Screening for multi-drug-resistant Gram-negative bacteria: what is effective and justifiable?
| Autor: | Niels Nijsingh, Christian Munthe, Anna Lindblom, Christina Åhrén |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Diagnostic Screening Programs
Methicillin-Resistant Staphylococcus aureus Risk medicine.medical_specialty Sanitation Antibiotic resistance Psychological intervention Hospital screening Public health ethics 03 medical and health sciences 0302 clinical medicine Symptomatic infection Drug Resistance Multiple Bacterial Intervention (counseling) Gram-Negative Bacteria Humans Medicine Antimicrobial stewardship 030212 general & internal medicine Intensive care medicine Health policy 0303 health sciences 030306 microbiology business.industry Colonisation General Medicine Bioethics Scale (social sciences) Carrier State Original Article business |
| Zdroj: | Monash Bioethics Review |
| ISSN: | 1836-6716 1321-2753 |
| DOI: | 10.1007/s40592-020-00113-1 |
| Popis: | Effectiveness is a key criterion in assessing the justification of antibiotic resistance interventions. Depending on an intervention’s effectiveness, burdens and costs will be more or less justified, which is especially important for large scale population-level interventions with high running costs and pronounced risks to individuals in terms of wellbeing, integrity and autonomy. In this paper, we assess the case of routine hospital screening for multi-drug-resistant Gram-negative bacteria (MDRGN) from this perspective. Utilizing a comparison to screening programs for Methicillin-Resistant Staphylococcus aureus (MRSA) we argue that current screening programmes for MDRGN in low endemic settings should be reconsidered, as its effectiveness is in doubt, while general downsides to screening programs remain. To accomplish justifiable antibiotic stewardship, MDRGN screening should not be viewed as a separate measure, but rather as part of a comprehensive approach. The program should be redesigned to focus on those at risk of developing symptomatic infections with MDRGN rather than merely detecting those colonised. |
| Databáze: | OpenAIRE |
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