. 2019 Aug 27;8:146. doi: 10.1186/s13756-019-0586-3

Table 5a.

Standard and additional infection control precautions by HRMO positive residents, per HRMO in a non-outbreak setting

HRMO or indication	Hand hygiene^b	Personal Protective Equipment			Single room/apartment	Sanitation		Use of shared facilities such as living room
HRMO or indication	Hand hygiene^b	Gloves^c	Apron/Single use isolation gown with long sleeves^c	Mask	Single room/apartment	Toilet/commode chair	Bathroom	Use of shared facilities such as living room
Enterobacteriaceae (ESBL included, not CPE^a)	Yes	Yes	Apron	No^d	no	No sharing with other residents	Sharing possible^e	Yes^f
CPE^a	Yes	Yes	Isolation gown	No^d	Yes^g	No sharing with other residents	No sharing with other residents	Depending on individual situation^h
Acinetobacter species	Yes	Yes	Isolation gown	No^d	Yes^g	No sharing with other residents	No sharing with other residents	Depending on individual situation^h
Pseudomonas aeruginosa	Yes	Yes	Apron	No^d	no	No sharing with other residents	Sharing possibleⁱ	Yes^f
Stenotrophomonas maltophilia	Yes	Yes	Apron	No^d	no	No sharing with other residents	Sharing possibleⁱ	Yes^f
Streptococcus pneumoniae (PRP)	Yes	Yes	Apron	FFP1^j	Yes^{g, k}	Sharing possible	Sharing possible^e	Yes, under conditions^{f, l}
Enterococcus faecium (VRE)	Yes	Yes	Apron	No^d	Yes, by preference^g	No sharing with other residents	No sharing with other residents	Yes^f
Recent admission foreign HCF	Yes	Yes	Isolation gown	None^{d, m}	Yes^g	No sharing with other residents	No sharing with other residents	Depending on individual situation ^{h, l}

^aCPE: Carbapenem resistant Enterobacteriaceae

^bWHO 5 moments of hand hygiene (part of standard precautions)

^cWear only when giving physical care to residents and/or contact with material of residents. Do not wear during pure social activities

^dUse a surgical mask whenever there is a risk of splashing of body fluids (part of standard precautions)

^eWhen resident shares a bathroom: HRMO positive resident is the last one to use the bathroom, immediate cleaning procedure after use

^fGive resident instruction on how to perform hand hygiene. If residents have wounds or indwelling catheters, cover these with an appropriate (wound)dressing

^gIf HRMO positive resident shares his room or apartment with another resident (e.g. couples), the other resident is also to be considered as an HRMO positive resident

^hConsult the medical microbiologist and/or infection control practitioner to determine if visiting shared facilities (e.g. living room) is appropriate (taking into account the risk of transmission to other residents). If using shared facilities is permitted, see footnote f

ⁱIf resident shares bathroom facilities, ensure that after use immediate cleaning and disinfection takes place (important issue because of long survival duration of these microorganisms)

^jFFP: Filtering facepiece particle; Put FFP1 mask in place before entering resident’s room (only in the acute phase of a respiratory infection which means, in the first 48 hours after appropriate antibiotic treatment has started)

^kSingle room/apartment is only necessary in the acute phase of a respiratory infection, which means in the first 48 hours after appropriate antibiotic treatment has started

^lUse of shared facilities not allowed in the acute phase of a respiratory infection, in the first 48 hours after appropriate antibiotic treatment has started

^mSpecial note: When a resident is suspected of MRSA carriage (e.g. after recent admission in foreign HCF, use surgical mask as part of the precautions for prevention of MRSA)