The first multi-centre point-prevalence survey in four Japanese university hospitals
The first multi-centre point-prevalence survey in four Japanese university hospitals
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DOI：
10.1016/j.jhin.2018.03.005
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发表时间：
2018-07-01
影响因子：
6.9
通讯作者：
Yagi, T.
中科院分区：
文献类型：
--
作者：
Morioka, H.;Nagao, M.;Yagi, T.
背景资料：日本政府通过了一项关于抗菌素耐药性的国家行动计划，旨在减少耐药病原体和抗菌素的使用。点患病率调查（PPS）是一种有用的监测方法，可以获得有关医院流行病学的信息;然而，日本以前没有进行过多中心PPS。目的：调查日本多所大学医院的医院流行病学、医疗相关感染（HCAIs）和抗菌药物使用的一般信息。方法：2016年7月，在日本的四所大学医院使用标准化方案进行了多中心PPS。结果：共纳入3199例患者。中位年龄和住院时间分别为64岁和10天。共有246例（7.7%; 95%置信区间（CI）：6.8-8.7）患者有256例活动性HCAI，933例（29.2%; 95% CI：27.6-30.8）患者接受了1318种抗菌剂。肺炎和胃肠道系统感染是最常见的HCAIs（N = 42，16.4%），肠杆菌科（N = 49，30.8%）是主要致病微生物。碳青霉烯类（N = 52，17.8%）、抗MRSA药物和具有抗假单胞菌活性的头孢烯类是HCAIs最常处方的抗菌药物。作为手术预防，278种抗菌药物中有46种（16.5%）口服。HCAI和抗菌药物的使用比例在每家医院的范围从4.8%到9.5%和19.3%-35.0%，respectively.Conclusion：这多中心PPS记录详细的HCAI数据和不同的抗菌药物的使用在日本的大学医院。有必要进一步监测，以减少HCAIs，并制定可行的计划，以实现抗菌素耐药性国家行动计划。(C)2018年，卫生保健感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: The Japanese government adopted a national action plan on antimicrobial resistance, which aims to reduce drug-resistant pathogens and antimicrobial use. A point-prevalence survey (PPS) is a useful surveillance method to gain information about hospital epidemiology; however, no multi-centre PPS has previously been performed in Japan.Aim: To investigate general information about hospital epidemiology, healthcare-associated infections (HCAIs), and antimicrobial use in multiple Japanese university hospitals.Methods: In July 2016, a multi-centre PPS was conducted using a standardized protocol at four university hospitals in Japan.Findings: A total of 3199 patients were included. Median age and duration of hospital stay were 64 years and 10 days, respectively. A total of 246 (7.7%; 95% confidence interval (CI): 6.8-8.7) patients had 256 active HCAIs, and 933 (29.2%; 95% CI: 27.6-30.8) patients received 1318 antimicrobials. Pneumonia and gastrointestinal system infection were the most common HCAIs (N = 42, 16.4%), and Enterobacteriaceae (N = 49, 30.8%) were the predominant causative organisms. Carbapenems (N = 52, 17.8%), anti-MRSA medications, and cephems with antipseudomonal activity were the most frequently prescribed antimicrobials for HCAIs. As surgical prophylaxis, 46 of 278 antimicrobials (16.5%) were administered orally. Proportions of HCAI and antimicrobial use in each hospital ranged from 4.8% to 9.5% and 19.3%-35.0%, respectively.Conclusion: This multi-centre PPS recorded detailed HCAI data and distinct antimicrobial use in Japanese university hospitals. Further surveillance is necessary to reduce HCAIs and formulate feasible plans to achieve the national action plan on antimicrobial resistance. (C) 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.