U Heudorf

Gesundheitsamt Frankfurt, Frankfurt, Hesse, Germany

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Publications (145)182.1 Total impact

  • E. Jager · U. Heudorf ·

    HNO 11/2015; DOI:10.1007/s00106-015-0063-0 · 0.58 Impact Factor
  • U Heudorf · D Färber · D Mischler · M Schade · C Zinn · C Cuny · D Nillius · M Herrmann ·
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    ABSTRACT: Background: While a limited number of studies have investigated the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in medical rehabilitation institutions, almost no data on the colonization of rehabilitation patients with multiresistant gram-negative rods is available. Here we report on a large multicenter study on the prevalence of MRSA and multiresistant pathogens in rehabilitation institutions in the Rhine-Main area in 2014. Materials and Methods: Altogether, 21 rehabilitation hospitals participated. For all patients, age, gender, previous history of hospitalizations, surgery, previous colonization with multidrug-resistant organisms, use of a medical device, current antimicrobial therapy, and the current infection status were ascertained. On voluntary basis, nare and throat swabs were taken for analysis of MRSA and rectal swabs were tested for extended spectrum betalactamase-producing gram-negative bacteria (ESBL). Results: 50% of 2 440 patients had a history of hospitalization within the previous 6 months while 39% had undergone surgery during the past 30 days. Approximately a quarter of the patients had been transferred to a rehabilitation hospital directly from an acute care hospital, had been under antimicrobial therapy with the past three months, or had travelled to a foreign country within the previous year. Risk factors such as lesions of the intact skin or presence of medical devices were rarely reported (< 5%) within the exception of patients undergoing geriatric or neurologic acute care rehabilitation. 0.7% (15/2155) of the patients were colonized with MRSA, while 7.7% (110/1434) showed a positive result for ESBL. The highest prevalence rates for multiresistant organisms were encountered among patients with neurologic rehabilitation (MRSA, 1.3%, and ESBL, 10.2%) or with geriatric rehabilitation (MRSA, 9.4%, and ESBL, 22.7%). Conclusion: In the rehabilitation patient population, the prevalence rates of MRSA and ESBL were found to be in the range of rates encountered in the general population (reported rates for MRSA, 0.5%, and ESBL, 6.3%). The known risk factors for MRSA such as skin lesions, medical devices and previous history for MRSA were also confirmed among this patient population. Direct transfer from an acute care hospital, antimicrobial treatment during the past 3 months, and wounds proved significant risk factors for ESBL colonization. Patients of neurologic rehabilitation and geriatric patients showed the highest rates of risk factors and the highest prevalence rates of multidrug-resistant organisms. It appears to be of importance for rehabilitation hospitals to be geared to the needs of patients with multidrug-resistant organisms, and prevent the transmission of these pathogens by appropriate hygiene measures.
    Die Rehabilitation 10/2015; 54(5):339-345. DOI:10.1055/s-0035-1559642 · 0.73 Impact Factor
  • U Heudorf ·
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    ABSTRACT: Infection prevention is one of the main tasks of the public health services. The "Protection against infection act" places all medical institutions and facilities for children (kindergartens and schools) under the obligation to assume responsibility and to cooperate. Duties of the institutions are described, and public health services are obliged to perform hygiene control visits.Regarding medical institutions, the guidelines of the German Commission on Hospital Hygiene and Infection Control have to be observed, and the counties were obliged to publish hygiene enactments. Subsequently, good improvements in hygiene management in medical institutions were achieved. In schools, however, severe hygienic problems (i.e. sanitary hygiene, indoor air hygiene) are detected, without any improvement - obviously due to a missing sense of responsibility in the school community.Causes for poor behaviour prevention (hand hygiene, ventilation) and missing situational prevention (i.e. cleaning) are discussed. Without reversion to the obviously needed but nearly forgotten subject school hygiene, obligatory guidelines and the assuming of responsibility, permanent improvements cannot be achieved. © Georg Thieme Verlag KG Stuttgart · New York.
    Das Gesundheitswesen 07/2015; 77(7). DOI:10.1055/s-0035-1550021 · 0.62 Impact Factor
  • T Westphal · K Voigt · U Heudorf ·
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    ABSTRACT: Background: The first and second amendment to the Drinking Water Ordinance came in to force in the years 2011 and 2012 causing additional tasks and responsibilities for operators of commercial large-scale systems, usually hot water systems in large residential buildings, and for the local health authorities. This article describes the experiences of the health authority in Frankfurt/Main with these new regulations. Some of the revisions in the first amendment of the ordinance (TrinkwV 2001 (2011)) were omitted in the second revision (TrinkwV 2001 (2012)) such as the obligation to notify for large-scale systems. Furthermore, the intervals between the obligatory inspections were extended from 1 to 3 years and merely exceedances of the legal limits were to be notified in contrast to the previous obligation to notify all values. Results: On the basis of the TrinkwV 2001 (2011) a large additional staff requirement had been estimated (13/21 positions). After the TrinkwV 2001 (2012) the tasks can be accomplished by less than 2 employees. While the notification obligation was still in force, the health authority received 4 461 notifications of large-scale systems, since then a further 477 have been notified. Of a total of 1 335 initial analyses, 794 (60%) exceeded the technical action value and in 113 properties with values exceeding 10 000/100 ml a usage restriction was necessary. Conclusions: Due to the suspension of the notification obligation to report any result of the analyses performed the assessment of the reports on large-scale systems has become difficult. An appropriate assessment of the implementation of the regulation is not possible, since the total number of large-scale systems is not known and a failure to report may result from a measured value below the technical action value as well as from a not inspected system. The large number of usage restrictions is an indication for the necessity to inspect and if required to treat and restore the system.
    Das Gesundheitswesen 07/2015; 77(7). DOI:10.1055/s-0035-1550027 · 0.62 Impact Factor
  • M Hogardt · P Proba · D Mischler · C Cuny · V A Kempf · U Heudorf ·
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    ABSTRACT: Multidrug-resistant organisms (MDRO) and in particular multidrug-resistant Gram-negative organisms (MRGN) are an increasing problem in hospital care. However, data on the current prevalence of MDRO in long-term care facilities (LTCFs) are rare. To assess carriage rates of MDRO in LTCF residents in the German Rhine-Main region, we performed a point prevalence survey in 2013. Swabs from nose, throat and perineum were analysed for meticillin-resistant Staphylococcus aureus (MRSA), perianal swabs were analysed for extended-spectrum beta-lactamase (ESBL)-producing organisms, MRGN and vancomycin-resistant enterococci (VRE). In 26 LTCFs, 690 residents were enrolled for analysis of MRSA colonisation and 455 for analysis of rectal carriage of ESBL/MRGN and VRE. Prevalences for MRSA, ESBL/MRGN and VRE were 6.5%, 17.8%, and 0.4%, respectively. MRSA carriage was significantly associated with MRSA history, the presence of urinary catheters, percutaneous endoscopic gastrostomy tubes and previous antibiotic therapy, whereas ESBL/MRGN carriage was exclusively associated with urinary catheters. In conclusion, this study revealed no increase in MRSA prevalence in LTCFs since 2007. In contrast, the rate of ESBL/MRGN carriage in German LTCFs was remarkably high. In nearly all positive residents, MDRO carriage had not been known before, indicating a lack of screening efforts and/or a lack of information on hospital discharge. © 2015, European Centre for Disease Prevention and Control (ECDC). All Rights Reserved.
    Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin 07/2015; 20(26). DOI:10.2807/1560-7917.ES2015.20.26.21171 · 5.72 Impact Factor
  • M Schade · U Heudorf · P Tiarks-Jungk ·
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    ABSTRACT: Background: The humanitarian consultation-hour is a voluntary, anonymous offer provided by the City of Frankfurt am Main, which was established in December 2001. Here, people without health insurance or undocumented migrants can be treated for free. The aim of this analysis is to investigate the utilization of the consultation-hour by gender, age, country of origin and diagnosis since 2008. Methods: The digital data documentation is available since 2008. Data from the years 2008-2013 were considered. The examination date, the date of birth, sex, country of origin, frequency of visits, diseases and medication amongst other data were examined. Results: In the period from 2008 to 2013, 8 574 consultations were counted and 2 384 patients were treated during office hours. The amount of consultations has doubled between 2008 (n=673) and 2009 (n=1 154) and is rising steadily since then (1 911 visits in 2013). The majority of patients come from Africa. Since 2008, an increase of patients from Bulgaria and Romania has been recorded. Approximately two-thirds of the patients are female, one third male. One fifth of those seeking help are children and adolescents under 20 years and adults over 60 years. The most common age group is between 20-40 years old. The main diagnoses include diseases of the cardiovascular and vascular system and the musculoskeletal system, metabolic diseases (diabetes mellitus), digestive diseases and pregnancy/childbirth. Conclusion: The humanitarian consultation-hour is an important offer provided by the Public Health Department of the City of Frankfurt am Main and is used by a large number of people who are seeking help. In particular, people from South Eastern Europe are increasingly visiting the consultation-hour. Activities such as the humanitarian consultation-hour can take over subsidiary activities for a transitional period, however long-term structural solutions must be provided to ensure access to health care for this vulnerable group.
    Das Gesundheitswesen 07/2015; 77(7):466-474. DOI:10.1055/s-0035-1550026 · 0.62 Impact Factor
  • R. Woltering · G. Hoffmann · J. Isermann · U. Heudorf ·
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    ABSTRACT: Background and Objective: An assessment of cleaning and disinfection in hospitals by the use of objective surveillance and review of mandatory corrective measures was undertaken. Methods: A prospective examination of the cleaning and disinfection of surfaces scheduled for daily cleaning in 5 general care hospitals by use of an ultraviolet fluorescence targeting method (UVM) was performed, followed by structured educational and procedural interventions. The survey was conducted in hospital wards, operating theatres and intensive care units. Cleaning performance was measured by complete removal of UVM. Training courses and reinforced self-monitoring were implemented after the first evaluation. 6 months later, we repeated the assessment for confirmation of success. Results: The average cleaning performance was 34% (31/90) at base-line with significant differences between the 5 hospitals (11–67%). The best results were achieved in intensive care units (61%) and operating theatres (58%), the worst results in hospital wards (22%). The intervention significantly improved cleaning performance up to an average of 69% (65/94; +34.7%; 95% confidence interval (CI): 21.2–48.3; p<0.05), with differences between the hospitals (20–95%). The largest increase was achieved in hospital wards (+45%; CI 29.2–60.8; p<0.05). Improvements in operating theatres (+22.9%; CI 10.9–56.7) and intensive care units (+5.6%; CI 25.8–36.9) were statistically not significant. Conclusions: The monitoring of cleaning and disinfection of surfaces by fluorescence targeting is appropriate for evaluating hygiene regulations. An intervention can lead to a significant improvement of cleaning performance. As part of a strategy to improve infection control in hospitals, fluorescence targeting enables a simple inexpensive and effective surveillance of the cleaning performance and corrective measures.
    Das Gesundheitswesen 06/2015; DOI:10.1055/s-0035-1545267 · 0.62 Impact Factor
  • A Hausemann · H Hofmann · U Otto · Ursel Heudorf ·
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    ABSTRACT: In addition to hand hygiene and reprocessing of medical products, cleaning and disinfection of surfaces is also an important issue in the prevention of germ transmission and by implication infections. Therefore, in 2014, the quality of the structure, process and result of surface preparation of all hospitals in Frankfurt am Main, Germany, was monitored. All 17 hospitals transferred information on the quality of structure. Process quality was obtained through direct observation during cleaning and disinfection of rooms and their plumbing units. Result quality was gained using the fluorescent method, i.e. marking surfaces with a fluorescent liquid and testing if this mark has been sufficiently removed by cleaning. Structure quality: in all hospitals the employees were trained regularly. In 12 of them, the foremen had the required qualifications, in 6 hospitals unclarity as to the intersection of the cleaning and care services remained. In 14 hospitals only visible contamination was cleaned on the weekends, whereas complete cleaning was reported to take place in 12 hospitals on Saturdays and in 2 hospitals on Sundays. The contractually stipulated cleaning (observations specified in brackets) averaged 178 m(2)/h (148 m(2)/h) per patient room and 69 m(2)/h (33 m(2)/h) for bathrooms. Process quality: during process monitoring, various hand contact surfaces were prepared insufficiently. Result quality: 63 % of fluorescent markings were appropriately removed. The need for improvement is given especially in the area of the qualification of the foremen and a in a clear definition of the intersection between cleaning and care services, as well as in the regulations for weekends and public holidays.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 04/2015; 58(6). DOI:10.1007/s00103-015-2150-5 · 1.42 Impact Factor
  • U Heudorf · A Hausemann ·

    Das Gesundheitswesen 04/2015; 77(04). DOI:10.1055/s-0035-1546879 · 0.62 Impact Factor
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    ABSTRACT: Background: Carbapenems are important therapeutic agents for treating infections caused by multidrug-resistant gram-negative bacteria. In November 2011, identification of gram-negative bacteria with acquired carbapenem resistance became notifiable in Hesse, Germany. Notification requirements were first based on results of antimicrobial susceptibility testing. Since April 2013 the definition of multidrug-resistance by the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch-Institut was used. Only the so called 4MRGN isolates, which are resistant to the four major antibiotic classes acylureidopenicillins, third- and fourth-generation cephalosporins, carbapenems and fluoroquinolone are notifiable. At the same time notification requirements for Pseudomonas aeruginosa were restricted to isolates from blood and cerebrospinal liquid. Methods: We analyzed notifications received from 1 January 2012 through 30 September 2014, which fulfill the current notification requirements as of April 2013. Results: Between 1 January 2012 and 30 September 2014, 876 4MRGN were reported. Of these, 22 % (193) were Klebsiella pneumoniae, 21 % (185) Acinetobacter baumannii complex, 14 % (125) Citrobacter spp., 14 % (124) Escherichia coli, 12 % (104) Enterobacter spp., 7 % (62) P. aeruginosa and 4,6% (40) Klebsiella oxytoca. The 876 notifications were linked to 685 patients and 784 first notifications of a 4MRGN species for any given patient. 419 (48 %) isolates were reported to harbor a carbapenemase. Conclusion: 4MRGN are considered a threat to public health and therefore should be given high priority in the selection of notifiable conditions, e.g. notifiable pathogens. Reporting of 4MRGN is time-consuming and mandatory notification was introduced in Hesse although available resources are very scarce. At a national level, the introduction of mandatory notification for 4MRGN should be compensated by a corresponding reduction of already existing reporting requirements.
  • U. Heudorf · A. Hausemann · M. Exner ·
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    ABSTRACT: In view of the frequent complaints about deficits in information transfer on multidrug-resistant organisms (MDRO) between inpatient and outpatient care, the revision of the German Infection Protection Act in 2011 stipulated that federal states were required to issue regulations on intersectoral information transfer. Although all of the 16 federal Regulations on Infection Control in Healthcare Institutions include the transfer of information from hospitals to primary care physicians, only 13 include emergency medical and ambulance services, and only four include ambulatory and inpatient care settings. Thus, for the most part, the objective of intersectoral information transfer has not yet been accomplished. All Regulations contain stipulations for information at the time when patients with MDRO are discharged or transferred. This is usually too late for the subsequent institutions to make the necessary preparations. There is only one state, which stipulates that information is to be provided before discharge and transfer. Four states refer to data protection when transferring information. When revising the Regulations, all relevant institutions (incl. nursing homes) should be incorporated and the timely information transfer previous to referral, admission or discharge has to be explicitly taken into account. Also, the Regulations should always encompass all MDRO which require hygiene precautions which go beyond the usual standard precautions (e.g. MRSA, 4MRGN). At the same time information transfer must not be disadvantageous for patients which need to be transferred or admitted to other institutions.
  • E Jager · A Hausemann · H Hofmann · U Otto · U Heudorf ·
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    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. DOI:10.1055/s-0034-1366776 · 1.05 Impact Factor
  • 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; 57(11). DOI:10.1007/s00103-014-2046-9 · 1.42 Impact Factor
  • M Schade · U Heudorf · C Hornberg ·

    Das Gesundheitswesen 09/2014; 76(08/09). DOI:10.1055/s-0034-1387005 · 0.62 Impact Factor
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    ABSTRACT: Background The federal state of Hesse, Germany, introduced a laboratory-based reporting scheme for carbapenem-resistant organisms (CROs). Method The results of the first year of mandated reporting of CROs from April 2012 through March 2013 to the Public Health Authority of Frankfurt/Main, responsible for a population of 700,000 inhabitants, are described. Results Within a period of 12 months 243 CROs were notified to the health authority. Of these 213 isolates had been reported from 16 of the 17 hospitals in Frankfurt/Main, 6 from ambulatory settings and 24 from clinics outside of Frankfurt/Main. Mean incidence rate per 1,000 patient days in hospitals was 0.138 (range 0.02-0.28). Conclusion In Frankfurt/Main almost all hospitals have reported CROs in the study period though the frequency of isolation varies strongly and many facilities only report CROs sporadically. Molecular data indicate a high diversity of different carbapenemases. Autochthonous transmission must be assumed despite the absence of major outbreaks. Rapid and coordinated efforts by clinicians and health departments are crucial to control the spread of CRO infections. The mandatory reporting scheme provides important data to guide the implementation of preventive measures.
    BMC Infectious Diseases 08/2014; 14(1):446. DOI:10.1186/1471-2334-14-446 · 2.61 Impact Factor
  • U Heudorf · M Schade ·
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    ABSTRACT: Unlabelled: 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. Material and method: 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). Results: Temperature data as well as air pollution and daily mortality exhibited extreme values in summer 2003 compared to the summer periods 2004-2013. Never again were such levels of temperature and air pollution reached. In 2003, excess mortality was 78%, and as high as 113% among the population aged >80 years. During the heat wave of 2010, the total excess mortality was 23% (significant) and 38% in the population aged >80 years, while during heat waves in 2006 and 2013 no significant increase in total mortality was seen (total excess mortality 12% and 4%; not significant). Conclusion: Lower excess mortality could be seen in Frankfurt am Main during heat waves following the implementation of HHAP and the heat warning system. This might be an effect of the measures implemented by the HHAP to reduce heat mortality. However, it cannot be ruled out that this might also be an effect of shorter heat wave periods and lower air pollution in the subsequent years. Therefore, further efforts are needed to improve the resilience of the population, especially the elderly population, to better cope with heat waves.
    Zeitschrift für Gerontologie + Geriatrie 07/2014; 47(6). DOI:10.1007/s00391-014-0673-2 · 0.81 Impact Factor
  • U Heudorf · C Gustav · D Mischler · J Schulze ·
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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. DOI:10.1007/s00103-013-1927-7 · 1.42 Impact Factor
  • C Klug · M Schade · R Dittmar · D Mischler · E Nagel · U Heudorf ·
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    ABSTRACT: Introduction: Owing to the increasing threat posed by multidrug-resistant organisms, several regional (MDRO-) MRE-networks have been established in recent years, also in the Rhine-Main region. More than 3 years after the official foundation of the MRE-Net Rhine-Main and an interim evaluation in 2011, a further evaluation by all members was conducted in 2013. The members were asked to name the objectives for joining the network, the benefit associated with participation in the network and an evaluation of the offered services (trainings, homepage, flyer, information hotline). Method: The facilities received standardized questionnaires by mail. The questionnaire was largely identical with that of the interim evaluation 2011, allowing for good comparability of the 2013 and 2011 results. Results: In 2013 the participant's objectives were even more ambitious than in 2011 and the benefit of participation in the network was scored higher than in 2011. Particularly homes of the elderly and ambulant care facilities associated the most ambitious aims with the participation and benefited most from their membership. The network services were rated even better in 2013 compared to 2011. Conclusion and discussion: The work of the net continues to be highly appreciated, in some cases even more so than two years earlier. This is an incentive for the organizers to pursue the route already embarked upon. © ecomed Medizin, Verlagsgruppe Hüthig Jehle Rehm GmbH, Landsberg
    Das Gesundheitswesen 03/2014; 76(11). DOI:10.1055/s-0034-1367008 · 0.62 Impact Factor
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    ABSTRACT: Since 2009, two regional networks for the prevention of methicillin resistant Staaureus (MRSA) and other multidrug resistant organisms (MDRO), the 'MDRO Network Rhine-Main', and the 'MRSA Network Saarland', have collaborated in a joint project funded by the Germany Ministry of Health and the State of Saarland. This network activity is in the framework of the 'Deutsche Antibiotika Resistenzstrategie, DART', a German Government initiative to combat antimicrobial resistance throughout all type of health care institutions. By addressing the primary goal of DART, i.e. the 'reduction of antimicrobial resistance spread', both networks have initiated numerous initiatives such as studies on the prevalence of regional antimicrobial resistance, interventions and education on the control of MDRO, development, preparation and distribution of teaching material for health care professionals, and information of the general public. Both conventional and e-learning techniques were employed, and several of these initiatives could be accompanied by a scientific evaluation of their impact on the respective target audience. The collaboration of both networks - targeting regions with important differences in infrastructure and population characteristics - has provided numerous positive effects on the exchange and comparison of scientific methods and data. New and continued challenges arise due to the continued shift of antimicrobial resistance, due to the emergence of nosocomial or community acquired pathogens with specific characteristics such as Clostridium difficile, and the need to ascertain continued service, information, and intervention even in the context of a limited funding duration. The following manuscript provides an overview on the activity of both networks and specifically highlights the various aspects of transsectoral activity. Based on the experience of the previous years, we conclude that such multimodal network is one of the most promising approaches to combat the spread of MDRO and ensuing infections by methods tailored to regional needs.
  • U Heudorf ·
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    ABSTRACT: According to the "Protection against Infection Act", public health services are obliged to supervise and consult the hygienic conditions not only in hospitals but also in ambulatory medical practices in Germany. Firstly, in this paper basic principles on transmission routes of pathogenic germs and general remarks on the infection control visits as well as on the special regulations (i. e., German commission on hospital hygiene and infection prevention) are described. Secondly, crucial points to be considered in all medical practices are mentioned. Finally, special issues in different practices are reported, such as dermatology, gastroenterology, gynaecology, paediatrics etc. This article aims to support the public health departments in their task to prevent infections in patients and personnel in medical practices.·
    Das Gesundheitswesen 11/2013; 75(11):697-704. DOI:10.1055/s-0033-1357165 · 0.62 Impact Factor

Publication Stats

1k Citations
182.10 Total Impact Points


  • 1995-2015
    • Gesundheitsamt Frankfurt
      Frankfurt, Hesse, Germany
  • 2001-2013
    • Frankfurt City Public Health Office
      Frankfurt, Hesse, Germany
  • 2004-2009
    • University of Bonn
      • Institute for Hygiene and Public Health
      Bonn, North Rhine-Westphalia, Germany