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Vol.35 No.3 contents | Japanese/English |
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Full Text of PDF (406K) Article in Japanese |
Reduction of Multidrug-resistant Pseudomonas aeruginosa through Long-term Supportive Measures for Appropriate Use of Antimicrobial Agents
Shusaku NOGUCHI1)2), Nao YOSHIDA1), Takahiro SENZAKI1), Yuki MORIKAKU1), Hiromu UENO2)4) and Toru MOCHIZUKI2)3)
1)Department of Pharmacy, Nippon Medical School Musashikosugi Hospital, 2)Department of Infection Control and Prevention, Nippon Medical School Musashikosugi Hospital, 3)Department of Emergency and Critical Care Medicine, Nippon Medical School Musashikosugi Hospital, 4)Department of Nursing Care, Nippon Medical School Musashikosugi Hospital
Countermeasures for drug-resistant bacteria constitute an important issue in infection control measures in hospitals. At our hospital, 15 years have passed since the Infection Control Team (ICT) was formed in August 2004 and supportive measures for the appropriate use of antimicrobial agents were implemented. Long-term measures and their effects of reducing multidrug-resistant bacteria were evaluated, and some knowledge was obtained. A notification system for the use of specific antimicrobial agents in conjunction with the ordering system was introduced, and ICT antimicrobial rounds were initiated as part of Antimicrobial Stewardship (AS) activities. Furthermore, positive blood culture patient rounds were implemented and guidelines for the perioperative use of antimicrobial agents were prepared. Additionally, an AS Team was established in 2018 to strengthen measures for ensuring appropriate use.
For carbapenem antimicrobial agents, the antimicrobial use density decreased from 2.20 (2004) to 0.61 (2017) and the mean number of administration days decreased from 8.40 (2006) to 5.89 (2010). The proportion of meropenem-sensitive Pseudomonas aeruginosa cases recovered from 71.6% (2008) to 97.1% (2018). The number of patients with multidrug-resistant P. aeruginosa (MDRP) decreased from 28 (2008) to 0 (2018), and the number of patients with two-drug-resistant P. aeruginosa decreased from 10 (2010) to 0. In particular, MDRP has not been detected for 29 consecutive months as of October 2019. Long-term continuous measures and education were considered to have resulted in stably low incidence rates of resistant bacteria.
Key words：appropriate use of antimicrobial agents, carbapenems, Infection Control Team, Antimicrobial Stewardship Team, MDRP
e-mail: shusaku＠nms.ac.jp
Received: December 11, 2019
Accepted: March 27, 2020
35 (3)：104─109,2020
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