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Kagami K, Ishiguro N, Iwasaki S, Taki K, Fukumoto T, Hayasaka K, Oyamada R, Watanabe T, Nakakubo S, Niinuma Y, Sugawara M, Takekuma Y. Correlation between antibiotic use and resistance of gram-negative bacteria at a university hospital in Japan from 2013 to 2021: a study using the Japan Surveillance for Infection Prevention and Healthcare Epidemiology system. Eur J Hosp Pharm 2023:ejhpharm-2023-003797. [PMID: 37438092 DOI: 10.1136/ejhpharm-2023-003797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES The Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE) system aggregates information related to antimicrobial resistance (AMR) measures. We aimed to investigate the correlation between antibiotic use and AMR at a university hospital from 2013 to 2021 in a time series analysis using the J-SIPHE system. We also studied this correlation in each ward (inter-ward analysis). METHODS Data on antibiotic use and resistance rates were collected from the J-SIPHE system, except for the resistance rate in each ward, which was calculated from the source data prepared for this system. RESULTS Piperacillin/tazobactam use was positively correlated with piperacillin/tazobactam resistance in Escherichia coli and Klebsiella pneumoniae in the inter-ward analysis, and in Pseudomonas aeruginosa in both analyses. Carbapenem use was positively correlated with meropenem resistance in Enterobacter cloacae in the time series analysis and in P. aeruginosa in both analyses, and imipenem/cilastatin resistance in P. aeruginosa in inter-ward analysis. Quinolone use was positively correlated with levofloxacin resistance in E. coli in both analyses, and in K. pneumoniae in inter-ward analysis. CONCLUSIONS This is the first study to investigate the correlation between antibiotic use and AMR at a single hospital in time series and inter-ward analyses using the J-SIPHE system and data prepared for this system, suggesting that this system may be useful for promoting AMR measures.
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Affiliation(s)
- Keisuke Kagami
- Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
| | - Nobuhisa Ishiguro
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
| | - Sumio Iwasaki
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Keisuke Taki
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Tatsuya Fukumoto
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Kasumi Hayasaka
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Reiko Oyamada
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
| | - Tsubasa Watanabe
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
| | - Sho Nakakubo
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Yusuke Niinuma
- Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan
- Department of Infection Control and Prevention, Hokkaido University Hospital, Sapporo, Japan
| | - Mitsuru Sugawara
- Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan
- Laboratory of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Yoh Takekuma
- Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan
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Kagami K, Ishiguro N, Iwasaki S, Usami T, Fukumoto T, Hayasaka K, Oyamada R, Watanabe T, Nakakubo S, Niinuma Y, Hagino T, Abe Y, Fujimoto I, Maekawa H, Fujibayashi R, Fuke S, Asahi K, Ota S, Nagakura T, Okubo T, Asanuma H, Ito T, Okano S, Komatsu E, Sasaki K, Hashimoto K, Washiya K, Kato Y, Kusumi K, Asai Y, Saito Y, Sakai Y, Sakurada M, Sakimoto Y, Ichikawa Y, Kinebuchi T, Kondo D, Kanno S, Kobayashi M, Hirabayashi K, Saitou S, Saito K, Ebina Y, Koshizaki Y, Chiba M, Yasuda A, Sato T, Togashi A, Abe T, Fujita T, Umehara K, Amishima M, Murakami N, Yagi T, Fujimoto S, Tajima T, Sugawara M, Takekuma Y. Correlation between antibiotic use and antibiotic resistance: A multicenter study using the Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE) system in Hokkaido, Japan. Am J Infect Control 2023; 51:163-171. [PMID: 35671846 DOI: 10.1016/j.ajic.2022.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE) system aggregates information related to antimicrobial resistance (AMR) measures in participating medical institutions nationwide and is intended to be used for promotion of AMR measures in participating facilities and their communities. This multicenter study aimed to determine the usefulness of the J-SIPHE system for evaluating the correlation between antibiotic use and antibiotic resistance in Hokkaido, Japan. METHODS Data on antibiotic use and detection rate of major resistant Gram-negative bacteria at 19 hospitals in 2020 were collected from the J-SIPHE system, and data correlations were analyzed using JMP Pro. RESULTS The detection rate of carbapenem-resistant Pseudomonas aeruginosa was significantly positively correlated with carbapenem use (Spearman's ρ = 0.551; P = .015). There were significant positive correlations between the detection rate of fluoroquinolone-resistant Escherichia coli and the use of piperacillin/tazobactam, carbapenems, and quinolones [ρ = 0.518 (P = .023), ρ = 0.76 (P < .001), and ρ = 0.502 (P = .029), respectively]. CONCLUSIONS This is the first multicenter study to investigate the correlation between antibiotic use and antibiotic resistance using the J-SIPHE system. The results suggest that using this system may be beneficial for promoting AMR measures.
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Affiliation(s)
- Keisuke Kagami
- Department of Pharmacy, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan; Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan.
| | - Nobuhisa Ishiguro
- Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan
| | - Sumio Iwasaki
- Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan; Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan
| | - Takayuki Usami
- Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan; Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan
| | - Tatsuya Fukumoto
- Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan; Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan
| | - Kasumi Hayasaka
- Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan; Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan
| | - Reiko Oyamada
- Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan
| | - Tsubasa Watanabe
- Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan
| | - Sho Nakakubo
- Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Kita-ku, Sapporo, Hokkaido, Japan
| | - Yusuke Niinuma
- Department of Pharmacy, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan; Department of Infection Control and Prevention, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan
| | - Takashi Hagino
- Infection Control Room, NTT Medical Center Sapporo, Chuo-ku, Sapporo, Hokkaido, Japan
| | - Yoshifumi Abe
- Infection Control Room, NTT Medical Center Sapporo, Chuo-ku, Sapporo, Hokkaido, Japan
| | - Ikuya Fujimoto
- Department of Pharmacy, Kitasapporo Hospital, Kita-ku, Sapporo, Hokkaido, Japan
| | - Hideki Maekawa
- Department of Pharmacy, Hokkaido Gastroenterology Hospital, Higashi-ku, Sapporo, Hokkaido, Japan
| | - Ryo Fujibayashi
- Department of Pharmacy, Hokkaido Gastroenterology Hospital, Higashi-ku, Sapporo, Hokkaido, Japan
| | - Satoshi Fuke
- Department of Respiratory Medicine, KKR Sapporo Medical Center, Toyohira-ku, Sapporo, Hokkaido, Japan; Department of Infection Control and Prevention, KKR Sapporo Medical Center, Toyohira-ku, Sapporo, Hokkaido, Japan
| | - Kuniko Asahi
- Department of Infection Control and Prevention, KKR Sapporo Medical Center, Toyohira-ku, Sapporo, Hokkaido, Japan; Department of Laboratory Medicine, KKR Sapporo Medical Center, Toyohira-ku, Sapporo, Hokkaido, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Shiroishi-ku, Sapporo, Hokkaido, Japan; Department of Infection Control and Prevention, Sapporo Hokuyu Hospital, Shiroishi-ku, Sapporo, Hokkaido, Japan
| | - Tatsuya Nagakura
- Department of Infection Control and Prevention, Sapporo Hokuyu Hospital, Shiroishi-ku, Sapporo, Hokkaido, Japan
| | - Toshinari Okubo
- Department of Pharmacy, IMS Sapporo Internal Medicine Rehabilitation Hospital, Teine-ku, Sapporo, Hokkaido, Japan
| | - Hideomi Asanuma
- Department of Neonatology, Hokkaido Medical Center for Child Health and Rehabilitation, Teine-ku, Sapporo, Hokkaido, Japan
| | - Toshihiro Ito
- Department of Cardiology, Sapporo Teishinkai Hospital, Higashi-ku, Sapporo, Hokkaido, Japan
| | - Sho Okano
- Department of Pharmacy, Sapporo Teishinkai Hospital, Higashi-ku, Sapporo, Hokkaido, Japan
| | - Erika Komatsu
- Department of Pharmacy, Ebetsu City Hospital, Ebetsu, Hokkaido, Japan
| | - Kota Sasaki
- Department of Clinical Laboratory, Ebetsu City Hospital, Ebetsu, Hokkaido, Japan
| | - Kei Hashimoto
- Department of Pharmacy, Hakodate Goryoukaku Hospital, Hakodate, Hokkaido, Japan
| | - Kazutoshi Washiya
- Department of Pharmacy, Hakodate Goryoukaku Hospital, Hakodate, Hokkaido, Japan
| | - Yumiko Kato
- Department of Infection Control and Prevention, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Katsunori Kusumi
- Department of Pharmacy, Hakodate Central General Hospital, Hakodate, Hokkaido, Japan
| | - Yasufumi Asai
- Department of Cardiology, Hakodate Shintoshi Hospital, Hakodate, Hokkaido, Japan
| | - Yuichi Saito
- Department of Pharmacy, Hakodate Shintoshi Hospital, Hakodate, Hokkaido, Japan
| | - Yoshiyuki Sakai
- Department of Pediatrics, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Minoru Sakurada
- Department of Pharmacy, Hakodate Municipal Hospital, Hakodate, Hokkaido, Japan
| | - Yuji Sakimoto
- Department of Pharmacy, Yakumo General Hospital, Yakumo Town, Futami-gun, Hokkaido, Japan; Infection Control Room, Yakumo General Hospital, Yakumo Town, Futami-gun, Hokkaido, Japan
| | - Yukari Ichikawa
- Infection Control Management, Asahikawa Red Cross Hospital, Asahikawa, Hokkaido, Japan
| | - Takahiro Kinebuchi
- Department of Laboratory Medicine, Social Welfare Corporation Hokkaido Social Work Association Furano Hospital, Furano, Hokkaido, Japan
| | - Dai Kondo
- Department of Pharmacy, Social Welfare Corporation Hokkaido Social Work Association Furano Hospital, Furano, Hokkaido, Japan
| | - Syuhei Kanno
- Department of Pharmacy, Oji General Hospital, Tomakomai, Hokkaido, Japan; Infection Control Room, Oji General Hospital, Tomakomai, Hokkaido Japan
| | - Minoru Kobayashi
- Infection Control Room, Oji General Hospital, Tomakomai, Hokkaido Japan
| | - Kagami Hirabayashi
- Department of Cardiologists, Tomakomai City Hospital, Tomakomai, Hokkaido, Japan; Department of Infection Control and Prevention, Tomakomai City Hospital, Tomakomai, Hokkaido, Japan
| | - Shinako Saitou
- Department of Infection Control and Prevention, Tomakomai City Hospital, Tomakomai, Hokkaido, Japan; Department of Infection Prevention and Control Certified Nurse, Tomakomai City Hospital, Tomakomai, Hokkaido, Japan
| | - Katsuhiko Saito
- Department of Pharmacy, Nemuro City Hospital, Nemuro, Hokkaido, Japan
| | - Yuuki Ebina
- Department of Pharmacy, Obihiro Kosei General Hospital, Obihiro, Hokkaido, Japan
| | - Yuusuke Koshizaki
- Department of Clinical Laboratory Technology, Obihiro Kosei General Hospital, Obihiro, Hokkaido, Japan
| | - Makoto Chiba
- Department of Pharmacy, Kitami Red Cross Hospital, Kitami, Hokkaido, Japan
| | - Atsushi Yasuda
- Department of Clinical Laboratory, Kitami Red Cross Hospital, Kitami, Hokkaido, Japan
| | - Toshiya Sato
- Department of Pediatrics, Iwamizawa Municipal General Hospital, Iwamizawa, Hokkaido, Japan; Department of Infection Prevention Office, Iwamizawa Municipal General Hospital, Iwamizawa, Hokkaido, Japan
| | - Atsuo Togashi
- Department of Pediatrics, Iwamizawa Municipal General Hospital, Iwamizawa, Hokkaido, Japan; Department of Infection Prevention Office, Iwamizawa Municipal General Hospital, Iwamizawa, Hokkaido, Japan
| | - Takashi Abe
- Department of Laboratory Medicine, Takikawa Municipal Hospital, Takikawa, Hokkaido, Japan
| | - Takahiro Fujita
- Department of Infectious Diseases, National Hospital Organization Hokkaido Cancer Center, Shiroishi-ku, Sapporo, Hokkaido, Japan
| | - Kengo Umehara
- Department of Pharmacy, National Hospital Organization Hokkaido Cancer Center, Shiroishi-ku, Sapporo, Hokkaido, Japan
| | - Masaru Amishima
- Office for Infection Control and Prevention, NHO Hokkaido Medical Center, Nishi-ku, Sapporo, Hokkaido, Japan
| | - Nobuo Murakami
- Center for Regional Medicine, Gifu University School of Medicine, Yanagido, Gifu, Japan; Gifu General Healthcheckup Centre, Hikie, Gifu, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Showa-ku, Nagoya, Japan
| | - Shuhei Fujimoto
- Department of Bacteriology and Bacterial Infection, Division of Host Defense Mechanism, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Taichi Tajima
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan
| | - Mitsuru Sugawara
- Department of Pharmacy, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan; Laboratory of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-ku, Sapporo, Hokkaido, Japan
| | - Yoh Takekuma
- Department of Pharmacy, Hokkaido University Hospital, Kita-ku, Sapporo, Hokkaido, Japan
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Gonzalez-Martinez A, Margareto A, Rodriguez-Sanchez A, Pesciaroli C, Diaz-Cruz S, Barcelo D, Vahala R. Linking the Effect of Antibiotics on Partial-Nitritation Biofilters: Performance, Microbial Communities and Microbial Activities. Front Microbiol 2018. [PMID: 29535704 PMCID: PMC5834488 DOI: 10.3389/fmicb.2018.00354] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The emergence and spread of antibiotics resistance in wastewater treatment systems have been pointed as a major environmental health problem. Nevertheless, research about adaptation and antibiotics resistance gain in wastewater treatment systems subjected to antibiotics has not been successfully developed considering bioreactor performance, microbial community dynamics and microbial activity dynamics at the same time. To observe this in autotrophic nitrogen removal systems, a partial-nitritation biofilter was subjected to a continuous loading of antibiotics mix of azithromycin, norfloxacin, trimethoprim, and sulfamethoxazole. The effect of the antibiotics mix over the performance, bacterial communities and bacterial activity in the system was evaluated. The addition of antibiotics caused a drop of ammonium oxidation efficiency (from 50 to 5%) and of biomass concentration in the bioreactor, which was coupled to the loss of ammonium oxidizing bacteria Nitrosomonas in the bacterial community from 40 to 3%. Biomass in the partial nitritation biofilter experienced a sharp decrease of about 80% due to antibiotics loading, but the biomass adapted and experienced a growth by stabilization under antibiotics feeding. During the experiment several bacterial genera appeared, such as Alcaligenes, Paracoccus, and Acidovorax, clearly dominating the bacterial community with >20% relative abundance. The system reached around 30% ammonium oxidation efficiency after adaptation to antibiotics, but no effluent nitrite was found, suggesting that dominant antibiotics-resistant phylotypes could be involved in nitrification–denitrification metabolisms. The activity of ammonium oxidation measured as amoA and hao gene expression dropped a 98.25% and 99.21%, respectively, comparing the system before and after the addition of antibiotics. On the other hand, denitrifying activity increased as observed by higher expression of nir and nos genes (83.14% and 252.54%, respectively). In addition, heterotrophic nitrification cyt c-551 was active only after the antibiotics addition. Resistance to the antibiotics was presumably given by ermF, carA and msrA for azithromycin, mutations of the gyrA and grlB for norfloxacin, and by sul123 genes for sulfamethoxazole. Joined physicochemical and microbiological characterization of the system were used to investigate the effect of the antibiotics over the bioprocess. Despite the antibiotics resistance, activity of Bacteria decreased while the activity of Archaea and Fungi increased.
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Affiliation(s)
| | - Alejandro Margareto
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain.,Catalan Institute for Water Research, Scientific and Technological Park of the University of Girona, Girona, Spain
| | | | | | - Silvia Diaz-Cruz
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain.,Catalan Institute for Water Research, Scientific and Technological Park of the University of Girona, Girona, Spain
| | - Damia Barcelo
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain.,Catalan Institute for Water Research, Scientific and Technological Park of the University of Girona, Girona, Spain
| | - Riku Vahala
- Department of Built Environment, School of Engineering, Aalto University, Espoo, Finland
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