Device-associated infection surveillance in Japan: 2025 annual report of the Japanese society for infection...

The Japanese Healthcare-associated Infections Surveillance (JHAIS) Committee of the Japanese Society for Infection Prevention and Control (JSIPC) initiated a nationwide surveillance program for medical device-associated infections in 2009. This report is a summary of the data collected and reported by hospitals participating in the JHAIS Surveillance from January 2023 through December 2025.

The wards covered by the surveillance program are intensive care units and acute-care general wards. We collected surveillance data on four major device-associated infections; central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP) and ventilator-associated events (VAE). Definitions and criteria of the targeted infections were based on the manual developed by the National Healthcare Safety Network (NHSN), a surveillance system in the United States. However, the JHAIS Surveillance Project also included clinically diagnosed sepsis in addition to laboratory-confirmed bloodstream infections, and infection rates were calculated for the overall as well as for each category.

Over the three-year period, aggregate counts of ventilator-days and associated infection events were compiled for intensive care units; values other than these were collected for both intensive care units and acute general wards. CLABSI including clinical sepsis 3434 events, CAUTI 5617 events, VAP 540 events, Ventilator-associated Condition (VAC) 508 events, Infection-related Ventilator-Associated Complication (IVAC) 211 events, and Possible Ventilator-Associated Pneumonia (PVAP) 129 events. Device-days were 1,829,660 central line-days, 3,413,781 urinary catheter-days. The total number of ventilator-days was 246,728. Specifically, among facilities participating in VAP surveillance was 129,417 ventilator-days, whereas among facilities participating in VAE surveillance was 164,314 ventilator-days. Some facilities contributed to both surveillances. The cumulative infection rates per 1000 device-days were: CLABSI 1.88 per 1000 central line-days; CAUTI 1.65 per 1000 catheter-days; VAP 4.17 per 1000 ventilator-days; VAC 3.09 per 1000 ventilator-days; IVAC 1.28 per 1000 ventilator-days; and PVAP 0.78 per 1000 ventilator-days. The highest incidence was observed for VAP, with a value exceeding that of PVAP by more than fivefold.

Among device-associated infections, the infection rate of VAP was the highest, showing a marked difference from CLABSI and CAUTI. In addition, substantial discrepancies were observed between the infection rates of VAP and PVAP. Hospitals should use these data to guide local improvement efforts aimed at reducing infection rates as much as possible.