Surveillance and Screening of AROs (Antimicrobial Resistant Organisms)

AROs: Presentations

Weds 18 June 2014 | Thurs 19 June 2014 | Fri 20 June 2014

Surveillance and Screening for Antimicrobial Resistant Organisms (AROs) 2014 - Final Program

Wednesday, 18 June 2014

08:00 – 08:15

08:15 – 09:45

QUESTION 1: Overview
a) What are AROs? What is their incidence and prevalence (in health care facilities and in the community)? (Global, US, Canadian, and Alberta perspectives) Why are they a problem, globally and in Canada - what burden do they impose on patients and the health system?

b) Where do AROs come from (genetics and evolution)? How big a factor is the use of antimicrobials, and what is the contribution from various settings (healthcare, home, agriculture)?

10:00 – 11:15

c) What is surveillance; what is screening? How are they related?

d) What can we learn from the experience of other jurisdictions? (International, US, Canadian, and Alberta perspectives) Why does control of AROs vary so much? - e.g., is mandatory public reporting of data on AROs helpful?

12:15 – 13:00

QUESTION 2: Surveillance
a) Why should we conduct surveillance? What do we do based on the results? What outcomes do we want, and are we achieving them?

b) How should we conduct surveillance – what options are available? What are the key areas of focus for surveillance in public health?

13:00 – 14:40

QUESTION 3: Screening
a) Should we screen for AROs? Pro versus Con. Should we rely on horizontal measures only, i.e., general prevention? Should we rely on vertical measures, i.e., screen for multiple specific organisms? If we screen, what options should we use? – e.g., community vs admission; acute care vs. continuing care; patient selection; methods. If we screen, what should we do with the results, and how should we evaluate a screening program?

15:00 – 16:00

b) Is there a role for decolonization, and if so, when, and how?

c) Why do screening practices vary so much between jurisdictions?

Thursday, 19 June 2014

08:30 – 10:30

QUESTION 4: What factors can facilitate or hinder effective ARO control in practice?
a) Organizational and cultural factors (barriers and enablers)

b) Lab capacity – what is the burden of ARO testing on labs; is it appropriate/cost-effective relative to other demands on lab resources? Are there changes or new options available that could reduce the burden?

10:00 – 12:00

QUESTION 5: Ethical and policy implications
a) What is appropriate screening for AROs in various settings?

b) What are the impacts of screening on patients, and on their family members and others? – eg, can screening do harm? Does it result in patients receiving reduced care due to “leperization” (stigma) and isolation? Does it impact eligibility/placement in home care and continuing care? Do patients have the right to refuse screening (or should they)?

c) What is the economic cost/benefit of screening from the point of view of the individual patient; health care providers; and the funder of the health care system? How do we evaluate/measure the economic value of screening?

d) What can patients, the public, and health care providers do to help? Would more education re: appropriate use of antibiotics help reduce the incidence of AROs, and what would be the most effective strategy? What is the appropriate role of health care providers in ensuring responsible stewardship of antimicrobials?

13:00 – 14:40

QUESTION 6: Research/evidence
a) Ongoing scientific gaps for facilitating policy in healthcare

b) Outlining a Framework for ARO Screening/Surveillance Studies

c) Designing Interventional Studies for Evaluation of ARO Control Strategies

d) How CIHR is Addressing Antimicrobial Resistance, Nationally, and Internationally

Friday, 20 June 2014

9:00 – 12:00

Reading of the Consensus Statement, open discussion, and comments on the statement