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

  • Clinical and Epidemiological Study
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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.

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Acknowledgments

We are grateful to the hospitals that participated in the survey. We would like to express our sincere gratitude to Ryuya Horiuchi, president of the Japanese Society of Hospital Pharmacists, for providing us with this precious work opportunity. This study was supported by the Japanese Society of Hospital Pharmacists.

Conflict of interest

All authors report no conflicts of interest relevant to this article.

Author information

Authors and Affiliations

  1. The Fifth Subcommittee, Committee on Academic, Japanese Society of Hospital Pharmacists, Tokyo, Japan

    Y. Muraki, M. Kitamura, Y. Maeda, T. Kitahara, T. Mori, H. Ikeue, M. Tsugita, K. Tadano, K. Takada, T. Akamatsu, T. Yamada & T. Shiraishi

  2. Department of Pharmacy, Faculty of Medicine, Mie University Hospital, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Y. Muraki & M. Okuda

  3. Department of Pharmacy, Jikei University School of Medicine, Minato-ku, Tokyo, Japan

    M. Kitamura

  4. Department of Pharmacy, Osaka Rosai Hospital, Sakai, Osaka, Japan

    Y. Maeda

  5. Department of Hospital Pharmacy, Nagasaki University Hospital, Nagasaki, Japan

    T. Kitahara

  6. Faculty of Pharmacy, Meijo University, Nagoya, Aichi, Japan

    T. Mori

  7. Department of Pharmacy, Kagawa Rosai Hospital, Marugame, Kagawa, Japan

    H. Ikeue

  8. Department of Pharmacy, Niitsu Medical Center Hospital, Niigata, Niigata, Japan

    M. Tsugita

  9. Faculty of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Ishikari-gun, Hokkaido, Japan

    K. Tadano

  10. Department of Pharmacy, Narita Hospital, Japanese Red Cross Society, Narita, Chiba, Japan

    K. Takada

  11. Department of Pharmacy, Kyushu Kosei Nenkin Hospital, Kitakyushu, Fukuoka, Japan

    T. Akamatsu

  12. Department of Translational Medical Science, Mie University Graduate School of Medicine, Tsu, Mie, Japan

    T. Yamada

  13. Department of Pharmacy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan

    T. Yamada

  14. Department of Pharmacy, Yamagata University Hospital, Yamagata, Yamagata, Japan

    T. Shiraishi

Authors
  1. Y. Muraki
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  2. M. Kitamura
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  3. Y. Maeda
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  4. T. Kitahara
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  5. T. Mori
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  6. H. Ikeue
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  7. M. Tsugita
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  8. K. Tadano
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  9. K. Takada
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  10. T. Akamatsu
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  11. T. Yamada
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  12. T. Yamada
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  13. T. Shiraishi
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  14. M. Okuda
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Corresponding author

Correspondence to M. Okuda.

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Muraki, Y., Kitamura, M., Maeda, Y. et al. Nationwide surveillance of antimicrobial consumption and resistance to Pseudomonas aeruginosa isolates at 203 Japanese hospitals in 2010. Infection 41, 415–423 (2013). https://doi.org/10.1007/s15010-013-0440-0

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  • DOI: https://doi.org/10.1007/s15010-013-0440-0

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