Evaluation of the guidelines for infection control and prevention, which was made for national university hospitals in Japan

首席研究员Satoshi Ichiyama领导了为日本国立大学医院制定感染控制和预防指南的委员会。该指南是参考疾病控制和预防中心（CDC）的指南修改后制定的，以适应医院，并于2001年11月完成。该指南包括五个部分：标准预防措施和基于传播的预防措施;预防和控制特定病原体（即，结核病、麻疹、军团菌）;预防特定的医院感染（即，尿路感染、呼吸机相关肺炎、手术部位感染）;环境感染控制;其他（即，血管内导管相关感染的管理，HBV、HCV和HIV职业暴露的管理）。该指南于2002年12月进行了修订，并增加了食物中毒指南。传染病专家感染控制医生（ICD）根据该指南在京都大学医院进行感染控制。截至2002年12月，共调查了636起案件。其中500人有严重感染性疾病相关的实验室检查异常，98人有ICD咨询，28人有抗生素使用不当。分别有62%和69%的病例建议了适当的诊断和治疗，其中分别有56%和51%的病例根据建议修改了诊断和治疗。此外，对14%的病例推荐了适当的感染控制措施，85%的病例进行了修改。总的来说，日本的许多医生对传染病和感染控制的认识不足，因此，ICD应致力于传染病的诊断和治疗，以遵守感染控制指南

Head investigator, Satoshi Ichiyama, headed the committee set up to make the guidelines for infection control and prevention for the National University Hospitals in Japan. The guidelines were made with referring the guidelines of Centers of Disease Control and Prevention (CDC) modified to fit the hospitals and were completed at November 2001. The guidelines comprises five parts: Standard precautions and transmission-based precautions; Prevention and control of specific pathogens (I.e., Tuberculosis, Measles, Legionella); Prevention of specific nosocomial infections (I.e., Urinary Tract Infection, Ventilator Associated Pneumonia, Surgical Site Infection); Environmental Infection Control; Others (I.e., Management of Intravascular Catheter-related Infections, Management of Occupational Exposures to HBV, HCV, and HIV). The guidelines were revised at December 2002, and the guideline for food poisoning was addedInfection Control Doctors (ICD), who were specialists for infectious diseases, practiced the infection control based on this guidelines at Kyoto University Hospital. Until December 2002, a total of 636 cases were investigated. Among them, 500 had abnormal laboratory data associated with severe infectious diseases, 98 had consultation to ICD, and 28 had inappropriate use of antibiotics. Appropriate diagnosis and treatment were recommended on 62% and 69% of the cases, respectively, and the diagnosis and treatment were modified according to the recommendations on 56% and 51% among them, respectively. Furthermore, appropriate infection control practices were recommended on 14% of the cases, with 85% modification. In conclusion, many of medical doctors in Japan had only inadequate knowledge of infectious diseases and infection control, therefore, ICD should commit to the diagnosis and treatment of infectious diseases for the compliance of infection control guidelines