Three interconnected work packages (WP1-3) supplemented by a management and dissemination package (WP4) are planned.

WP1: Aims to design a multi-level network model that reflects patient traffic in various European healthcare systems. It will provide the framework to study the transmission dynamics of MDR-E and the effectiveness of infection control strategies to contain their spread within and across healthcare systems.

WP2: Specific molecular studies assessing the transmissibility of different MDR-E species and strains will be conducted. In these studies, we will apply a novel cutting-edge methodology of targeted sequencing, which makes the large studies planned in this project economically feasible.

WP3: Based on a systematic literature review and a formal Delphi process for collating evidence, we will identify promising infection control strategies for containing MDR-E and assess their effectiveness in simulation studies in the multi-level network model using species and strain specific transmission parameters.