Babu Rajendran, NithyaGladstone, Beryl PrimroseRodríguez-Baño, JesúsSifakis, FrangiscosVoss, AndreasCarmeli, YehudaBurkert, Francesco RobertGkolia, PanagiotaTacconelli, Evelina2017-02-212017-02-212017-01-05Babu Rajendran N, Gladstone BP, Rodríguez-Baño J, Sifakis F, Voss A, Carmeli Y, et al. EpideMiology and control measures of outBreaks due to Antibiotic-Resistant orGanisms in EurOpe (EMBARGO): a systematic review protocol. BMJ Open. 2017; 7(1):e013634http://hdl.handle.net/10668/2586Journal Article; Erratum in: BMJ Open. 2017 Jan 27;7(1):e013634corr1INTRODUCTION Improving our understanding of outbreaks due to antibiotic-resistant bacteria (ARB) and their control is critical in the current public health scenario. The threat of outbreaks due to ARB requires multifaceted efforts. However, a global overview of epidemiological characteristics of outbreaks due to ARB and effective infection control measures is missing. In this paper, we describe the protocol of a systematic review aimed at mapping and characterising the epidemiological aspects of outbreaks due to ARB and infection control measures in European countries. METHODS AND ANALYSIS The databases MEDLINE, Web of Knowledge and Cochrane library will be searched using a 3-step search strategy. Selection of articles for inclusion will be performed by 2 reviewers using predefined eligibility criteria. All study designs will be included if they report an outbreak and define the microbiological methods used for microorganism identification. The target bacteria will be methicillin-resistant and vancomycin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, ceftazidime-resistant and carbapenem-resistant Acinetobacter baumannii, ceftazidime-resistant and carbapenem-resistant Pseudomonas aeruginosa, ciprofloxacin-resistant Escherichia coli, extended-spectrum β-lactamase-producing E. coli and Klebsiella pneumoniae, carbapenem-resistant and carbapenamase-producing Enterobacteriaceae. Data will be extracted using a tailored pilot tested form and the quality of reporting will be assessed using the ORION (Outbreak Reports and Intervention Studies Of Nosocomial infections) tool. Data will be synthesised and reported by the type of ARB, setting and country. Infection control measures and bundles of measures will be described. The effectiveness will be reported as defined by the authors. Regression analysis will be used to define independent factors associated with outbreaks' control. Heterogeneity between studies will be assessed by forest plots and I² statistics. ETHICS AND DISSEMINATION Ethical approval is not applicable for this study. Findings will be disseminated through journal publication and conference presentations and talks.enEpidemiologyAcinetobacter baumanniiCarbapenémicosCeftazidimaCiprofloxacinoInfección hospitalariaBrotes de enfermedadesResistencia a la meticilinaStaphylococcus aureus resistente a meticilinaMedical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Moraxellaceae::Acinetobacter::Acinetobacter baumanniiMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial AgentsMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::CarbapenemsMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Cephalosporins::Cephaloridine::CeftazidimeMedical Subject Headings::Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 2-Ring::Quinolines::Quinolones::Fluoroquinolones::CiprofloxacinMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Cross InfectionMedical Subject Headings::Health Care::Environment and Public Health::Public Health::Disease OutbreaksMedical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::EnterobacteriaceaeMedical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Escherichia::Escherichia coliMedical Subject Headings::Geographicals::Geographic Locations::EuropeMedical Subject Headings::Health Care::Environment and Public Health::Public Health::Public Health Practice::Communicable Disease Control::Infection ControlMedical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Klebsiella::Klebsiella pneumoniaeMedical Subject Headings::Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial::beta-Lactam Resistance::Penicillin Resistance::Methicillin ResistanceMedical Subject Headings::Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus::Staphylococcus aureus::Methicillin-Resistant Staphylococcus aureusMedical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Pseudomonadaceae::Pseudomonas::Pseudomonas aeruginosaMedical Subject Headings::Disciplines and Occupations::Health Occupations::Medicine::Public HealthMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Regression AnalysisMedical Subject Headings::Chemicals and Drugs::Carbohydrates::Glycoconjugates::Glycopeptides::VancomycinMedical Subject Headings::Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Amidohydrolases::beta-Lactamasesreview article28057656open access10.1136/bmjopen-2016-0136342044-6055PMC5223682