MRE Rhein-Main network celebrates its ninth anniversary

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Active for a responsible use of antibiotics in the fight against resistant germs

by Ilse Romahn

(6/12/2019) The Rhein-Main MRE network, founded in 2010, is celebrating its ninth anniversary on Wednesday, June 12th. Professor Ursel Heudorf, head of the network, presents the results and perspectives of the ceremony.

More than 300,000 leaflets on various topics were distributed, numerous trainings for doctors and hygiene specialists, more than 500 information events in health care facilities with more than 8,000 participants. The website https://www.mre-rhein-main.de and the information phone (069) 21248884 are well used.

Hesse is located in the VRE belt, a region ranging from Saarland to Saxony-Anhalt, with particularly high rates of ERV (vancomycin-resistant enterococci) in patients' blood cultures. This is why the network has conducted two studies last year. The network examined samples from 17 hospitals in the region (Rheingau-Taunus district in the west to Main-Kinzig district in the east) by means of a whole genome sequencing at the Institute of Medical Microbiology. "We were very surprised to find that there was only one type of VRE with the same subtype in almost every participating clinic, and we did not expect that." Other studies have shown that this AER had no particular resistance to disinfectants, could not be transferred better or had no more pathogenic effect, we did not find a real explanation for the AER belt, "said Heudorf. In another study conducted in a clinic with a large catchment area, it was shown that there were still several types of ERV, in 2016, but since 2017, only one type of ERV has been found.

"One of the key objectives of our network is to enable and improve the rehabilitation of patients with MDS, and after assistance and a first major study in 2014, we will propose this year a new review of rehabilitation patients with multidrug-resistant pathogens, "said Heudorf. 18 clinics have already announced their participation. "We want to not only investigate multidrug-resistant pathogens, but also devote ourselves to the use of antibiotics in rehab facilities."

In 2016, the MRE Rhein-Main network set up an Antibiotics Management Working Group, which deals with the proper use of antibiotics in clinics. Dr. Rolf Tessmann, Chief Medical Officer at the Berufsgenossenschaftliche Universitätsklinik and head of the working group, reports on the work and accomplishments of the network's birthday party. In some clinics, significant savings in antibiotics could be achieved. Dr. Arne Behm, specialist in urology and member of the Hesse Urologists' Cooperative, will give a lecture on "Urological antibiotic therapy and catheter care – with sense and reason?", A particularly important issue in the treatment of elderly or dependent patients.

Only the responsible use of antibiotics can reduce the resistance of bacteria. That's why the network, together with experts from various professional associations, has created flyers to inform patients about antibiotics for respiratory infections, urinary tract infections and, more recently, in 2018, the ills d & # 39; ear. Studies show that these infections often do not require antibiotics, either because they are caused by viruses, or that they can be well controlled by rest and "home remedies".

Improving the use of antibiotics is very important in Hesse. In cooperation with experts from different clinics in Hesse, the Hessen State Medical Association organizes continuing education programs and training of antibiotic experts for the clinics. In the ambulatory care sector, Kassenärztliche Vereinigung Hessen regularly informs its doctors of the appropriate use of antibiotics and its recommendations, and can already demonstrate clear success. For 2019/2020, the MRE Rhein-Main network is planning, in collaboration with the other MRE Hessian networks and with the support of the State Medical Association, the Association of Medical Doctors of the health insurance and the Ministry of Social Affairs and Integration of Hesse, the rational use of antibiotics. It is planned to present some parts of the RAI project (Rationale Antibiotikatherapie by Information and Communication, https://www.rai-projekt.de on the Internet) in Hesse.

"Another project is very important to me," says pediatrician Heudorf: "We have received many inquiries about how to proceed with EDM in special schools". He often teaches severely and multiplies deficient children, who are treated with catheters, have many medical treatments and hospitalizations behind them. This is also associated with a higher risk of colonization by antibiotic-resistant pathogens. This leads to uncertainty in special schools. With representatives of funding agencies and in coordination with other networks and experts, the MRE Rhein-Main network has now created a model hygiene plan for schools with special needs. "We hope that this model of hygiene plan, approved by the Ministry of Social Affairs and Education, be issued as a decree for schools, in addition to the 2014 decree of the Ministry of Education. Education on the education of children with EDM The goal is to improve the safety and thus to better treat affected children and to avoid exaggerated and restrictive measures.This is very important for me in as a pediatrician. "

Once again this year, the MRE network will award MRE seals to participating organizations that meet the criteria and actively participate in the network. This year, 80 of the 350 participating institutions are 80: 29 hospitals, 7 rehabilitation clinics, 36 retirement homes, 3 outpatient nursing services and 5 emergency services. Heudorf thanks the institutions and emphasizes: "The challenges posed by multidrug-resistant pathogens are not diminishing – but in our network we are improving together". (FFM)