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

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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