Abstract
Introduction: The global spread of emerging infections has increased the demand for infectious disease (ID) experts. There is no established method to evaluate the sufficiency of professionals on a regional basis. We aimed to determine the correlation of the number of ID doctors and certified nurses in infection control (CNIC) with the prevalence of representative antimicrobial-resistant (AMR) pathogens across the 47 prefectures in Japan using publicly available databases.Methods: We determined the number of ID doctors and CNIC registered in each prefecture based on the Japanese Association for Infectious Diseases and the Japanese Nursing Association websites and calculated their numbers per 100,000 population. Data on representative AMR pathogens were extracted from the Japan Nosocomial Infections Surveillance database. Spearman’s correlation coefficient was used to measure statistical associations.Results: There was no epidemiologically applicable correlation between the deployment of ID doctors and CNIC and the isolation rates of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, cefotaxime- or levofloxacin-resistant Escherichia coli and Klebsiella pneumoinae, and meropenem-resistant Pseudomonas aeruginosa. Solely, the isolation rate of levofloxacin-resistant K. pneumoinae and the number of CNIC were statistically correlated (correlation coefficient = −0.33; p = 0.02), while the isolation rate of cefotaxime-resistant E. coli was paradoxically correlated with the number of ID doctors (correlation coefficient = 0.33; p = 0.02).Conclusions: Our macroscopic analysis using the open database was not a reliable method to evaluate the sufficiency of ID experts across the prefectures in Japan. A scheme to assess the appropriate distribution of ID experts should be developed.
Highlights
The global spread of emerging infections has increased the demand for infectious disease (ID) experts
There was no correlation of the deployment of ID doctors and certified nurses in infection control (CNIC) with the isolation of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE), and MEPM-resistant P. aeruginosa (Figure 1)
The isolation rates of CTX-resistant E. coli correlated with the number of ID doctors
Summary
The global spread of emerging infections has increased the demand for infectious disease (ID) experts. With the emergence of a global pandemic of antimicrobial resistance (AMR) [1], a well-organized platform for infection prevention and control (IPC) activities should be established. Infectious disease (ID) doctors and certified nurses in infection control (CNIC) play a crucial role in medical IPC activities. The Japanese Association for Infectious Diseases stated that each medical institute with over 300 beds should have at least one full-time ID doctor on duty and required 3,000 to 4,000 ID doctors working in Japanese hospitals [4]. Medical staff education and training need to be improved to produce more ID experts to achieve these recommendations
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