Infection

, Volume 41, Issue 2, pp 415–423

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

  • 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
Clinical and Epidemiological Study

DOI: 10.1007/s15010-013-0440-0

Cite this article as:
Muraki, Y., Kitamura, M., Maeda, Y. et al. Infection (2013) 41: 415. doi:10.1007/s15010-013-0440-0

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 R2 (aR2) 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.

Keywords

SurveillanceJapanAntimicrobial consumptionResistanceAnatomical Therapeutic ChemicalDefined daily dose

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Y. Muraki
    • 1
    • 2
  • M. Kitamura
    • 1
    • 3
  • Y. Maeda
    • 1
    • 4
  • T. Kitahara
    • 1
    • 5
  • T. Mori
    • 1
    • 6
  • H. Ikeue
    • 1
    • 7
  • M. Tsugita
    • 1
    • 8
  • K. Tadano
    • 1
    • 9
  • K. Takada
    • 1
    • 10
  • T. Akamatsu
    • 1
    • 11
  • T. Yamada
    • 12
  • T. Yamada
    • 1
    • 13
  • T. Shiraishi
    • 1
    • 14
  • M. Okuda
    • 2
  1. 1.The Fifth Subcommittee, Committee on Academic, Japanese Society of Hospital PharmacistsTokyoJapan
  2. 2.Department of Pharmacy, Faculty of MedicineMie University Hospital, Mie UniversityTsuJapan
  3. 3.Department of PharmacyJikei University School of MedicineMinato-kuJapan
  4. 4.Department of PharmacyOsaka Rosai HospitalSakaiJapan
  5. 5.Department of Hospital PharmacyNagasaki University HospitalNagasakiJapan
  6. 6.Faculty of PharmacyMeijo UniversityNagoyaJapan
  7. 7.Department of PharmacyKagawa Rosai HospitalMarugameJapan
  8. 8.Department of PharmacyNiitsu Medical Center HospitalNiigataJapan
  9. 9.Faculty of Pharmaceutical SciencesHealth Sciences University of HokkaidoIshikari-gunJapan
  10. 10.Department of PharmacyNarita Hospital, Japanese Red Cross SocietyNaritaJapan
  11. 11.Department of PharmacyKyushu Kosei Nenkin HospitalKitakyushuJapan
  12. 12.Department of Translational Medical ScienceMie University Graduate School of MedicineTsuJapan
  13. 13.Department of PharmacyHokkaido University HospitalSapporoJapan
  14. 14.Department of PharmacyYamagata University HospitalYamagataJapan