Naoya Tagui, Masayoshi Kondo, K. Kuroda, K. Sugaya, Yoshiko Suzuki, H. Maruyama, H. Takase
The Ministry of Health, Labor and Welfare has established an action plan for antimicrobial resistance, as the spread of antimicrobial-resistant bacteria is currently an urgent problem. One of the goals included in the plan is a 33% reduction in the use of antibacterial agents by 2020, compared with that in 2013. The inappropriate use of antibacterial agents is a likely cause of the increase in antimicrobial-resistant bacteria; thus, various initiatives are being undertaken at medical institutions to emphasize the appropriate use of antibacterial agents, with a distinctive feature of the plan being the ambitious target of a 50% reduction in the use of oral cephalosporins, fluoroquinolones, and macrolide antibiotics, which are used in large quantities in Japan. Herein, various initiatives were undertaken to reduce the use of oral third-generation cephalosporins and fluoroquinolones, and the outcomes of such initiatives have been assessed, with there being few reports on similar initiatives for reducing the use of oral antibacterial agents, although initiatives aimed at limiting the use of injectable antibacterial agents have been reported. The results showed a significant reduction in the overall use of these medications as well as in the number of patients with renal dysfunction who were administered excess oral fluoroquinolones.
{"title":"Initiatives to Reduce the Use of Oral Third-generation Cephalosporins and Fluoroquinolones to Help Achieve the Goals of the National Action Plan for Antimicrobial Resistance Control and Their Outcomes","authors":"Naoya Tagui, Masayoshi Kondo, K. Kuroda, K. Sugaya, Yoshiko Suzuki, H. Maruyama, H. Takase","doi":"10.4058/JSEI.35.247","DOIUrl":"https://doi.org/10.4058/JSEI.35.247","url":null,"abstract":"The Ministry of Health, Labor and Welfare has established an action plan for antimicrobial resistance, as the spread of antimicrobial-resistant bacteria is currently an urgent problem. One of the goals included in the plan is a 33% reduction in the use of antibacterial agents by 2020, compared with that in 2013. The inappropriate use of antibacterial agents is a likely cause of the increase in antimicrobial-resistant bacteria; thus, various initiatives are being undertaken at medical institutions to emphasize the appropriate use of antibacterial agents, with a distinctive feature of the plan being the ambitious target of a 50% reduction in the use of oral cephalosporins, fluoroquinolones, and macrolide antibiotics, which are used in large quantities in Japan. Herein, various initiatives were undertaken to reduce the use of oral third-generation cephalosporins and fluoroquinolones, and the outcomes of such initiatives have been assessed, with there being few reports on similar initiatives for reducing the use of oral antibacterial agents, although initiatives aimed at limiting the use of injectable antibacterial agents have been reported. The results showed a significant reduction in the overall use of these medications as well as in the number of patients with renal dysfunction who were administered excess oral fluoroquinolones.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123367265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Miyoshi, H. Takane, Shota Morishita, Kensaku Okada, Tsuyoshi Kitaura, H. Chikumi
Antimicrobial use density (AUD) and days of therapy (DOT) are widely used to evaluate antimicrobial consumption, with surveillance of antimicrobial use being important for predicting the emergence and spread of drug-resistant bacteria. The proportion receiving antimicrobial therapy (n/1,000 admissions) and the AUD/DOT ratio as the assumed average daily dose may be useful additional indicators; however, the correlation between these measurements and antimicrobial resistance remains unclear. While we found that, in univariate analysis, the total AUD/DOT ratios of IPM/CS, panipenem/betamipron (PAPM/BP) and biapenem (BIPM) group, MEPM and doripenem (DRPM) group, and the total proportion receiving antimicrobial therapy with IPM/CS, PAPM/BP and BIPM group were significantly correlated with carbapenem resistance, the aim of this study was to evaluate carbapenem use and daily dose trends for relationships with imipenem/cilastatin (IPM/CS) or meropenem (MEPM) resistance rates of Pseudomonas aeruginosa at our hospital between January 2009 and December 2017. Based on multiple regression analysis, the total AUD/DOT ratio of MEPM and DRPM group was the only significant indicator for resistance rates of IPM/CS (β = -0.818, P = 0.007) and MEPM (β = -0.796, P = 0.010). Furthermore, according to the sigmoid dose-response model analysis, the total AUD/DOT ratio of MEPM and DRPM group equivalent to one tenth of maximum resistance rate was 0.938, suggesting that the AUD/DOT ratio of carbapenem antibiotics is not only an indicator of daily dose, but also of Pseudomonas aeruginosa resistance.
抗菌药物使用密度(AUD)和治疗天数(DOT)被广泛用于评估抗菌药物的使用情况，对抗菌药物使用情况的监测对于预测耐药细菌的出现和传播非常重要。接受抗菌药物治疗的比例(n/1,000入院患者)和假定平均日剂量的AUD/DOT比可能是有用的附加指标;然而，这些测量结果与抗菌素耐药性之间的相关性尚不清楚。单因素分析发现，IPM/CS、帕尼培南/倍他米龙(PAPM/BP)和比阿培南(BIPM)组、MEPM和多利培南(DRPM)组的总AUD/DOT比，以及IPM/CS、PAPM/BP和BIPM组接受抗菌治疗的总比例与碳青霉烯类耐药显著相关。本研究的目的是评估2009年1月至2017年12月我院铜绿假单胞菌亚胺培南/西司他汀(IPM/CS)或美罗培南(MEPM)耐药率与碳青霉烯类药物使用和日剂量趋势的关系。多元回归分析显示，MEPM和DRPM组总AUD/DOT比值是IPM/CS (β = -0.818, P = 0.007)和MEPM (β = -0.796, P = 0.010)耐药率的唯一显著指标。此外，根据sigmoid剂量反应模型分析，MEPM和DRPM组相当于最大耐药率十分之一的总AUD/DOT比为0.938，表明碳青霉烯类抗生素的AUD/DOT比不仅是日剂量的指标，也是铜绿假单胞菌耐药的指标。
{"title":"Surveillance and Correlation of Carbapenem Use Metrics with Resistance of Pseudomonas aeruginosa: A Single-center Retrospective Study","authors":"Y. Miyoshi, H. Takane, Shota Morishita, Kensaku Okada, Tsuyoshi Kitaura, H. Chikumi","doi":"10.4058/JSEI.35.233","DOIUrl":"https://doi.org/10.4058/JSEI.35.233","url":null,"abstract":"Antimicrobial use density (AUD) and days of therapy (DOT) are widely used to evaluate antimicrobial consumption, with surveillance of antimicrobial use being important for predicting the emergence and spread of drug-resistant bacteria. The proportion receiving antimicrobial therapy (n/1,000 admissions) and the AUD/DOT ratio as the assumed average daily dose may be useful additional indicators; however, the correlation between these measurements and antimicrobial resistance remains unclear. While we found that, in univariate analysis, the total AUD/DOT ratios of IPM/CS, panipenem/betamipron (PAPM/BP) and biapenem (BIPM) group, MEPM and doripenem (DRPM) group, and the total proportion receiving antimicrobial therapy with IPM/CS, PAPM/BP and BIPM group were significantly correlated with carbapenem resistance, the aim of this study was to evaluate carbapenem use and daily dose trends for relationships with imipenem/cilastatin (IPM/CS) or meropenem (MEPM) resistance rates of Pseudomonas aeruginosa at our hospital between January 2009 and December 2017. Based on multiple regression analysis, the total AUD/DOT ratio of MEPM and DRPM group was the only significant indicator for resistance rates of IPM/CS (β = -0.818, P = 0.007) and MEPM (β = -0.796, P = 0.010). Furthermore, according to the sigmoid dose-response model analysis, the total AUD/DOT ratio of MEPM and DRPM group equivalent to one tenth of maximum resistance rate was 0.938, suggesting that the AUD/DOT ratio of carbapenem antibiotics is not only an indicator of daily dose, but also of Pseudomonas aeruginosa resistance.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131204099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of Improvement in Infection Control Performance by Joint-conference: Effect on the Amount of Alcohol-based Hand Sanitizers and the Detection Rate of Antimicrobial Resistance","authors":"Manami Nakashita, Atsuko Ito, Kakuei Osaki, Satoru Mitsuboshi","doi":"10.4058/JSEI.35.241","DOIUrl":"https://doi.org/10.4058/JSEI.35.241","url":null,"abstract":"In this study","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123726201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We standardized the sodium hypochlorite immersion disinfection method and revised the infection control manual through the activities of the Disinfectant Stewardship Team (DST). In this study, we conducted an actual survey on immersion disinfection using sodium hypochlorite as part of the revised manual compliance check. After the manual was revised, the survey period was from September 2018 to March 2019. The targets were 22 departments in all hospital wards. The survey contents confirmed the disinfection status of sodium hypochlorite by direct observation and hearing. Furthermore, the concentration of sodium hypochlorite was confirmed using a colorimetric method. A total of 43 cases were investigated. Of these, 41 cases in which all contents were investi-gated were analyzed. The overall compliance rate was 36.6% (15 cases). In terms of the compliance rate for each content, the concentration was 58.5% (24 cases), disinfection status was 71.0% (29 cases), and immersion time was 83.0% (34 cases). Deficiencies in concentration had an effect on the decline in overall compliance. Investigation of the actual condition of immersion disinfection with sodium hypochlorite re-vealed the inappropriate use in hospital wards. In addition, improvement points could be clarified by evaluating the compliance status of each content, including concentration measurement.
{"title":"Survey on Immersion Disinfection Using Sodium Hypochlorite in Hospital Wards","authors":"Yoshiyuki Furumi, I. Nakamura, Tomohide Shimodaira, Sachi Takei, Ayako Komatu, Asami Okukawa, Hiroshi Soeda, Tukako Hayakawa, Hidehiro Watanabe","doi":"10.4058/JSEI.35.206","DOIUrl":"https://doi.org/10.4058/JSEI.35.206","url":null,"abstract":"We standardized the sodium hypochlorite immersion disinfection method and revised the infection control manual through the activities of the Disinfectant Stewardship Team (DST). In this study, we conducted an actual survey on immersion disinfection using sodium hypochlorite as part of the revised manual compliance check. After the manual was revised, the survey period was from September 2018 to March 2019. The targets were 22 departments in all hospital wards. The survey contents confirmed the disinfection status of sodium hypochlorite by direct observation and hearing. Furthermore, the concentration of sodium hypochlorite was confirmed using a colorimetric method. A total of 43 cases were investigated. Of these, 41 cases in which all contents were investi-gated were analyzed. The overall compliance rate was 36.6% (15 cases). In terms of the compliance rate for each content, the concentration was 58.5% (24 cases), disinfection status was 71.0% (29 cases), and immersion time was 83.0% (34 cases). Deficiencies in concentration had an effect on the decline in overall compliance. Investigation of the actual condition of immersion disinfection with sodium hypochlorite re-vealed the inappropriate use in hospital wards. In addition, improvement points could be clarified by evaluating the compliance status of each content, including concentration measurement.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128768641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In Japan, patients with coronavirus disease 2019 (COVID-19) need to be hospitalized We admitted patients with mild-to-severe disease as well as asymptomatic carriers at a designated hospital;however, we were also aware of the potential issues of shortage of personal protective equipment (PPE) and nosocomial infections among healthcare workers Therefore, we opened an entire ward as a living place for asymptomatic to mildly symptomatic patients, thereby lessening the number of donning and doffing of PPE and minimizing the workload and risk of healthcare workers of being infected in the hospital For those with severe disease, we considered the corridor of intensive care unit as the so called "orange zone" to use PPE to minimize the workload and risk Here, we have described the details of our strategy
{"title":"Economical Zoning Strategy and its Effectiveness for Patients with COVID-19","authors":"N. Morishita","doi":"10.4058/JSEI.35.193","DOIUrl":"https://doi.org/10.4058/JSEI.35.193","url":null,"abstract":"In Japan, patients with coronavirus disease 2019 (COVID-19) need to be hospitalized We admitted patients with mild-to-severe disease as well as asymptomatic carriers at a designated hospital;however, we were also aware of the potential issues of shortage of personal protective equipment (PPE) and nosocomial infections among healthcare workers Therefore, we opened an entire ward as a living place for asymptomatic to mildly symptomatic patients, thereby lessening the number of donning and doffing of PPE and minimizing the workload and risk of healthcare workers of being infected in the hospital For those with severe disease, we considered the corridor of intensive care unit as the so called \"orange zone\" to use PPE to minimize the workload and risk Here, we have described the details of our strategy","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129225494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It is generally recognized that most Bacillus cereus blood stream infections are caused by the contamination of infusion solution due to contaminated hands of healthcare personnel and skin of patients. The contamination of hands and skin with B. cereus spores frequently occur from contaminated hospital linens such as reused towels. Disposable medical gloves can also be a source of B. cereus spore contamination. The present study was therefore undertaken to quantitatively measure the attachment behavior of B. cereus spores to the surface of disposable gloves made from various materials, such as latex, nitrile rubber, and vinyl chloride plastic. Our modified bead extraction method was used for the assay. The number of spores attaching to gloves was highest for vinyl chloride gloves, followed by latex gloves and nitrile rubber gloves, and the difference in the numbers of attached spores between vinyl chloride gloves and nitrile rubber gloves was significant (P = 0.028, <0.05). We therefore recommend nitrile rubber gloves for medical use rather than other gloves.
{"title":"Quantitative Evaluation of Bacillus Cereus Spore Attachment to the Surface of Disposable Medical Gloves Made from Various Materials","authors":"Yuka Ishihara, Hisae Usami, Ikue Shamoto, M. Ohta","doi":"10.4058/JSEI.35.198","DOIUrl":"https://doi.org/10.4058/JSEI.35.198","url":null,"abstract":"It is generally recognized that most Bacillus cereus blood stream infections are caused by the contamination of infusion solution due to contaminated hands of healthcare personnel and skin of patients. The contamination of hands and skin with B. cereus spores frequently occur from contaminated hospital linens such as reused towels. Disposable medical gloves can also be a source of B. cereus spore contamination. The present study was therefore undertaken to quantitatively measure the attachment behavior of B. cereus spores to the surface of disposable gloves made from various materials, such as latex, nitrile rubber, and vinyl chloride plastic. Our modified bead extraction method was used for the assay. The number of spores attaching to gloves was highest for vinyl chloride gloves, followed by latex gloves and nitrile rubber gloves, and the difference in the numbers of attached spores between vinyl chloride gloves and nitrile rubber gloves was significant (P = 0.028, <0.05). We therefore recommend nitrile rubber gloves for medical use rather than other gloves.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129955906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Sasaki, Akira Kurishima, Misa Amano, Ayumi Kanamaru, Akiko Yamakuchi, H. Takayasu, M. Yano
In Tama-Nanbu Chiiki Hospital, a pharmacist-initiated antimicrobial stewardship program was started to optimize the use of antimicrobial agents in the hospital. Previously, at 10 months after the start of the program, the therapy durations for both 4 th cephem and carbapenem were short-ened. However, at that time, the resistance rate of Pseudomonas aeruginosa for both agents did not markedly change. Currently, we evaluated the correlation between the resistance rate of Pseudomonas aeruginosa and above mentioned antibiotics at 3 years after intervention. Al-though the day of therapy (DOT) was almost the same as that at 10 months of intervention, we achieved decreased resistance of Pseudomonas aeruginosa for both antibiotics. A positive correlation was observed between 4 th cephem resistance rate in Pseudomonas aeruginosa and DOT (0.90, p = 0.04). To reduce the antimicrobial resistance rate, a longer period of intervention is recommended.
{"title":"Impact of Pharmacist Initiated Antimicrobial Stewardship Program ~Evaluation of Antimicrobial Resistance Rate at Three Years after Intervention~","authors":"Y. Sasaki, Akira Kurishima, Misa Amano, Ayumi Kanamaru, Akiko Yamakuchi, H. Takayasu, M. Yano","doi":"10.4058/JSEI.35.201","DOIUrl":"https://doi.org/10.4058/JSEI.35.201","url":null,"abstract":"In Tama-Nanbu Chiiki Hospital, a pharmacist-initiated antimicrobial stewardship program was started to optimize the use of antimicrobial agents in the hospital. Previously, at 10 months after the start of the program, the therapy durations for both 4 th cephem and carbapenem were short-ened. However, at that time, the resistance rate of Pseudomonas aeruginosa for both agents did not markedly change. Currently, we evaluated the correlation between the resistance rate of Pseudomonas aeruginosa and above mentioned antibiotics at 3 years after intervention. Al-though the day of therapy (DOT) was almost the same as that at 10 months of intervention, we achieved decreased resistance of Pseudomonas aeruginosa for both antibiotics. A positive correlation was observed between 4 th cephem resistance rate in Pseudomonas aeruginosa and DOT (0.90, p = 0.04). To reduce the antimicrobial resistance rate, a longer period of intervention is recommended.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121179102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Retsu Fujita, Y. Takano, Tokiko Watanabe, Haruyo Sakaki, Hitomi Kurosu, Shiho Kubota, Yukari Nakamura, Chikako Agata, S. Shinomiya, Akiko Sasaki, A. Sawa, K. Morikane, Y. Harihara
In this study, we aim to investigate the infection control measures taken against norovirus (NV) infection in special elderly nursing homes, status of three different professions in learning and practicing NV infection control measures in these homes, and related educational challenges. A self-administered questionnaire survey was conducted with 705 nurses, certified care workers, and nursing care staff working in 235 randomly selected special nursing homes across Japan from June to August 2017. Responses from 368 participants (52.2%) were included in the analysis. Internal (85.3%) and external trainings (53.8%), as well as internet (46.5%), were the most common sources of knowledge regarding the control measures. Most participants (84.8%) had attended NV infection control workshops, consisting of teaching the safe handling of vomit and feces to prevent contamination (84.2%), basic knowledge of NV infection (83.4%), proper hand hygiene (78.5%), appropriate use of personal protective equipment and procedure to wear and remove it (64.7%), environmental disinfection (53.3%), and educating residents and visitors regarding the prevention of spread of infection (37.2%). Nursing care staff had significantly lower understand-ing than nurses or certified care workers regarding NV infection control measures that were taught in the workshops and practiced in the nursing home facility, indicating a gap in the learning status. In addition, there was divergence in the content of the workshops, suggesting inter-facility differences in the educational content regarding the control measures. Thus, support for learning regarding NV infection control measures tailored to the needs of individual special nursing homes and the professions working in these homes remains a challenge.
{"title":"Current Status and Issues of Learning Norovirus Infection Control of the Three Types of Staff Members Who Work at Special Elderly Nursing Home","authors":"Di Wang, Kazumi Kawakami, A. Kudo, K. Iwabuchi","doi":"10.4058/JSEI.35.168","DOIUrl":"https://doi.org/10.4058/JSEI.35.168","url":null,"abstract":"In this study, we aim to investigate the infection control measures taken against norovirus (NV) infection in special elderly nursing homes, status of three different professions in learning and practicing NV infection control measures in these homes, and related educational challenges. A self-administered questionnaire survey was conducted with 705 nurses, certified care workers, and nursing care staff working in 235 randomly selected special nursing homes across Japan from June to August 2017. Responses from 368 participants (52.2%) were included in the analysis. Internal (85.3%) and external trainings (53.8%), as well as internet (46.5%), were the most common sources of knowledge regarding the control measures. Most participants (84.8%) had attended NV infection control workshops, consisting of teaching the safe handling of vomit and feces to prevent contamination (84.2%), basic knowledge of NV infection (83.4%), proper hand hygiene (78.5%), appropriate use of personal protective equipment and procedure to wear and remove it (64.7%), environmental disinfection (53.3%), and educating residents and visitors regarding the prevention of spread of infection (37.2%). Nursing care staff had significantly lower understand-ing than nurses or certified care workers regarding NV infection control measures that were taught in the workshops and practiced in the nursing home facility, indicating a gap in the learning status. In addition, there was divergence in the content of the workshops, suggesting inter-facility differences in the educational content regarding the control measures. Thus, support for learning regarding NV infection control measures tailored to the needs of individual special nursing homes and the professions working in these homes remains a challenge.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115104511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Sasaki, Misa Amano, Ayumi Kanamaru, Akiko Yamakuchi, H. Takayasu, M. Yano
In March 2018, an antimicrobial stewardship (AS) team commenced an active intervention in patients with bacteremia at the Tama-Nanbu Chiiki Hospital, Japan. An AS pharmacist audited and reviewed the prescription of antimicrobial agents in patient with bacteremia and suggested empirical and definitive changes to the antimicrobials. A total of 247 patients were evaluated, which resulted in 102 interventions, with 88% acceptance rate. The rate of appropriate de-escalation rose from 55% to 79% (p < 0.05). Although the total consumption of antimicrobial agents did not markedly change the observa-tion period, the use of broad-spectrum antibiotics such as tazobactam/piperacillin was signifi-cantly decreased. It was concluded that the activities of the AS team are important as they lead to proper selection of antimicrobial drug therapy.
{"title":"Impact of an Antimicrobial Stewardship Pharmacist's Intervention on Blood Culture-positive Patients","authors":"Y. Sasaki, Misa Amano, Ayumi Kanamaru, Akiko Yamakuchi, H. Takayasu, M. Yano","doi":"10.4058/JSEI.35.157","DOIUrl":"https://doi.org/10.4058/JSEI.35.157","url":null,"abstract":"In March 2018, an antimicrobial stewardship (AS) team commenced an active intervention in patients with bacteremia at the Tama-Nanbu Chiiki Hospital, Japan. An AS pharmacist audited and reviewed the prescription of antimicrobial agents in patient with bacteremia and suggested empirical and definitive changes to the antimicrobials. A total of 247 patients were evaluated, which resulted in 102 interventions, with 88% acceptance rate. The rate of appropriate de-escalation rose from 55% to 79% (p < 0.05). Although the total consumption of antimicrobial agents did not markedly change the observa-tion period, the use of broad-spectrum antibiotics such as tazobactam/piperacillin was signifi-cantly decreased. It was concluded that the activities of the AS team are important as they lead to proper selection of antimicrobial drug therapy.","PeriodicalId":414784,"journal":{"name":"Japanese Journal of Infection Prevention and Control","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114350459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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