Japanese Society for Infection Prevention and Control-Online Journal

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Infection Prevention and Control in Stratified Long-term Care Beds in Japanese Long-term Care Facilities: A Point Prevalence Survey

Kumiko SUZUKI¹⁾, Shinichiro MORIOKA¹⁾^～³⁾, Nobuaki MATSUNAGA¹⁾, Kayoko HAYAKAWA¹⁾²⁾, Yumi MOTOKI⁴⁾⁵⁾, Yozo TAKEHISA⁴⁾⁵⁾ and Norio OHMAGARI¹⁾^～³⁾
¹⁾AMR Clinical Reference Center, National Center for Global Health and Medicine, ²⁾Disease Control and Prevention Center, National Center for Global Health and Medicine, ³⁾Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, ⁴⁾Japan Association of Medical and Facilities, ⁵⁾Hakuai Memorial Hospital

Background: Understanding the epidemiology of multidrug-resistant organisms (MDROs) and the state of infection control systems in healthcare institutions may contribute to the measures for combating MDROs and improving patient outcomes. Although Japan is a super-aged society unlike any other in the world, there have been only limited studies on long-term care hospitals, where 90% of beds are occupied by elderly patients.
Materials/methods: We conducted a point prevalence survey on the status of infection prevention and control systems, and healthcare-associated infections at 1,032 healthcare institutions, stratified long-term care beds in Japanese long-term care facilities. Questionnaire forms were sent to the participating healthcare institutions and collected via mail from January to March 2020.
Results: The response rate was 7.8% (80 centers). Of the responding institutions, 90% calculated "long-term care ward hospitalization fee 1, " which applies to hospitalization in wards that accommodate many patients with a high need for healthcare and assistance in daily living. At these institutions, 41.9% of patients were discharged home or to a care facility. Additional reimbursement for infection prevention 1 or 2 was calculated, and infection control teams had been set up at 63.8% of the institutions. For hand hygiene practice, some institutions reported the use of alcohol-based hand sanitizer, whereas other institutions did not. The antimicrobial use rate on point prevalence survey days was 9.4%. Of all patients who used antimicrobials, 28.6% had carried MDROs within the past year.
Conclusions: The number of elderly people who go back and forth between healthcare institutions and the community is expected to continue increasing. If suitable measures are not taken to prevent and control the occurrence and spread of MDROs in long-term care hospitals, MDROs may spread from healthcare institutions to community-dwelling elderly people. Our survey results indicate that in long-term care hospitals, where human, physical, and financial resources are limited, it would be effective for all staff engaged in the care of patients to thoroughly implement standard infection prevention measures.

Key words：long-term care facilities, multidrug-resistant organisms, infection prevention and control

e-mail: ksuzuki＠hosp.ncgm.go.jp

Received: December 16, 2021
Accepted: August 10, 2022

38 (1)：26─32,2023