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Hospital programs for surveilling multi-drug resistant Gram-negative bacteria should be more streamlined to be effective, proportional and fair, CARe researchers argue.

Hospital screening of patients for antibiotic resistant bacteria is a backbone of good antibiotic stewardship. In a new original research article, published in the established healthcare ethical journal Monah Bioethics Review, an interdisciplinary group of CARe researchers argue for reform of existing hospital screening programs to detect colonization of multi-drug resistant gram-negative (MDRGN) bacteria in patients.

These should not, as is current practice in many places, be designed on the template of established successful programs for MRSA bacteria, but be more streamlined and mixed with elevated hygiene protolls and infection protection of selected patient groups. The authors consists of scholars on antibiotic stewardship, infectious disease medicine and microbiology, together with specialists in philosophy and public health ethics. Their argument rests on this combination of expertise, using aspects of epidemiology, infectious disease prevention, and basic public health ethical considerations to argue that present programs are likely to be ineffective, while retaining considerable downsides of screening programs for patients and the healthcare system, thus failing to meet standards of proprtionality and fairness. Led by CARe postdoctoral researcher Niels Nijsingh, the authors have developed an alternative proposal that mixes a more streamlined screening approach mixed with specially designed preventive and protective measures to achieve effective protection against harmful hospital transmission of MDRGN bacteria.

Link to the article (open access): https://link.springer.com/article/10.1007/s40592-020-00113-1