550. Reduction of MRSA at a tertiary hospital in Japan since the introduction of a new infectious diseases department 
Session: Poster Abstract Session: MRSA Surveillance and Infection Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • poster IDSA final 1024x768.pdf (1.7 MB)
  • Background:  Infectious diseases (ID) specialty is still an evolving field in Japan.  Kameda Medical Center is a tertiary teaching hospital with 925 beds in a rural area of Japan.  In 2005, the hospital introduced ID department, consisting from two ID specialists and a few clinical fellows.  Since then, multiple interventions were made to improve ID practices and infection control. The hospital also opened a new building with 324 single patient rooms in 2005. We aimed to assess their effect as a whole on controlling MRSA.  

    Methods:  Interventions included initiating ID consultation upon request and for all positive blood culture cases (approximately 1300 cases per year), rigorous education to hospital staffs on appropriate antimicrobial use and good infection control practices, reinforcing the use of standard precaution and contact precaution if needed, mandatory reporting on carbapenem use, reducing antimicrobial formula and introducing maximal barrier precaution for central line insertion.  Historical infection control data were reviewed, as well as microbiology laboratory data for the incidence of Staphylococcus aureus bacteremia. 

    Results:  The incidence of MRSA colonization or infection per 1,000 patient-days in the whole hospital decreased from 1.12 in 2005 to 0.26 in 2010 (r = -0.983, p<0.01).  When we analyzed only the existent open-bay wards, the MRSA incidence still decreased from 0.90 in 2005 to 0.26 in 2010 (r = -0.941, p<0.01).  The rate of methicillin-resistance among all S. aureus infection or colonization decreased from 58% in 2005 to 28% in 2010 (r = -0.974, p<0.01).  The incidence of MRSA bacteremia per 1,000 patient-days also decreased from 0.16 in 2005 to 0.04 in 2010 (r = -0.935, p<0.01), whereas the incidence of all S. aureus bacteremia did not change significantly

    Conclusion:  Since the introduction of ID department, case-based antimicrobial stewardship and education increased the awareness of appropriate antimicrobial use and infection control in the whole hospital.  Introducing infection control interventions happened quickly with the support by ID specialists.  These changes, as a whole, lead to the continuous reduction of MRSA over years.  We believe that Japan needs more ID specialists to improve infection control and patient care. 

     


    Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

    Hidetaka Kitazono, MD1, Naoko Furuya, RN2, Makiko Yoshida, PhD, MPH2, Misa Sogi, MD1, Ryota Hase, M.D.1, Kentaro Tochitani, M.D.1, Kiyoharu Muranaka, MD1, Yoshifumi Uwamino, MD1, Mai Inakaku, MD3, Shoji Shimizu, MD1, Yoshihito Otsuka, PhD4, Goh Ohji, MD, PhD, DTM&H5, Shungo Yamamoto, MD1, Kentaro Iwata, MD6 and Naoto Hosokawa, MD, PhD1, (1)General Medicine and Infectious Diseases, Kameda Medical Center, Kamogawa City, Chiba, Japan, (2)Infection Control, Kameda Medical Center, Kamogawa, Chiba, Japan, (3)Department of General Internal Medicine, Iizuka Hospital, Iizuka city, Fukuoka, Japan, (4)Clinical laboratory department, Kameda Medical Center, Kamogawa-city, Chiba, Japan, (5)Division of Infectious Diseases Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan, (6)Division of Infectious Diseases Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan

    Disclosures:

    H. Kitazono, None

    N. Furuya, None

    M. Yoshida, None

    M. Sogi, None

    R. Hase, None

    K. Tochitani, None

    K. Muranaka, None

    Y. Uwamino, None

    M. Inakaku, None

    S. Shimizu, None

    Y. Otsuka, None

    G. Ohji, None

    S. Yamamoto, None

    K. Iwata, None

    N. Hosokawa, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.