Carbapenem-resistant Enterobacteriaceae intra- and inter-transmission machanisms and environmental infection prevention

• Project/Area Number: 18K16169
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 54030:Infectious disease medicine-related
• Research Institution: Tohoku University
• Principal Investigator: KANAMORI Hajime 東北大学, 医学系研究科, 講師 (70625318)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000); Fiscal Year 2020: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2018: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
• Keywords: カルバペネム耐性腸内細菌科細菌 / カルバペネマーゼ / 医療環境 / 環境感染制御 / カルバペネム耐性腸内細菌目細菌 / 環境制御 / 薬剤耐性 / 感染対策 / カルバペネム耐性菌 / 全ゲノム解析 / カルバペネム耐性腸内細菌科細菌(CRE) / 分子疫学 / 伝播様式 / 感染制御 / ゲノム疫学

Outline of Final Research Achievements

The carbapenemase gene identified by genomic analysis of clinical isolates of carbapenem-resistant Enterobacteriaceae (CRE) at a university hospital was blaIMP-1 which was mainly maintained by certain clones of Enterobacter cloacae complex. To prevent healthcare-associated infections among cases in which CRE and multidrug-resistant Pseudomonas aeruginosa (MDRP) were detected or secondary infections in a critically ill patient with COVID-19, it is important to evaluate the contamination status of environmental surfaces in patient rooms and to enhance environmental hygiene. blaNDM-5-producing Escherichia coli was detected from a pediatric patient with no history of overseas travel. Establishment of regional surveillance system is necessary to detect endemic and imported strains of CRE.

Academic Significance and Societal Importance of the Research Achievements

地域のゲノム疫学研究を行い、耐性機序および伝播様式を解明した。医療環境がCREの伝播に関連しており、医療環境表面においてバイオバーデンを減少させるため、紫外線照射装置などの感染予防技術を臨床応用した。全ゲノム解析による伝播様式の解明および環境感染制御は、CREだけでなく、今後新たに出現する可能性のある薬剤耐性菌を制御する上で重要な感染予防戦略である。本研究から得られた知見を他の地域の医療施設に応用することで、日本の薬剤耐性対策の向上につながることが期待される。

Research Products

• [Journal Article] Waterborne Outbreaks in Hemodialysis Patients and Infection Prevention (2022)
  • Author(s): Hajime Kanamori, David J Weber, Jennifer E Flythe, William A Rutala
  • Journal Title: Open Forum Infectious Diseases Volume: 9 Issue: 3
  • DOI: 10.1093/ofid/ofac058
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] A case of meningitis due to extensively drug-resistant Pseudomonas aeruginosa imported through medical evacuation: Genomic and environmental investigation (2021)
  • Author(s): Hiroaki Baba, Hajime Kanamori, Makoto Katsumi, Takami Sato, Takae Chida, Shinobu Ikeda, Yuki Suzuki, Hisakazu Yano, Koichi Tokuda
  • Journal Title: Journal of Travel Medicine Volume: - Issue: 6
  • DOI: 10.1093/jtm/taab047
  • Peer Reviewed
• [Presentation] 便培養からNDM産生Escherichia coliが検出された小児市中患者の一例 (2021)
  • Author(s): 須田 那津美, 桜井 博毅, 谷河 翠, 徳田 浩一, 金森 肇
  • Organizer: 第36回日本環境感染学会総会・学術集会
• [Presentation] Longitudinal genomic analysis of IMP-1 metallo-β-lactamase-producing Enterobacteriaceae at a tertiary care hospital in north-east Japan (P0807) (2020)
  • Author(s): Hajime Kanamori, Yuko Makino, Hiroaki Baba, Tetsuji Aoyagi, Koichi Tokuda, Shiro Endo, Hisakazu Yano, Mitsuo Kaku
  • Organizer: 30th ECCMID
• [Presentation] Genomic and environmental investigation of hospital room occupied by an imported case of meningitis due to extensively drug-resistant (XDR) Pseudomonas aeruginosa (2020)
  • Author(s): Hiroaki Baba, Hajime Kanamori, Makoto Katsumi, Takami Sato, Keiko Ishikawa, Takae Chida, Shinobu Ikeda, Koichi Tokuda
  • Organizer: 30th ECCMID
• [Presentation] 海外からの多剤耐性緑膿菌の持ち込み症例における病室内環境調査と院内伝播防止に関する検討 (2020)
  • Author(s): 馬場啓聡, 金森肇, 勝美真琴, 佐藤貴美, 石川恵子, 鈴木未希, 千田貴恵, 池田しのぶ, 徳田浩一
  • Organizer: 第35回日本環境感染学会総会・学術集会
• [Presentation] Longitudinal genomic analysis of IMP-1 metallo-β-lactamase-producing Enterobacteriaceae at a tertiary care hospital in Northeast Japan (2020)
  • Author(s): Hajime Kanamori; Yuko Makino; Hiroaki Baba; Kendo Oshima; Tetsuji Aoyagi; Koichi Tokuda; Shiro Endo; Hisakazu Yano; Mitsuo Kaku
  • Organizer: 30th European Congress of Clinical Microbiology & Infectious Diseases
  • Int'l Joint Research
• [Presentation] Genomic and environmental investigation of hospital room occupied by an imported case of meningitis due to extensively drug-resistant (XDR) Pseudomonas aeruginosa (2020)
  • Author(s): Hiroaki Baba; Hajime Kanamori; Makoto Katsumi; Takami Sato; Keiko Ishikawa; Takae Chida; Shinobu Ikeda; Koichi Tokuda
  • Organizer: 30th European Congress of Clinical Microbiology & Infectious Diseases
  • Int'l Joint Research