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548 Device-associated infection surveillance project by the Japanese Society of Environmental Infections

Sunday, April 3, 2011
Trinity Ballroom (Hilton Anatole)
Retsu Fujita, MSN , The University of Tokyo Graduate School of Medicine, Tokyo, Japan
Yaoko Takano, MSN , Keio University Hospital, Tokyo, Japan
Tokiko Watanabe, MSN , Okayama University Hospital, Okayama, Japan
Haruyo Sakaki, Ph.D , Nishisaitama-chuo National Hospital, Saitama, Japan
Hitomi Kurosu, MSN , Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital, Tokyo, Japan
Ryoko Shibatani, RN , Osaka koseinenkin Hospital, Osaka, Japan
Keita Morikane, MD , Yamagata University Hospital, Yamagata, Japan
Yasushi Harihara, MD , Kanto Medical Center, NTT-EC, Tokyo, Japan
Toshiro Konishi, MD , Kanto Medical Center, NTT-EC, Tokyo, Japan
Background:

The Japanese Society of Environmental Infections launched the device-associated infection surveillance project in 2009. This surveillance project is designed to achieve the two following objectives. One is to provide the society members and medical institutions with information on the occurrence of device-associated infections in Japan, and the other is to make an international comparison of surveillance data for the relative evaluation of the occurrence of device-associated infections.

Objective:

The objective of this paper is to introduce our surveillance system and to evaluate the results of the first year.

Methods:

Three types of device-associated infections were selected to be surveyed: central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) in intensive care units. In this surveillance, the diagnostic definition and method for calculating the infection rate used are in line with those specified in the National Healthcare Safety Network (NHSN) manual, in order to compare and analyze the nationwide surveillance data from the United States and Europe. Recruitment of participating institutions was initiated in February 2009.   In terms of comparison with NHSN data, ‘medical-surgical ICU’ was selected for similar patient background.

Results:

By April 2010, a total of 24 institutions participated. It was validated that each system for registration of institutions, data collection, and return of reports could work smoothly with no problems. The pooled mean BSI rate per 1000 device-days was 1.7, with a median value of 1.8. It was slightly high compared to the NHSN data (pooled mean: 1.5, median vale: 0). The mean and median values for central line utilization ratio were 0.59, respectively. It was higher than NHSN ratio (pooled mean: 0.39, median vale: 0.34). The pooled mean UTI rate was 2.8, median value was 3.0. It was comparable with NHSN data (pooled mean: 3.4, median vale: 2.1). The pooled mean urinary catheter utilization ratio was 0.81, median value was 0.86. It was slightly high with NHSN ratio (pooled mean: 0.64, median vale: 0.66). The pooled mean VAP rate was 4.3, median value was 1.5. It was higher than NHSN data (pooled mean: 2.2, median vale: 0.7). The pooled mean ventilator utilization ratio was 0.46, with a median value of 0.36. It was slightly high compared to the NHSN ratio (pooled mean: 0.29, median vale: 0.24).

Conclusions:

It was validated that the systems could work smoothly. Infection rate for BSI and VAP were slightly high in comparison with NHSN data, and UTI rate was comparable. Future issues to be addressed are: increase participant institutions; assess the validity of the NHSN’s diagnostic definition in Japan; and analyze potential factors affecting the onset of infection.