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LEADER 00000cam a2200553 i 4500 
003    OCoLC 
005    20180804040252.2 
006    m     o  d f       
007    cr un||||||||| 
008    140104s2012    onca    obt  f000 0 eng   
019    NCBIBSocn821262521 
040    NLM|beng|erda|epn|cNLM|dCELBN|dE7B|dEBLCP|dVT2|dOCLCQ
       |dOCLCO|dFVL|dOCLCQ|dOCLCA|dOCLCF|dCEF 
042    pcc 
049    MAIN 
050  4 RC116.G677|bS375 2012eb 
055  4 RC116.G677|bS375 2012eb 
060 00 QW 142.5.C6 
082 04 616.92071|222 
100 1  Ho, Chuong,|eauthor. 
245 10 Screening, isolation, and decolonization strategies for 
       vancomycin-resistant enterococci or extended spectrum beta
       -lactamase producing organisms :|ba systematic review of 
       the clinical evidence and health services impact /|cChuong
       Ho, Andrea Lau, Karen Cimon, Kelly Farrah, Michael Gardam.
264  1 Ottawa, Ontario :|bCanadian Agency for Drugs and 
       Technologies in Health,|cSeptember 2012. 
300    1 online resource (1 PDF file (iii, 60 pages)) :
       |billustration. 
336    text|btxt|2rdacontent 
337    computer|bc|2rdamedia 
338    online resource|bcr|2rdacarrier 
490 1  Rapid response report : systematic review 
500    Title from PDF title page. 
504    Includes bibliographical references. 
505 0  Acronyms and abbreviations -- Executive summary -- 1. 
       Context and policy issues -- 2. Research questions -- 3. 
       Key message -- 4. Methods -- A. Clinical evidence: 5. 
       Results -- B. Health services impact: 6. Methods; 7. 
       Results; 8. Discussion -- 9. Conclusions and implications 
       for decision or policy-making -- 10. References -- 
       Appendix 1: Literature search strategy -- Appendix 2: 
       Selection of included trials for clinical evidence -- 
       Appendix 3: Clinical study inclusion / exclusion form -- 
       Appendix 4: Clinical study data extraction form -- 
       Appendix 5: Included trials for clinical evidence -- 
       Appendix 6: Excluded trials for clinical evidence -- 
       Appendix 7: Clinical evidence study characteristics -- 
       Appendix 8: Clinical evidence patient characteristics -- 
       Appendix 9: Clinical evidence interventions and 
       comparators -- Appendix 10: Critical appraisal of included
       studies for clinical evidence -- Appendix 11: Main 
       clinical study findings and authors' conclusions -- 
       Appendix 12: Selection of studies for health service 
       impact -- Appendix 13: Health services impact study 
       characteristics -- Appendix 14: Health services impact 
       study findings. 
520 3  Bacterial resistance to antibiotics is an increasing 
       problem in Canada and worldwide. Vancomycin-resistant 
       enterococci (VRE) are strains of Enterococcus faecium or 
       Enterococcus faecalis that contain genes conferring 
       resistance to vancomycin. Escherichia coli (E. coli), 
       Klebsiella pneumonia (K. pneumonia), and other gram-
       negative bacteria may produce the enzymes known as 
       extended spectrum beta-lactamases (ESBL). These have the 
       ability to inactivate beta lactam antibiotics such as 
       penicillin, ampicillin, and the cephalosporins. The 
       presence and growth (colonization) of VRE and ESBL-
       producing micro-organisms in the gastrointestinal tract is
       usually of no consequence for the host, but under certain 
       circumstances, such as immunosuppression, gastrointestinal
       surgery, or physical debilitation, they may serve as a 
       source of infection for the carrier. These hosts may also 
       serve as a reservoir for the transmission of VRE and ESBL-
       producing organisms to other persons. Results from the 
       Canadian Nosocomial Infection Surveillance Program showed 
       that from 1999 to 2005, the rate of VRE colonization and 
       VRE infection increased from 0.37 to 1.32 cases, and from 
       0.02 to 0.05 cases respectively per 1,000 patients 
       admitted to hospital. The laboratory-based Canadian Ward 
       Surveillance Study in 2008 found that ESBL-producing E. 
       coli were identified in all Canadian geographic regions, 
       and that 4.9% of E. coli isolates were ESBL producers. 
       Specific prevention and control measures for antibiotic-
       resistant organisms (AROs) include screening (a process to
       identify persons colonized with AROs) and isolation of the
       carriers. Hospital infection prevention and control 
       strategies have been developed in some Canadian 
       jurisdictions, and these are compatible with other 
       national and international documents. Non-specific 
       strategies for controlling ARO transmission and infection 
       include hand hygiene; environmental cleaning; 
       antimicrobial stewardship; and bundled practices, such as 
       those to prevent central line-associated blood stream 
       infections. Antibiotic-resistant organisms, such as VRE 
       and ESBL-producers, lead to the increased use of hospital 
       resources due to extended hospital stays, laboratory tests,
       physician consultations, costly medications if therapy for
       a VRE or ESBL-related infection were to arise, and the 
       need to adhere to infection prevention and control 
       measures to prevent the further spread of these pathogens.
       Some of the increased resource usage results from the 
       morbidity caused by VRE or ESBL-producing organism 
       infections, while some is a consequence of control 
       strategies. For example, it may be harder to transfer a 
       patient to a rehabilitation facility if they are currently
       in isolation, which will in and of itself, prolong the 
       length of stay. The objective of this systematic review is
       to evaluate the clinical evidence for the effectiveness of
       screening, isolation, and decolonization strategies for 
       persons colonized or infected with VRE and ESBL-producing 
       organisms in acute and long-term care facilities. The 
       health services impact of these strategies will be 
       discussed. 
536    CADTH is funded by Canadian federal, provincial, and 
       territorial governments. 
650  0 Vancomycin resistance. 
650  0 Gram-negative bacterial infections|xDiagnosis. 
650  0 Gram-negative bacterial infections|xTreatment. 
655  2 Review. 
655  4 Electronic books. 
700 1  Lau, Andrea,|eauthor. 
700 1  Cimon, Karen,|eauthor. 
700 1  Farrah, Kelly,|eauthor. 
700 1  Gardam, Michael,|eauthor. 
710 2  Canadian Agency for Drugs and Technologies in Health,
       |eissuing body. 
710 2  National Library of Medicine|eissuing body. 
830  0 Rapid response report (Canadian Agency for Drugs and 
       Technologies in Health) 
830  0 NCBI BookShelf 
856 40 |uhttp://www.ncbi.nlm.nih.gov/books/NBK174613|zConnect to 
       ebook (University of Melbourne only) 
990    National Center for Biotechnology Information 
990    Batch Ebook load (bud2) - do not edit, delete or attach 
       any records. 
991    |zNEW New collection NLM.bookshelf 2018-08-03 
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