Nationwide multicenter questionnaire surveys on countermeasures against antimicrobial resistance and infections in hospitals

BMC Infectious Diseases

Yoshiaki Gu¹  Keigo Shibayama²  Noriko Sasaki³  Seiko Mizuno³  Hisashi Itoshima³  Jung-ho Shin³  Susumu Kunisawa³  Takuya Okuno³  Yuichi Imanaka³  Daiichi Morii⁴  Norio Ohmagari⁵  Makiko Yoshida⁶  Mitsuo Kaku⁷ 

[1] AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan;Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan;Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, 606-8501, Kyoto, Japan;Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan;Department of Infectious Diseases, AMR Clinical Reference Center, and Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan;Department of Infectious Diseases, Tohoku University Graduate School of Medicine, Sendai, Japan;Division of Infectious Diseases and Infection Control, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan;

关键词: Antimicrobial resistance;    Antimicrobial stewardship;    Healthcare-associated infection;    Infection control;    Surveillance;   

DOI  :  10.1186/s12879-021-05921-2

来源: Springer

【 摘 要 】

BackgroundThe goals of the National Action Plan on Antimicrobial Resistance (AMR) of Japan include “implementing appropriate infection prevention and control” and “appropriate use of antimicrobials,” which are relevant to healthcare facilities. Specifically, linking efforts between existing infection control teams and antimicrobial stewardship programs was suggested to be important. Previous studies reported that human resources, such as full-time equivalents of infection control practitioners, were related to improvements in antimicrobial stewardship.MethodsWe posted questionnaires to all teaching hospitals (n = 1017) regarding hospital countermeasures against AMR and infections. To evaluate changes over time, surveys were conducted twice (1st survey: Nov 2016, 2nd survey: Feb 2018). A latent transition analysis (LTA) was performed to identify latent statuses, which refer to underlying subgroups of hospitals, and effects of the number of members in infection control teams per bed on being in the better statuses.ResultsThe number of valid responses was 678 (response rate, 66.7%) for the 1st survey and 559 (55.0%) for the 2nd survey. More than 99% of participating hospitals had infection control teams, with differences in activity among hospitals. Roughly 70% had their own intervention criteria for antibiotics therapies, whereas only about 60 and 50% had criteria established for the use of anti-methicillin-resistant Staphylococcus aureus antibiotics and broad-spectrum antibiotics, respectively. Only 50 and 40% of hospitals conducted surveillance of catheter-associated urinary tract infections and ventilator-associated pneumonia, respectively. Less than 50% of hospitals used maximal barrier precautions for central line catheter insertion.The LTA identified five latent statuses. The membership probability of the most favorable status in the 2nd study period was slightly increased from the 1st study period (23.6 to 25.3%). However, the increase in the least favorable status was higher (26.3 to 31.8%). Results of the LTA did not support a relationship between increasing the number of infection control practitioners per bed, which is reportedly related to improvements in antimicrobial stewardship, and being in more favorable latent statuses.ConclusionsOur results suggest the need for more comprehensive antimicrobial stewardship programs and increased surveillance activities for healthcare-associated infections to improve antimicrobial stewardship and infection control in hospitals.

【 授权许可】

CC BY