Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Bond K, Tjosvold L, Harstall C. Effectiveness of screening for endemic antibiotic resistant organisms (AROs) in hospital settings. Edmonton: Institute of Health Economics (IHE). 2014 Authors' objectives The following research questions were addressed in this review:
1. What are the clinical effects of a universal screening strategy for ARO carriage when compared with no screening?
2. What are the clinical effects of a universal screening strategy for ARO carriage when compared with targeted screening (screening of selected patient populations)?
3. What are the clinical effects of targeted screening for ICU patients, surgical patients, and other high-risk patients (for example, patients on hemodialysis, transferred patients) compared with no screening? Authors' conclusions ARO infections can have a serious impact on patients and hospital staffing resources and the cost and resources required for effective prevention and control of endemic AROs. Despite much research having been conducted on HA ARO infection prevention and control, there is currently little high-quality evidence that screening of patients (whether universal or targeted, and primarily relating to MRSA) is associated with reduction in HA ARO incidence, infection, mortality or morbidity in endemic settings. Results from a single, large RCT suggest that universal approaches to infection control may be more effective than approaches that aim to target single pathogens. Current clinical practice guidelines recommend that admission screening of high-risk patients be conducted for MRSA, VRE, and CROs. No guidelines currently recommend screening for ESBL-producing organisms. Given the current lack of reliable research evidence with which to guide decisions regarding screening, future research should focus on conducting well-designed, prospective studies that can disentangle the relative contributions of the measures used in the various approaches to HA ARO infection prevention and control. Indexing Status Subject indexing assigned by CRD MeSH Anti-Bacterial Agents; Bacteria; Diagnostic Tests, Routine; Drug Resistance, Microbial; Hospitals; Humans Language Published English Country of organisation Canada English summary An English language summary is available. Address for correspondence #1200, 10405 Jasper Avenue, Edmonton, AB T5J 3N4, Canada. Tel: +1 780 448 4881, Fax: +1 780 448 0018 Email: info@ihe.ca AccessionNumber 32014001072 Date abstract record published 09/09/2014 |