Nationwide surveillance of antimicrobial consumption and resistance to Pseudomonas aeruginosa isolates at 203 Japanese hospitals in 2010

被引：43

作者：

Muraki, Y. ^{[1
,2
]}

Kitamura, M. ^{[1
,3
]}

Maeda, Y. ^{[1
,4
]}

Kitahara, T. ^{[1
,5
]}

Mori, T. ^{[1
,6
]}

Ikeue, H. ^{[1
,7
]}

Tsugita, M. ^{[1
,8
]}

Tadano, K. ^{[1
,9
]}

Takada, K. ^{[1
,10
]}

Akamatsu, T. ^{[1
,11
]}

Yamada, T.

Shiraishi, T. ^{[1
,12
]}

Okuda, M. ^{[2
]}

机构：

[1] Japanese Soc Hosp Pharmacists, Comm Acad, Subcomm 5, Tokyo, Japan

[2] Mie Univ, Mie Univ Hosp, Fac Med, Dept Pharm, Tsu, Mie 5148507, Japan

[3] Jikei Univ, Dept Pharm, Sch Med, Minato Ku, Tokyo, Japan

[4] Osaka Rosai Hosp, Dept Pharm, Sakai, Osaka, Japan

[5] Nagasaki Univ Hosp, Dept Hosp Pharm, Nagasaki, Japan

[6] Meijo Univ, Fac Pharm, Nagoya, Aichi 468, Japan

[7] Kagawa Rosai Hosp, Dept Pharm, Marugame, Kagawa, Japan

[8] Niitsu Med Ctr Hosp, Dept Pharm, Niigata, Japan

[9] Hlth Sci Univ Hokkaido, Fac Pharmaceut Sci, Sapporo, Hokkaido, Japan

[10] Narita Hosp, Japanese Red Cross Soc, Dept Pharm, Chiba, Japan

[11] Kyushu Kosei Nenkin Hosp, Dept Pharm, Kitakyushu, Fukuoka, Japan

[12] Yamagata Univ Hosp, Dept Pharm, Yamagata, Japan

来源：

INFECTION | 2013年 / 41卷 / 02期

关键词：

Surveillance; Japan; Antimicrobial consumption; Resistance; Anatomical Therapeutic Chemical; Defined daily dose; ANTIBIOTIC USE; RISK-FACTORS; IMPACT; SUSCEPTIBILITY; INFECTION; PROGRAM;

D O I：

10.1007/s15010-013-0440-0

中图分类号：

R51 [传染病];

学科分类号：

100201 [内科学];

摘要：

Purpose In Japan, a national surveillance study of antimicrobial consumption has never been undertaken. This study aimed to describe antimicrobial consumption and resistance to Pseudomonas aeruginosa in 203 Japanese hospitals, to identify targets for quality improvement. Methods We conducted an ecological study using retrospective data (2010). Antimicrobial consumption was collected in the World Health Organization (WHO) anatomical therapeutic chemical/defined daily dose (ATC/DDD) format. Rates of imipenem (IPM), meropenem (MEPM), ciprofloxacin (CPFX), or amikacin (AMK) resistance were expressed as the incidence of non-susceptible isolates. Additionally, hospitals were asked to provide data concerning hospital characteristics and infection control policies. Hospitals were classified according to functional categories of the Medical Services Act in Japan. Results Data were collected from 203 Japanese hospitals (a total of 91,147 beds). The total antimicrobial consumption was 15.49 DDDs/100 bed-days (median), with consumptions for penicillins, carbapenems, quinolones, and glycopeptides being 4.27, 1.60, 0.41, and 0.49, respectively. The median incidences of IPM, MEPM, CPFX, and AMK resistance were 0.15, 0.10, 0.13, and 0.03 isolates per 1,000 patient-days, respectively. Antimicrobial notification and/or approval systems were present in 183 hospitals (90.1 %). In the multivariate analysis, the piperacillin/tazobactam, quinolones, and/or total consumptions and the advanced treatment hospitals showed a significant association with the incidence of P. aeruginosa resistant to IPM, MEPM, CPFX, and AMK [adjusted R-2 (aR(2)) values of 0.23, 0.30, 0.22, and 0.35, respectively). Conclusion This is the first national surveillance study of antimicrobial consumption in Japan. A continuous surveillance program in Japan is necessary in order to evaluate the association among resistance, antimicrobial restriction, and consumption.

引用

页码：415 / 423

页数：9

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