Trend of Antimicrobial use and drug resistant bacteria and the comparison between our facility and 4 other facilities in Fukui Prefecture

[Speaker] Hiroko Shigemi:1,2
[Co-author] Katsunori Tai:2, Maiko Kadowaki:1, Akikazu Shimada:1, Miwa Morikawa:1, Yukihiro Umeda:1, Yuko Waseda:1, Masaki Anzai:1, Tamotsu Ishizuka:1, Hiromichi Iwasaki:2
1:Department of Respiratory Medicine, University of Fukui Hospital, Japan, 2:Department of Infection Control and Prevention, University of Fukui Hospital, Japan

[Background] The purposes of Infectious Control Team (ICT) activity are to decrease hospital associated infection (HAI) and to take emergent measures against HAI. Our slogan is to lower the rate of Methicillin-resistant Staphylococcus aureus (MRSA) (MRSA bacteremia/Staphylococcus aureus bacteremia) detection to less than 30% and listed the concrete goals as follow. 1) Used amount of hand hygiene disinfectant is over 15L/1000 patients/day. 2) Quantity consumption of carbapenems and TAZ/PIPC are less than AUD 20 (DDD/1000 patients /day) and 20% decrease of the 3rd generation cephem antibiotics. 3) Prompt report to ICT office when suspected cases are detected. Our facility has established a network system with more than 20 hospitals in our prefecture taking the cooperation each other and monitoring regularly. [Purposes] The aim is to promote our activity in ICT. Antibiotics surveillance and Hand hygiene surveillance were performed and compared with those of other facilities in our prefecture. [Methods] We analyzed usage amount of antibiotics, detection of positive blood culture, detection of resistant bacteria and quantify consumed of hand hygiene disinfectant, retrospectively, from 2014 through 2016 in our hospital. And then our data were compared with the same surveillances that were performed in 4 other hospitals which obtained additional certificate to control infections from official health institution. [Results] Antibiotics uses were AUD 15~22 in our hospital and 7~20 (Hospital A,B,C), 20~40(Hospital D). Quantify consumed of hand hygiene disinfectant, were 5~6 (ml/patient/day) in our facility. Others were 6~11(Hospital A) and 1~6 (B,C, D). Rates of performing blood culture were 2.3% (in our hospital) vs 0.8% (the average in other 4 hospitals), Rates of MRSA were 27% vs 38% and detection numbers of Clostridium difficile (CD) were 0.25 persons /1000 patients /day vs 0.12. [Conclusion] Due to antibiotics surveillance, rates of MRSA and other resistant bacteria were lower except occurrence number of CD in comaparison between our facility and other 4 hospitals. Quantify consumed of hand hygiene disinfectant is supposed to strongly related with those outcome.

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