54 Impact Factor
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    ABSTRACT: Background: The Rudolf Schuelke Foundation addresses topics related to hygiene, infection prevention and public health. In this context a
  • U Heudorf, T Eikmann, M Exner
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    ABSTRACT: In 2001, the German Protection against Infection Act came into force, implementing a variety of new regulations. For the first time, obligatory infection control visits of the public health departments in surgical ambulatory practices were implemented, as well as optional infection control visits in all medical, dental and paramedical practices using invasive methods. Based on the data of the public health department of the city of Frankfurt am Main, Germany, an evaluation of this new regulation is given in this paper. First, prioritization of these new tasks was mandatory. First priority was given to the obligatory visits in surgical practices, second priority to the hygiene visits in practices performing endoscopy in gastroenterology as well as in urology and in practices of traditional healers, and third priority was given to all other doctors' practices. After receiving preliminary information and further training of the doctors etc., the control visits were performed by members of the public health department, using a checklist based on the guidelines of the German Commission on Hospital Infection Prevention ("Kommission für Krankenhaushygiene und Infektionsprävention"). Since 2001, more than 1100 infection control visits in medical practices in Frankfurt am Main were documented. Not only in surgical, but also in gastroenterological and urological practices great improvement could be achieved, regarding not only hand hygiene and reprocessing surface areas, but especially in reprocessing medical devices. In practices for internal medicine and those of general practitioners, errors in hand hygiene, skin antiseptic and surface disinfection also decreased. According to our results, especially regarding the improved quality of structure as well as quality of process and with regard to the public discussion on this hygiene topic, our evaluation is absolutely positive. The new regulation proved worthwhile.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2013; · 0.72 Impact Factor
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    ABSTRACT: Many studies have shown the urgent need for improving oral health hygiene in nursing home residents. Deficits in the knowledge of the personnel about dental and oral hygiene are often cited as one of the causes. Therefore, an oral health education programme was provided to the personnel of 20 nursing homes in Frankfurt/Main. Here the results of the assessment of the impact of the education programme on knowledge and attitudes of the personnel as well as on oral health of the residents are presented.In May/June 2010, 471 nurses in 20 nursing homes in the Frankfurt/Main, Germany, received a two-hour education programme on oral health. The lessons were held by dentists with special education in geriatric dentistry. The personnel were asked to complete a questionnaire regarding knowledge and attitudes on oral health care before the education programme and 4-6 months afterwards. The oral health status of 313 residents (i. e., about 10% of the total residents) was examined by two dentists. Before and 4-6 months after education of the caregivers, the following data were recorded in the residents: number of teeth, caries, plaque index (PI), sulcus bleeding index (SBI), community periodontal index of treatment needs (CPITN) and denture hygiene index (DHI).By attending the lessons, good improvements in knowledge of the caregivers could be obtained. The education programme was rated as very good/good by 85% of the nurses, having reduced their fear of oral care in the seniors and having gained more competence in practical oral hygiene procedures. Mean age of the residents was 80±13 years. About 32% of the residents were edentulous. Teeth were carious in 53% of the residents. Initially, one half of the residents exhibited plaque index>2, in 29% of the residents a severe and in 59% of them a very severe parodontitis was found (CPITN 3 or, respectively, 4). At 4-6 months after the education programme, an improvement in oral and dental hygiene of the residents could be demonstrated, significant for plaque index, cleanliness of the tongue and denture hygiene index.The positive assessment of the nursing personnel as well as the positive effects on oral hygiene in the residents are in agreement with the results of many other studies in many countries. Therefore, these education programmes will be continued in the long-term care facilities in Frankfurt/Main, Germany.·
    Das Gesundheitswesen 01/2013; · 0.62 Impact Factor
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    ABSTRACT: Background: The Rudolf Schuelke Foundation addresses topics related to hygiene, infection prevention and public health. In this context a panel of scientists from various European countries discussed "The Role of Surface Disinfection in Infection Prevention". The most important findings and conclusions of this meeting are summarised in the present consensus paper. Aim: Although the relevance of surface disinfection is increasingly being accepted, there are still a number of issues which remain controversial. In particular, the following topics were addressed: Transferral of microbes from surface to patients as a cause of infection, requirements for surface disinfectants, biocidal resistance and toxicity, future challenges. Methods and findings: After discussion and review of current scientific literature the authors agreed that contaminated surfaces contribute to the transmission of pathogens and may thus pose an infection hazard. Targeted surface disinfection based on a risk profile is seen as an indispensable constituent in a multibarrier approach of universal infection control precautions. Resistance and cross-resistance depend on the disinfectant agent as well as on the microbial species. Prudent implementation of surface disinfection regimens tested to be effective can prevent or minimize adverse effects. Conclusions: Disinfection must be viewed as a holistic process. There is a need for defining standard principles for cleaning and disinfection, for ensuring compliance with these principles by measures such as written standard operating procedures, adequate training and suitable audit systems. Also, test procedures must be set up in order to demonstrate the efficacy of disinfectants including new application methods such as pre-soaked wipes for surface disinfection.
    GMS hygiene and infection control. 01/2013; 8(1):Doc10.
  • U. Heudorf, T. Eikmann, M. Exner
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    ABSTRACT: Im Jahr 2001 trat das Infektionsschutzgesetz (IfSG) in Kraft, das zahlreiche Neuerungen brachte. Es verpflichtet die Gesundheitsämter u. a. in § 36 erstmals, die Hygiene in ,,Einrichtungen für ambulantes Operieren“ zu überwachen (Pflicht-Aufgabe) und ermöglicht zudem die diesbezügliche Beratung sowie auch Überprüfung von Arzt- und Zahnarztpraxen (Kann-Aufgabe). Auf Basis der Erfahrungen der letzten 10 Jahre in Frankfurt am Main wird im vorliegenden Beitrag eine Evaluation dieser seit 2001 geltenden Regelung vorgestellt. Zur Umsetzung der neuen Aufgaben wurden diese zunächst wie folgt priorisiert: 1. Priorität: die infektionshygienische Überwachung der Einrichtungen für ambulantes Operieren (Pflichtaufgabe), 2. Priorität: die Überwachung von Praxen, die Maßnahmen mit hoher Invasivität durchführen (wie z. B. von gastroenterologischen und urologischen Praxen, die Endoskopien durchführen, sowie von invasiv tätigen Heilpraktiker- und Zahnarztpraxen), und als 3. Priorität: die Überwachung in allen anderen Praxen. Die Begehungen der Praxen erfolgen nach deren Vorabinformation sowie nach durchgeführten Fortbildungsangeboten und weiteren Hilfen. Sie werden anhand standardisierter Checklisten auf Basis der einschlägigen Empfehlungen der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) vorgenommen. Insgesamt wurden seit Bestehen der neuen Regelung mehr als 1100 Praxisbegehungen in Frankfurt am Main durchgeführt. Sowohl in den Praxen für ambulantes Operieren als auch in den gastroenterologischen und urologischen Praxen wurden durch die Begehungen erhebliche Verbesserungen erreicht. Diese betrafen nicht nur die Händehygiene und Flächenaufbereitung, sondern insbesondere auch die Aufbereitung der Medizinprodukte. Auch nahmen in den internistischen und hausärztlichen Praxen über die Jahre die Fehler bei der Hände-, Haut- und Flächendesinfektion ab. Die Evaluation dieser neuen Aufgabe der Gesundheitsämter fällt vor dem Hintergrund der zahlreichen Begehungen und der guten Ergebnisse mit nachgewiesenen Verbesserungen der Struktur- und Prozessqualität sowie der intensiven (fach)öffentlichen Diskussion über Hygiene in medizinischen Einrichtungen uneingeschränkt positiv aus. Die Regelung hat sich bewährt.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2013; 56(3). · 0.72 Impact Factor
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  • U Heudorf, A Hausemann, E Jager
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    ABSTRACT: : The German Commission on Hospital Hygiene and Infection Prevention has published several recommendations regarding hygiene in the intensive care unit. Compliance with these recommendations was surveyed. In 2005 and 2011, the intensive care units of all hospitals in Frankfurt am Main, Germany, were examined by members of the public health department, using a checklist based on the respective recommendations. Recommendations on the architecture and function of intensive care wards were almost fully complied with, except for the stipulated amount of space and nursing personnel. Compliance with recommendations for prevention of ventilator-associated pneumonia and for prevention of catheter-related bloodstream infections was excellent, with only some minor exceptions. Regarding hand hygiene, in 2011 fewer faults were documented than in 2005. All hospitals took part in the German project of the world-wide campaign "clean care is safer care." In 2005, device-associated infections were surveyed in 92% intensive care units, and in 2011 in all of them. By 2011, screening of methicillin-resistant Staphylococcus aureus had been established in all intensive care units. Most problems that were observed regarded a scarcity of space and of facilities for isolation of patients and of nursing personnel. Improvements were seen in hand hygiene and in screening for multidrug resistant organisms (MDRO).
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 11/2012; 55(11-12):1483-94. · 0.72 Impact Factor
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    ABSTRACT: Due to the Infectious Disease Prevention Act, public health services in Germany are obliged to check the infection prevention in hospitals and other medical facilities as well as in nursing homes. In Frankfurt/Main, Germany, standardized control visits have been performed for many years. In 2011 focus was laid on cleaning and disinfection of surfaces. All 41 nursing homes were checked according to a standardized checklist covering quality of structure (i.e. staffing, hygiene concept), quality of process (observation of the cleaning processes in the homes) and quality of output, which was monitored by checking the cleaning of fluorescent marks which had been applied some days before and should have been removed via cleaning in the following days before the final check. In more than two thirds of the homes, cleaning personnel were salaried, in one third external personnel were hired. Of the homes 85% provided service clothing and all of them offered protective clothing. All homes had established hygiene and cleaning concepts, however, in 15% of the homes concepts for the handling of Norovirus and in 30% concepts for the handling of Clostridium difficile were missing. Regarding process quality only half of the processes observed, i.e. cleaning of hand contact surfaces, such as handrails, washing areas and bins, were correct. Only 44% of the cleaning controls were correct with enormous differences between the homes (0-100%). The correlation between quality of process and quality of output was significant. There was good quality of structure in the homes but regarding quality of process and outcome there was great need for improvement. This was especially due to faults in communication and coordination between cleaning personnel and nursing personnel. Quality outcome was neither associated with the number of the places for residents nor with staffing. Thus, not only quality of structure but also quality of process and outcome should be checked by the public health services.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 08/2012; 55(8):961-9. · 0.72 Impact Factor
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    ABSTRACT: The German national guideline to prevent the spread of MRSA in acute care hospitals demands isolation of patients with MRSA, whereas a guideline for management of MRSA/MRDO-patients in rehabilitation is pending. Many rehabilitation clinics believe they should isolate these patients and therefore deny rehabilitation of this patient group arguing that rehabilitation and isolation are incompatible. In order to improve the rehabilitation of MDRO-patients the MDRO network Rhein-Main has developed a recommendation for rehabilitation clinics.Based on literature data on the prevalence of MRSA/MDRO in rehabilitation clinics, the data on transmission of MDRO in such clinics and on existing recommendations, a new recommendation was established by experts in hygiene and by management of rehabilitation clinics in the region.Current studies in Germany as well as in France exhibit the same prevalence of MDRO patients in rehabilitation units as well as in acute care clinics. Transmission occurs mainly via hand contact during patient care or medical therapy in critically ill patients with high maintenance. However, the risk of transmissions in patients with great mobility is not increased. Hence, good standard hygiene, especially good hand hygiene both in staff and patients, is the key method to prevent transmission. Isolation or other restriction of mobility does not seem necessary. These data formed the basis of the newly established recommendation, which sets out in a clearly laid-out and tabular manner the standard hygiene procedures necessary for safe rehabilitation of all patients and the additional measures necessary for rehabilitation of MDRO-patients. The recommendation provides guidance and thus will enable a better rehabilitation of MDRO-patients.
    Die Rehabilitation 06/2012; 51(4):254-8. · 0.71 Impact Factor
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    ABSTRACT: In 2007, we reviewed the working principles and working procedures of the German Human Biomonitoring Commission together with the reference values and human biomonitoring (HBM) values derived up to that time. Since then, the Commission has decided to derive additionally HBM I values on the basis of tolerable daily intakes and has used and evaluated this new approach on the metabolites of (2-ethylhexyl) phthalate (DEHP) in urine. Furthermore, the Commission has derived a HBM I value for thallium in urine, has recinded the HBM values for lead in blood, and has updated the HBM values for cadmium in urine. Based on the representative data of the German Environmental Survey on Children from 2003 to 2006 (GerES IV), the Commission has updated the reference values for a large number of environmental pollutants in urine and blood of children in Germany. Since 2007, the Commission has derived new and updated reference values for PFOS and PFOA in human plasma, for thallium in urine, for aromatic amines in urine, for a comprehensive number of phthalate metabolites in urine, and for organochlorine pesticides in human breast milk. Furthermore, the Commission has evaluated background exposure levels for two naphthalene metabolites and acrylamide (using acrylamide-haemoglobin adduct) for the general population. This paper reports the new values, including those already published, in order to provide an updated overview.
    International journal of hygiene and environmental health 02/2012; 215(2):150-8. · 2.64 Impact Factor
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    U Heudorf, K Boehlcke, M Schade
    Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 01/2012; 17(35). · 5.49 Impact Factor

Publication Stats

855 Citations
111.28 Total Impact Points


  • 2001–2013
    • Frankfurt City Public Health Office
      Frankfurt, Hesse, Germany
  • 2012
    • University Hospital Frankfurt
      Frankfurt, Hesse, Germany
  • 2011
    • Ruhr-Universität Bochum
      • Institute for Prevention and Occupational Medicine
      Bochum, North Rhine-Westphalia, Germany
  • 2004–2009
    • University of Bonn
      • Institute for Hygiene and Public Health
      Bonn, North Rhine-Westphalia, Germany
  • 1995–2004
    • Gesundheitsamt Frankfurt
      Frankfurt, Hesse, Germany
  • 2001–2002
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      • Occupational Social and Environmental Medicine and Policlinic
      Erlangen, Bavaria, Germany