Clinical Implication of the Relationship between Antimicrobial Resistance and Infection Control Activities in
Tomokazu Shoji1,2, Natsu Sato1, Haruhisa Fukuda3
1Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Noshio, Kiyose 204-8588, Tokyo, Japan.
Abstract:
There are few multicenter investigations regarding the relationship between antimicrobial resistance (AMR) and infection-control activities in Japanese hospitals. Hence, we aimed to identify Japanese hospital subgroups based on facility characteristics and infection-control activities. Moreover, we evaluated the relationship between AMR and hospital subgroups. We conducted a cross-sectional study using administrative claims data and antimicrobial susceptibility data in 124 hospitals from April 2016 to March 2017. Hospitals were classified using cluster analysis based the principal component analysis-transformed data. We assessed the relationship between each cluster and AMR using analysis of variance. Ten variables were selected and transformed into four principal components, and five clusters were identified. Cluster 5 had high infection control activity. Cluster 2 had partially lower activity of infection control than the other clusters. Clusters 3 and 4 had a higher rate of surgeries than Cluster 1. The methicillin-resistant Staphylococcus aureus (MRSA)/S. aureus detection rate was lowest in Cluster 1, followed, respectively, by Clusters 5, 2, 4, and 3. The MRSA/S. aureus detection rate differed significantly between Clusters 4 and 5 (p = 0.0046). Our findings suggest that aggressive examination practices are associated with low AMR whereas surgeries, an infection risk factor, are associated with high AMR.
Insights
Japanese hospitals with high infection control activities showed lower antimicrobial resistance (AMR). Aggressive screening practices were linked to reduced AMR, while increased surgeries correlated with higher AMR rates.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Public Health
Background:
- Limited multicenter research exists on antimicrobial resistance (AMR) and infection control in Japanese hospitals.
- Understanding hospital subgroups is crucial for targeted AMR reduction strategies.
Purpose of the Study:
- To identify Japanese hospital subgroups based on facility characteristics and infection control activities.
- To evaluate the relationship between identified hospital subgroups and AMR prevalence.
Main Methods:
- A cross-sectional study involving 124 Japanese hospitals from April 2016 to March 2017.
- Cluster analysis of principal component analysis-transformed administrative claims and antimicrobial susceptibility data.
- Analysis of variance (ANOVA) to assess AMR differences across hospital clusters.
Main Results:
- Five distinct hospital clusters were identified based on facility characteristics and infection control activities.
- Cluster 5 exhibited high infection control activity, while Cluster 2 showed partially lower activity.
- The detection rate of methicillin-resistant *Staphylococcus aureus* (MRSA) was lowest in Cluster 1 (low surgery rates) and highest in Cluster 3 (high surgery rates).
- Significant differences in MRSA/ *S. aureus* detection rates were observed between clusters with varying infection control and surgical activity levels.
Conclusions:
- Hospital subgrouping based on infection control and facility characteristics is feasible.
- Aggressive examination practices are associated with lower AMR.
- Higher rates of surgeries, an infection risk factor, are associated with increased AMR.
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