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Universal Screening for Antibiotic-Resistant Organisms: A Review of the Clinical and Cost-Effectiveness

Published on: October 13, 2015
Project Number: RC0709-000
Product Line: Rapid Response
Research Type: Other Diagnostics
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the comparative clinical effectiveness of a universal screening strategy versus no screening for antibiotic resistant organisms? 
  2. What is the comparative clinical effectiveness of a universal screening strategy versus targeted screening of intensive care unit patients, surgical patients and other high risk patients for antibiotic resistant organisms?
  3. What is the comparative clinical effectiveness of targeted screening versus no screening for antibiotic resistant organisms for intensive care unit patients, surgical patients, and other high risk patients?
  4. What is the comparative cost-effectiveness of a universal screening strategy versus targeted screening or no screening for antibiotic resistant organisms?

Key Message

One review of systematic reviews and primary clinical studies, five primary clinical studies, and 15 economic evaluations were identified regarding the clinical and cost-effectiveness of various screening strategies for antibiotic resistant organisms. Taking into consideration issues with generalizability, difficulty interpreting the true effect of screening against the backdrop of a matrix of infection control measures, and substantial risk of confounding, the evidence suggests that from both clinical and cost perspectives having an MRSA screening program is likely beneficial compared to not having a screening program. Targeted screening may be preferred over universal screening due to more convincing evidence in support of clinical benefits and cost-savings, and reduced concern related to antibiotic resistance and downstream costs. Limited evidence was available in support of VRE screening programs and no evidence was identified regarding the clinical or cost-effectiveness of other screening programs for other AROs.

Tags

drug resistance, hospitalization, infection control, infectious diseases, mrsa, mass screening, methicillin-resistant staphylococcus aureus, patient admission, vancomycin resistance, beta-lactam resistance, Antibiotic resistant organisms, Bacterial, VRE, admission screening, drug resistant