Skip to main content
Erschienen in: Infection 2/2013

01.04.2013 | Clinical and Epidemiological Study

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

verfasst von: Y. Muraki, M. Kitamura, Y. Maeda, T. Kitahara, T. Mori, H. Ikeue, M. Tsugita, K. Tadano, K. Takada, T. Akamatsu, T. Yamada, T. Yamada, T. Shiraishi, M. Okuda

Erschienen in: Infection | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

Abstract

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.
Literatur
2.
Zurück zum Zitat Giske CG, Monnet DL, Cars O, Carmeli Y; ReAct-Action on Antibiotic Resistance. Clinical and economic impact of common multidrug-resistant gram-negative bacilli. Antimicrob Agents Chemother. 2008;52:813–21.PubMedCrossRef Giske CG, Monnet DL, Cars O, Carmeli Y; ReAct-Action on Antibiotic Resistance. Clinical and economic impact of common multidrug-resistant gram-negative bacilli. Antimicrob Agents Chemother. 2008;52:813–21.PubMedCrossRef
3.
Zurück zum Zitat Izumida M, Nagai M, Ohta A, Hashimoto S, Kawado M, Murakami Y, Tada Y, Shigematsu M, Yasui Y, Taniguchi K. Epidemics of drug-resistant bacterial infections observed in infectious disease surveillance in Japan, 2001–2005. J Epidemiol. 2007;17:S42–7.PubMedCrossRef Izumida M, Nagai M, Ohta A, Hashimoto S, Kawado M, Murakami Y, Tada Y, Shigematsu M, Yasui Y, Taniguchi K. Epidemics of drug-resistant bacterial infections observed in infectious disease surveillance in Japan, 2001–2005. J Epidemiol. 2007;17:S42–7.PubMedCrossRef
4.
Zurück zum Zitat Rogues AM, Dumartin C, Amadéo B, Venier AG, Marty N, Parneix P, Gachie JP. Relationship between rates of antimicrobial consumption and the incidence of antimicrobial resistance in Staphylococcus aureus and Pseudomonas aeruginosa isolates from 47 French hospitals. Infect Control Hosp Epidemiol. 2007;28:1389–95.PubMedCrossRef Rogues AM, Dumartin C, Amadéo B, Venier AG, Marty N, Parneix P, Gachie JP. Relationship between rates of antimicrobial consumption and the incidence of antimicrobial resistance in Staphylococcus aureus and Pseudomonas aeruginosa isolates from 47 French hospitals. Infect Control Hosp Epidemiol. 2007;28:1389–95.PubMedCrossRef
5.
Zurück zum Zitat Polk RE, Fox C, Mahoney A, Letcavage J, MacDougall C. Measurement of adult antibacterial drug use in 130 US hospitals: comparison of defined daily dose and days of therapy. Clin Infect Dis. 2007;44:664–70.PubMedCrossRef Polk RE, Fox C, Mahoney A, Letcavage J, MacDougall C. Measurement of adult antibacterial drug use in 130 US hospitals: comparison of defined daily dose and days of therapy. Clin Infect Dis. 2007;44:664–70.PubMedCrossRef
6.
Zurück zum Zitat Goossens H, Ferech M, Vander Stichele R, Elseviers M; ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365:579–87.PubMed Goossens H, Ferech M, Vander Stichele R, Elseviers M; ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365:579–87.PubMed
7.
Zurück zum Zitat Kuster SP, Ruef C, Ledergerber B, Hintermann A, Deplazes C, Neuber L, Weber R. Quantitative antibiotic use in hospitals: comparison of measurements, literature review, and recommendations for a standard of reporting. Infection. 2008;36:549–59.PubMedCrossRef Kuster SP, Ruef C, Ledergerber B, Hintermann A, Deplazes C, Neuber L, Weber R. Quantitative antibiotic use in hospitals: comparison of measurements, literature review, and recommendations for a standard of reporting. Infection. 2008;36:549–59.PubMedCrossRef
8.
Zurück zum Zitat Miliani K, L’Hériteau F, Lacavé L, Carbonne A, Astagneau P; Antimicrobial Surveillance Network Study Group. Imipenem and ciprofloxacin consumption as factors associated with high incidence rates of resistant Pseudomonas aeruginosa in hospitals in northern France. J Hosp Infect. 2011;77:343–7.PubMedCrossRef Miliani K, L’Hériteau F, Lacavé L, Carbonne A, Astagneau P; Antimicrobial Surveillance Network Study Group. Imipenem and ciprofloxacin consumption as factors associated with high incidence rates of resistant Pseudomonas aeruginosa in hospitals in northern France. J Hosp Infect. 2011;77:343–7.PubMedCrossRef
10.
Zurück zum Zitat Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Eighteenth informational supplement. CLSI document M100-S18, vol. 28. Wayne: CLSI; 2008. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Eighteenth informational supplement. CLSI document M100-S18, vol. 28. Wayne: CLSI; 2008.
11.
Zurück zum Zitat Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Nineteenth informational supplement. CLSI document M100-S19, vol. 29. Wayne: CLSI, 2009. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Nineteenth informational supplement. CLSI document M100-S19, vol. 29. Wayne: CLSI, 2009.
12.
Zurück zum Zitat Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twentieth informational supplement. CLSI document M100-S20, vol. 30. Wayne: CLSI; 2010. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twentieth informational supplement. CLSI document M100-S20, vol. 30. Wayne: CLSI; 2010.
13.
Zurück zum Zitat Pakyz AL, Oinonen M, Polk RE. Relationship of carbapenem restriction in 22 university teaching hospitals to carbapenem use and carbapenem-resistant Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2009;53:1983–6.PubMedCrossRef Pakyz AL, Oinonen M, Polk RE. Relationship of carbapenem restriction in 22 university teaching hospitals to carbapenem use and carbapenem-resistant Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2009;53:1983–6.PubMedCrossRef
14.
Zurück zum Zitat Bantar C, Sartori B, Vesco E, Heft C, Saúl M, Salamone F, Oliva ME. A hospitalwide intervention program to optimize the quality of antibiotic use: impact on prescribing practice, antibiotic consumption, cost savings, and bacterial resistance. Clin Infect Dis. 2003;37:180–6.PubMedCrossRef Bantar C, Sartori B, Vesco E, Heft C, Saúl M, Salamone F, Oliva ME. A hospitalwide intervention program to optimize the quality of antibiotic use: impact on prescribing practice, antibiotic consumption, cost savings, and bacterial resistance. Clin Infect Dis. 2003;37:180–6.PubMedCrossRef
15.
Zurück zum Zitat Harbarth S, Harris AD, Carmeli Y, Samore MH. Parallel analysis of individual and aggregated data on antibiotic exposure and resistance in gram-negative bacilli. Clin Infect Dis. 2001;33:1462–8.PubMedCrossRef Harbarth S, Harris AD, Carmeli Y, Samore MH. Parallel analysis of individual and aggregated data on antibiotic exposure and resistance in gram-negative bacilli. Clin Infect Dis. 2001;33:1462–8.PubMedCrossRef
16.
Zurück zum Zitat Miyawaki K, Miwa Y, Seki M, Asari S, Tomono K, Kurokawa N. Correlation between the consumption of meropenem or doripenem and meropenem susceptibility of Pseudomonas aeruginosa in a university hospital in Japan. Biol Pharm Bull. 2012;35:946–9.PubMedCrossRef Miyawaki K, Miwa Y, Seki M, Asari S, Tomono K, Kurokawa N. Correlation between the consumption of meropenem or doripenem and meropenem susceptibility of Pseudomonas aeruginosa in a university hospital in Japan. Biol Pharm Bull. 2012;35:946–9.PubMedCrossRef
17.
Zurück zum Zitat Fukushima Y, Fukushima F, Kamiya K, Hayashi Y, Tatewaki M, Yamada I, Hirata H, Sugiyama K, Ishii Y, Fukuda T. Relation between the antimicrobial susceptibility of clinical isolates of Pseudomonas aeruginosa from respiratory specimens and antimicrobial use density (AUD) from 2005 through 2008. Intern Med. 2010;49:1333–40.PubMedCrossRef Fukushima Y, Fukushima F, Kamiya K, Hayashi Y, Tatewaki M, Yamada I, Hirata H, Sugiyama K, Ishii Y, Fukuda T. Relation between the antimicrobial susceptibility of clinical isolates of Pseudomonas aeruginosa from respiratory specimens and antimicrobial use density (AUD) from 2005 through 2008. Intern Med. 2010;49:1333–40.PubMedCrossRef
18.
Zurück zum Zitat Muller A, Monnet DL, Talon D, Hénon T, Bertrand X. Discrepancies between prescribed daily doses and WHO defined daily doses of antibacterials at a university hospital. Br J Clin Pharmacol. 2006;61:585–91.PubMedCrossRef Muller A, Monnet DL, Talon D, Hénon T, Bertrand X. Discrepancies between prescribed daily doses and WHO defined daily doses of antibacterials at a university hospital. Br J Clin Pharmacol. 2006;61:585–91.PubMedCrossRef
19.
Zurück zum Zitat de With K, Bestehorn H, Steib-Bauert M, Kern WV. Comparison of defined versus recommended versus prescribed daily doses for measuring hospital antibiotic consumption. Infection. 2009;37:349–52.PubMedCrossRef de With K, Bestehorn H, Steib-Bauert M, Kern WV. Comparison of defined versus recommended versus prescribed daily doses for measuring hospital antibiotic consumption. Infection. 2009;37:349–52.PubMedCrossRef
20.
Zurück zum Zitat López-Dupla M, Martínez JA, Vidal F, Almela M, Soriano A, Marco F, López J, Olona M, Mensa J. Previous ciprofloxacin exposure is associated with resistance to beta-lactam antibiotics in subsequent Pseudomonas aeruginosa bacteremic isolates. Am J Infect Control. 2009;37:753–8.PubMedCrossRef López-Dupla M, Martínez JA, Vidal F, Almela M, Soriano A, Marco F, López J, Olona M, Mensa J. Previous ciprofloxacin exposure is associated with resistance to beta-lactam antibiotics in subsequent Pseudomonas aeruginosa bacteremic isolates. Am J Infect Control. 2009;37:753–8.PubMedCrossRef
21.
Zurück zum Zitat Falagas ME, Kopterides P. Risk factors for the isolation of multi-drug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa: a systematic review of the literature. J Hosp Infect. 2006;64:7–15.PubMedCrossRef Falagas ME, Kopterides P. Risk factors for the isolation of multi-drug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa: a systematic review of the literature. J Hosp Infect. 2006;64:7–15.PubMedCrossRef
22.
Zurück zum Zitat Lautenbach E, Weiner MG, Nachamkin I, Bilker WB, Sheridan A, Fishman NO. Imipenem resistance among Pseudomonas aeruginosa isolates: risk factors for infection and impact of resistance on clinical and economic outcomes. Infect Control Hosp Epidemiol. 2006;27:893–900.PubMedCrossRef Lautenbach E, Weiner MG, Nachamkin I, Bilker WB, Sheridan A, Fishman NO. Imipenem resistance among Pseudomonas aeruginosa isolates: risk factors for infection and impact of resistance on clinical and economic outcomes. Infect Control Hosp Epidemiol. 2006;27:893–900.PubMedCrossRef
23.
Zurück zum Zitat Jacoby TS, Kuchenbecker RS, Dos Santos RP, Magedanz L, Guzatto P, Moreira LB. Impact of hospital-wide infection rate, invasive procedures use and antimicrobial consumption on bacterial resistance inside an intensive care unit. J Hosp Infect. 2010;75:23–7.PubMedCrossRef Jacoby TS, Kuchenbecker RS, Dos Santos RP, Magedanz L, Guzatto P, Moreira LB. Impact of hospital-wide infection rate, invasive procedures use and antimicrobial consumption on bacterial resistance inside an intensive care unit. J Hosp Infect. 2010;75:23–7.PubMedCrossRef
24.
Zurück zum Zitat Takesue Y, Nakajima K, Ichiki K, Ishihara M, Wada Y, Takahashi Y, Tsuchida T, Ikeuchi H. Impact of a hospital-wide programme of heterogeneous antibiotic use on the development of antibiotic-resistant Gram-negative bacteria. J Hosp Infect. 2010;75:28–32.PubMedCrossRef Takesue Y, Nakajima K, Ichiki K, Ishihara M, Wada Y, Takahashi Y, Tsuchida T, Ikeuchi H. Impact of a hospital-wide programme of heterogeneous antibiotic use on the development of antibiotic-resistant Gram-negative bacteria. J Hosp Infect. 2010;75:28–32.PubMedCrossRef
25.
26.
Zurück zum Zitat von Gunten V, Reymond JP, Beney J. Clinical and economic outcomes of pharmaceutical services related to antibiotic use: a literature review. Pharm World Sci. 2007;29:146–63.CrossRef von Gunten V, Reymond JP, Beney J. Clinical and economic outcomes of pharmaceutical services related to antibiotic use: a literature review. Pharm World Sci. 2007;29:146–63.CrossRef
27.
Zurück zum Zitat Niwa T, Shinoda Y, Suzuki A, Ohmori T, Yasuda M, Ohta H, Fukao A, Kitaichi K, Matsuura K, Sugiyama T, Murakami N, Itoh Y. Outcome measurement of extensive implementation of antimicrobial stewardship in patients receiving intravenous antibiotics in a Japanese university hospital. Int J Clin Pract. 2012;66:999–1008.PubMedCrossRef Niwa T, Shinoda Y, Suzuki A, Ohmori T, Yasuda M, Ohta H, Fukao A, Kitaichi K, Matsuura K, Sugiyama T, Murakami N, Itoh Y. Outcome measurement of extensive implementation of antimicrobial stewardship in patients receiving intravenous antibiotics in a Japanese university hospital. Int J Clin Pract. 2012;66:999–1008.PubMedCrossRef
Metadaten
Titel
Nationwide surveillance of antimicrobial consumption and resistance to Pseudomonas aeruginosa isolates at 203 Japanese hospitals in 2010
verfasst von
Y. Muraki
M. Kitamura
Y. Maeda
T. Kitahara
T. Mori
H. Ikeue
M. Tsugita
K. Tadano
K. Takada
T. Akamatsu
T. Yamada
T. Yamada
T. Shiraishi
M. Okuda
Publikationsdatum
01.04.2013
Verlag
Springer-Verlag
Erschienen in
Infection / Ausgabe 2/2013
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-013-0440-0

Weitere Artikel der Ausgabe 2/2013

Infection 2/2013 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.