Surveillance level	Strategies	Organisms included	Recommendation	Limitations
1st level laboratory based surveillance	Surveillance of routine clinical microbiology laboratory-results	Various MDROs	Mandatory	Low number of collected samples, identification of specimens as coming from LTCF patients, exclusion of colonization data
2nd level laboratory based surveillance	Active surveillance cultures	Generally CPE, possible extension to other MDROs	Strongly recommended	Generally limitation to colonization by CPE, exclusion of routine isolates from infections
3rd level laboratory based surveillance	Prospective facility screening of LTCF residents for MDROs	Various MDROs	On a voluntary basis, and recommended	Generally point prevalence study, exclusion of routine isolates from infections, costly and time-consuming