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Vol.38 No.2 contents | Japanese/English |
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Full Text of PDF (3,779K) Article in Japanese |
Antimicrobial Stewardship in "Ryoyo" Wards in Japanese Long-term Care Facilities: A Point Prevalence Survey
Shinichiro MORIOKA1)～3), Kumiko SUZUKI1), Nobuaki MATSUNAGA1), Kayoko HAYAKAWA1)2), Yumi MOTOKI4)5), Yozo TAKEHISA4)5) and Norio OHMAGARI1)2)
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 Care Facilities, 5)Hakuai Memorial Hospital
Background: Understanding the current status of infectious disease treatment and antimicrobial resistance in ryoyo wards (supportive care beds in Japanese long-term care facilities) is important for clarifying and addressing any issues.
Methods: We conducted a point prevalence survey from January to May 2020, targeting 1,032 medical institutions with ryoyo wards. Basic information on the institution, patient status, and treatment details of patients who were using antimicrobial agents on the day of the survey were recorded.
Results: Valid responses were obtained from 80 medical institutions (response rate: 7.8%). Of the 6, 729 patients in ryoyo wards, 9.4% were on antimicrobials. Antimicrobial users had a median age of 87.0 years and 49.5% were male. Antimicrobials were used for treatment in 92.4% and prophylaxis in 7.6% of users. Of antimicrobial users, 36.4% had pneumonia and 24.4% had urinary tract infections (UTIs). Among patients with UTIs, 42% of E. coli and 38% of Klebsiella species detected by urine culture were resistant to third-generation cephalosporins. Among patients with pneumonia, 29.3% and 14.1% were treated with third-generation cephalosporins and carbapenems, respectively. Among patients with UTIs, 24.1%, 19.5%, and 7.5% were treated with fluoroquinolones, third-generation cephalosporins, and carbapenems, respectively.
Conclusion: High prevalence of extended spectrum beta lactamase-producing bacteria and broad-spectrum antimicrobial use were the main characteristics of infectious disease treatment in ryoyo wards. It is necessary to monitor the use of antimicrobial agents and drug-resistant bacteria continuously in ryoyo wards and develop effective intervention measures for treating infections.
Key words：long-term care, antimicrobial stewardship, multidrug-resistant organisms, antimicrobial use
e-mail: shmorioka＠hosp.ncgm.go.jp
Received: February 20, 2022
Accepted: October 21, 2022
38 (2)：46─56,2023
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