Abstract
BackgroundAntimicrobial resistance (AMR) is now recognized as a major threat to public health, and surveillance of AMR is essential for successful containment. In 2000, Japan Nosocomial Infections Surveillance (JANIS) Clinical Laboratory (CL) division has been launched as a voluntary AMR surveillance funded by the Ministry of Health, Labour and Welfare and managed by the National Institute of Infectious Diseases. In this study, we aimed to propose a model of sustainable national AMR surveillance which provides not only national AMR surveillance reports but also benchmarking reports to each hospital to facilitate infection control practices.MethodsJANIS CL division collects comprehensive specimen-based data complies with JANIS data format from participating hospitals each month. It had targeted only blood and cerebrospinal fluid samples but was expanded to all types of specimens in 2007 at revision of JANIS. The JANIS system interprets the antimicrobial susceptibility according to the same criteria and conducts removal of duplicates to allow accurate comparison between hospitals. Monthly feedback reports are created automatically within 48 h, while quarterly and annual reports are generated after data validation.ResultsAt the beginning, 468 hospitals were enrolled in the JANIS CL division, but the number of hospitals that submitted data decreased to 210 (45%) in 2006. After surveillance revision in 2007, annual recruitment of hospitals was initiated and as of 2015, 1475 hospitals participated, and 1461 (99%) of them submitted data throughout the year. Nationwide surveillance data collected over the past decade revealed that the prevalence of methicillin-resistant Staphylococcus aureus has decreased since 2008, and that its prevalence is higher in the western part of Japan, where the number of hospitals per capita is higher than in the eastern part.ConclusionsJANIS CL division serves a model of sustainable national AMR surveillance system. Comprehensive data for all specimens promotes understanding of the sampling frequency and prevalence of AMR. As a well-established system for providing rich information to guide action both locally and nationally, JANIS may also be utilized for sharing AMR data globally.
Highlights
Antimicrobial resistance (AMR) is recognized as a major threat to public health, and surveillance of AMR is essential for successful containment
We aimed to propose a model of sustainable national AMR surveillance which overcame those barriers and creates national reports and benchmarking reports for each hospital to facilitate infection control practices
Surveillance sites of Japan Nosocomial Infections Surveillance (JANIS) Clinical Laboratory (CL) divisions was fixed to 468 hospitals who were enrolled to the project at the time of launching
Summary
Antimicrobial resistance (AMR) is recognized as a major threat to public health, and surveillance of AMR is essential for successful containment. In 2000, Japan Nosocomial Infections Surveillance (JANIS) Clinical Laboratory (CL) division has been launched as a voluntary AMR surveillance funded by the Ministry of Health, Labour and Welfare and managed by the National Institute of Infectious Diseases. Antimicrobial resistance (AMR) is recognized as a major threat to public health that limits patients’ treatment options for bacterial infections. In 2015, the 68th World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance [1]. Multidrug-resistant Pseudomonas aeruginosa emerged and spread in hospitals across Japan. This led the Ministry of Health, Labour and Welfare (MHLW) to establish a surveillance system for nosocomial infections and AMR, the Japan Nosocomial Infections Surveillance (JANIS)
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