Creation and demonstration of new cost-effective infection control indicators by utilizing hospital big data

• Project/Area Number: 19K10554
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: Kyoto Prefectural University of Medicine (2021-2022); Tokyo Medical and Dental University (2019-2020)
• Principal Investigator: Nukui Yoko 京都府立医科大学, 医学(系)研究科(研究院), 教授 (20568232)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Project Status: Completed (Fiscal Year 2022)
• Budget Amount: ¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000); Fiscal Year 2021: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2019: ¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000)
• Keywords: 薬剤耐性菌 / ビッグデータ / 新型コロナウイルス感染症 / 抗菌薬適正使用 / アウトブレイク / 感染対策 / 多剤耐性菌

Outline of Research at the Start

多剤耐性菌による感染症は世界的脅威である。毎年多くのアウトブレイクが生じ、患者の予後並びに医療経済上多大なる影響を与え、適切な感染対策の推進が重要である。また、薬剤耐性(AMR)対策アクションプランの根幹ともいえる抗菌薬適正使用は各施設で推進されているが、費用対効果についての検討は十分ではない。
本研究は当院の医療ビッグデータを元に、多剤耐性菌伝播のリスク因子の確立、抗菌薬適正使用・耐性菌への感染対策に関する医療経済的解析を行い、最終的には費用対効果に優れた新たな感染対策指標の作成及び実証を行うことを目的とする。

Outline of Final Research Achievements

Antimicrobial-resistant (AMR) bacteria are a global threat. This study　utilized big data to analyze efforts to achieve the AMR Action Plan at a university hospital. As a result, four targets for resistance rates were achieved, and the use of oral third generation cephalosporins was reduced by as much as 90%. The promotion of appropriate use of antimicrobial agents also reduced the annual purchase of antimicrobial agents by 30 million yen.
In addition, analyses were conducted on new COVID-19 pandemic that occurred during the study period. New infection control indicators, such as PCR screening tests upon admission and isolation criteria for suspected cases, were developed, enabling reduction of in-hospital cluster and excess medical costs. The use of big data enabled cost-effective infection control measures even during a pandemic period.

Academic Significance and Societal Importance of the Research Achievements

病院ビッグデータを活用することにより、未曽有のCOVID-19パンデミック禍で時間的・人的リソースが限られた状況下においても薬剤耐性菌及びCOVID-19対策の有効性に関する解析・実証が可能なことが明らかとなった。今後の更なる新興・再興感染症対応にとって、重要な基盤研究となった。

Research Products

• [Journal Article] Neutralizing type I interferon autoantibodies in Japanese patients with severe COVID-19 (2022)
  • Author(s): Eto S, Nukui Y, Tsumura M, Nakagama Y, Kashimada K, Mizoguchi Y, Utsumi T, Taniguchi M, Sakura F, Noma K, Yoshida Y, Ohshimo S, Nagashima S, Okamoto K, Endo A, Imai K, Kanegane H, Ohnishi H, Hirata S, Sugiyama E, Shime N, Ito M, Ohge H, Kido Y, Bastard P, Casanova JL, Ohara O, Tanaka J, Morio T, Okada S
  • Journal Title: J Clin Immunol Volume: 42 Pages: 1360-1370
  • DOI: 10.21203/rs.3.rs-1430985/v1
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Emergence of a High-Risk Klebsiella michiganensis Clone Disseminating Carbapenemase Genes (2022)
  • Author(s): Prah Isaac、Nukui Yoko、Yamaoka Shoji、Saito Ryoichi
  • Journal Title: Frontiers in Microbiology Volume: 13 Pages: 880248-880248
  • DOI: 10.3389/fmicb.2022.880248
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies (2022)
  • Author(s): Manry J, Bastard P, Gervais A, Le Voyer T, Rosain J, Philippot Q, Michailidis E, Hoffmann HH, Eto S,・・・, Tsumura M, et al
  • Journal Title: Proceedings of the National Academy of Sciences Volume: 119 Issue: 21
  • DOI: 10.1073/pnas.2200413119
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Patients with B-cell lymphoma receiving anti-CD20 monoclonal antibody-containing chemotherapies and seroreactive patterns in response to COVID-19 vaccination (2022)
  • Author(s): Inaba T, Okumura K, Maekura C, Muramatsu A, Kobayashi T, Kuroda J, Nukui Y
  • Journal Title: Int J Hematol Volume: 115 Issue: 6 Pages: 913-4
  • DOI: 10.1007/s12185-022-03349-1
  • Peer Reviewed / Open Access
• [Journal Article] <i>bla</i> _KPC-2 -Encoding IncP-6 Plasmids in Citrobacter freundii and Klebsiella variicola Strains from Hospital Sewage in Japan (2022)
  • Author(s): Ota Yusuke、Prah Isaac、Nukui Yoko、Koike Ryuji、Saito Ryoichi
  • Journal Title: Applied and Environmental Microbiology Volume: 88 Issue: 8
  • DOI: 10.1128/aem.00019-22
  • Peer Reviewed / Open Access
• [Journal Article] Viral load of SARS-CoV-2 Omicron is not high despite its high infectivity (2022)
  • Author(s): Yuasa S, Nakajima J, Takatsuki Y, Takahashi Y, Tani-Sassa C, Iwasaki Y, Nagano K, Sonobe K, Yoshimoto T, Nukui Y, Takeuchi H, Tanimoto K, Tanaka Y, Kimura A, Ichimura N, Tohda S
  • Journal Title: J Med Virol Volume: 94 Issue: 11 Pages: 5543-46
  • DOI: 10.1002/jmv.27974
  • Peer Reviewed / Open Access
• [Journal Article] Klebsiella Species and Enterobacter cloacae Isolates Harboring <i>bla</i> _OXA-181 and <i>bla</i> _OXA-48 : Resistome, Fitness Cost, and Plasmid Stability (2022)
  • Author(s): Mahazu Samiratu、Prah Isaac、Ota Yusuke、Hayashi Takaya、Nukui Yoko、Suzuki Masato、Hoshino Yoshihiko、Akeda Yukihiro、Suzuki Toshihiko、Ishino Tomoko、Ablordey Anthony、Saito Ryoichi
  • Journal Title: Microbiology Spectrum Volume: 10 Issue: 6
  • DOI: 10.1128/spectrum.03320-22
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Appropriateness of surgical antimicrobial prophylaxis in Japanese university hospitals (2022)
  • Author(s): Morioka H, Ohge H, Nagao M, Kato H, Kokado R, Yamada K, Yamada T, Shimono N, Nukui Y, Yoshihara S, Sakamaki I, Nosaka K, Kubo Y, Kawamura H, Fujikura Y, Kitaura T, Sunakawa M, Yagi T
  • Journal Title: J Hosp Infect Volume: 129 Pages: 189-97
  • DOI: 10.1016/j.jhin.2022.06.017
  • Peer Reviewed / Open Access
• [Journal Article] The risk of COVID-19 death is much greater and age-dependent with type I IFN autoantibodies (2022)
  • Author(s): Manry J, Bastard P, Nukui Y, Cobat A et al.
  • Journal Title: Res sq Volume: -
  • DOI: 10.21203/rs.3.rs-1225906/v1
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Viral loads and profile of the patients infected with SARS‐CoV‐2 Delta, Alpha, or R.1 variants in Tokyo (2021)
  • Author(s): Tani‐Sassa Chihiro、Iwasaki Yumi、Ichimura Naoya、Nagano Katsutoshi、Takatsuki Yuna、Yuasa Sonoka、Takahashi Yuta、Nakajima Jun、Sonobe Kazunari、Nukui Yoko、Takeuchi Hiroaki、Tanimoto Kousuke、Tanaka Yukie、Kimura Akinori、Tohda Shuji
  • Journal Title: Journal of Medical Virology Volume: 94 Issue: 4 Pages: 1707-1710
  • DOI: 10.1002/jmv.27479
  • Peer Reviewed / Open Access
• [Journal Article] Autoantibodies neutralizing type I IFNs are present in ~4% of uninfected individuals over 70 years old and account for ~20% of COVID-19 deaths (2021)
  • Author(s): Paul Bastard、Adrian Gervais、Tom Le Voyer、Jeremie Rosain、Quentin Philippot、Jeremy Manry、 Eleftherios Michailidis、Hans-Heinrich Hoffmann、Shohei Eto、Marina Garcia-Prat 、Lucy Bizien、 Alba Parra-Martinez、Rui Yang、Liis Haljasmagi、Melanie Migaud、...、Satoshi Okada、et al.
  • Journal Title: Science Immunology Volume: 6 Issue: 62 Pages: 1-26
  • DOI: 10.1126/sciimmunol.abl4340
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] SARS‐CoV‐2 R.1 lineage variants that prevailed in Tokyo in March 2021 (2021)
  • Author(s): Nagano Katsutoshi、Tani‐Sassa Chihiro、Iwasaki Yumi、Takatsuki Yuna、Yuasa Sonoka、Takahashi Yuta、Nakajima Jun、Sonobe Kazunari、Ichimura Naoya、Nukui Yoko、Takeuchi Hiroaki、Tanimoto Kousuke、Tanaka Yukie、Kimura Akinori、Tohda Shuji
  • Journal Title: Journal of Medical Virology Volume: 93 Issue: 12 Pages: 6833-6836
  • DOI: 10.1002/jmv.27240
  • Peer Reviewed / Open Access
• [Journal Article] Clinical validation of an immunochromatographic SARS-Cov-2 IgM/IgG antibody assay with Japanese cohort (2021)
  • Author(s): Kaneko S, Nukui Y, Arashiro T, Aiso Y, Sugii M, Hadano Y, Nagata K, Taki R, Ueda K, Hanada S, Suzaki S, Harada N, Yamaguchi Y, Nakanishi H, Kurosaki M, Nagasawa M, Izumi N.
  • Journal Title: Journal of Medical Virology Volume: 93 Issue: 1 Pages: 569-572
  • DOI: 10.1002/jmv.26363
  • Peer Reviewed / Open Access
• [Journal Article] Evaluation of polymerase chain reaction-based open reading frame typing method for the clonality investigation of Clostridioides difficile isolates (2021)
  • Author(s): Ota Y, Hongou N, Nukui Y, Koike R, Tohda S, Saito R
  • Journal Title: Anaerobe Volume: 72 Pages: 102462-102462
  • Peer Reviewed / Open Access
• [Journal Article] Three-day regimen of oseltamivir for post-exposure prophylaxis of influenza in hospital wards: a study protocol for a prospective, multi-center, single-arm trial (2021)
  • Author(s): Ishiguro Nobuhisa、Ito Yoichi M.、Iwasaki Sumio、Nagao Miki、Kawamura Hideki et al.
  • Journal Title: BMC Infectious Diseases Volume: 21 Issue: 1 Pages: 887-887
  • DOI: 10.1186/s12879-021-06602-w
  • Peer Reviewed / Open Access
• [Journal Article] Seroprevalence of SARS-CoV-2 in Utsunomiya City, Greater Tokyo, after the first pandemic in 2020 (2021)
  • Author(s): Nawa N, Kuramochi J, Sonoda S, Yamaoka Y, Nukui Y, Miyazaki Y, Fujiwara T
  • Journal Title: Journal of General and Family Medicine Volume: 22 Issue: 3 Pages: 160-162
  • DOI: 10.1002/jgf2.408
  • Peer Reviewed / Open Access
• [Journal Article] 肝炎ウイルスの病態と曝露後対応 (2021)
  • Author(s): 貫井 陽子
  • Journal Title: 医学のあゆみ Volume: 277 Pages: 455-458
  • Peer Reviewed
• [Journal Article] Draft Genome Sequence of a Clostridioides difficile Sequence Type 97 Strain Belonging to Hypervirulent Clade 2 (2020)
  • Author(s): Usui Yukino, Nukui Yoko, Koike Ryuji, Tohda Shuji, Saito Ryoichi
  • Journal Title: Microbiology Resource Announcements Volume: 9 Issue: 14 Pages: 245-246
  • DOI: 10.1128/mra.00245-20
  • Peer Reviewed / Open Access
• [Journal Article] Molecular epidemiologic and clinical analysis of Helicobacter cinaedi bacteremia in Japan (2019)
  • Author(s): Nukui Yoko, Chino Takashi, Tani Chihiro, Sonobe Kazunari, Aiso Yoshibumi, Tohda Shuji, Koike Ryuji, Saito Ryoichi
  • Journal Title: Helicobacter Volume: 25 Issue: 1 Pages: 23-27
  • DOI: 10.1111/hel.12675
  • Peer Reviewed / Open Access
• [Journal Article] Whole-genome analysis of EC129, an NDM-5-, CTX-M-14-, OXA-10- and MCR-1-co-producing Escherichia coli ST167 strain isolated from Japan (2019)
  • Author(s): Nukui Yoko, Ayibieke Alafate, Taniguchi Makoto, Aiso Yoshibumi, Shibuya Yuka, Sonobe Kazunari, Nakajima Jun. Kanehira Saki, Hadano Yoshiro, Tohda Shuji, Koike Ryuji, Saito Ryoichi
  • Journal Title: Journal of Global Antimicrobial Resistance Volume: 18 Pages: 148-150
  • DOI: 10.1016/j.jgar.2019.07.001
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Hypervirulent clade 2, ribotype 019/sequence type 67 Clostridioides difficile strain from Japan (2019)
  • Author(s): Saito Ryoichi, Usui Yukino, Ayibieke Alafate, Nakajima Jun, Prah Isaac, Sonobe Kazunari, Aiso Yoshibumi, Ito Shiori, Itsui Yasuhiro, Hadano Yoshiro, Nukui Yoko, Koike Ryuji, Tohda Shuji
  • Journal Title: Gut Pathogens Volume: 11 Issue: 1 Pages: 54-61
  • DOI: 10.1186/s13099-019-0336-3
  • Peer Reviewed / Open Access
• [Journal Article] 実地医家の知っておきたい多剤耐性菌 (2019)
  • Author(s): 貫井 陽子
  • Journal Title: Medical Practice Volume: 36 Pages: 43-48
• [Journal Article] ビッグデータを活用して病院幹部を納得させる (2019)
  • Author(s): 貫井 陽子
  • Journal Title: インフェクションコントロール Volume: 29 Pages: 58-63
• [Presentation] 予定入院前スクリーニングSARS-CoV-2 RT PCRについての検討 (2023)
  • Author(s): 山本千恵、山野哲弘、稲葉亨、貫井陽子
  • Organizer: 第97回日本感染症学会学術集会
• [Presentation] 蚊媒介ウイルス感染症Up to date (2023)
  • Author(s): 貫井 陽子
  • Organizer: 第97回日本感染症学会学術集会
  • Invited
• [Presentation] Genetic Analysis of Antimicrobial Resistant Enterobacteriaceae in Travelers and Patients Who Were Treated Overseas (2023)
  • Author(s): Nukui Y, Chie Y, Inaba T, Aiso Y, Tohda S, Ota Y, Saito R
  • Organizer: ASM Microbe 2023
  • Int'l Joint Research
• [Presentation] 病院におけるCOVID-19拡大を経験しての感染対策アップデート (2023)
  • Author(s): 貫井 陽子
  • Organizer: 第24回口腔ケア協会学術大会
  • Invited
• [Presentation] 感染症予防のための今知っておくべき新知識・新情報 (2023)
  • Author(s): 貫井 陽子
  • Organizer: 生物実践安全講習会
  • Invited
• [Presentation] SARS-CoV-2の遺伝子検査とウイルス分離の関連性からみたコロナスクリーニング検査の解釈について (2022)
  • Author(s): 谷野洋子、山田幸司、山本千恵、稲葉亨、貫井陽子、中屋隆明
  • Organizer: 第69回日本臨床検査医学会学術集会
• [Presentation] 新型コロナウイルス感染症管理 院内感染対策・ゾーニング (2021)
  • Author(s): 貫井 陽子
  • Organizer: 第70回日本感染症学会東日本地方会
  • Invited
• [Presentation] 早期感染制御研修プログラム導入による薬剤師次世代育成への試み (2020)
  • Author(s): 相曽啓史, 丸谷美保子, 渡邊由香, 齋藤良一, 貫井陽子, 高橋広弘充
  • Organizer: 第35回日本環境感染学会総会
• [Presentation] Molecular epidemiological analysis of multidrug-resistant Pseudomonas aeruginosa that caused an outbreak in an intensive care unit in Japan (2019)
  • Author(s): Nukui Y, Maki Y, Aiso Y, Nakajima J, Sonobe K, Saito R, Tohda S, Koike R
  • Organizer: ASM Microbe 2019
  • Int'l Joint Research
• [Presentation] Development of a Technique to Monitor the Implementation of De-escalation of Antibacterial Agent (2019)
  • Author(s): Moriwaki M, Toba M, Tahashi C, Aiso Y, Hadano Y, Nukui Y, Obayashi S, Fushimi K
  • Organizer: International Forum on Quality＆Safety in Healthcare
  • Int'l Joint Research
• [Presentation] Assessment of the infection control round in our hospital (2019)
  • Author(s): Shima M, Aiso Y, Watanabe Y, Hadano Y, Nukui Y
  • Organizer: 9th International Congress of the Asia Pacific Society of Infection Control
  • Int'l Joint Research
• [Presentation] ASは広域抗菌薬初回投与時の血液培養実施率に影響をあたえるか (2019)
  • Author(s): 鈴木貴子, 相曽啓史, 丸谷美保子, 杉井麻耶, 渋谷有香, 羽田野義郎, 貫井陽子
  • Organizer: 第67回日本化学療法学会学術集会
• [Presentation] MRSA菌血症患者に対する抗菌薬適正支援の評価 (2019)
  • Author(s): 渋谷有香, 相曽啓史, 鈴木貴子, 丸谷美保子, 杉井麻耶, 羽田野義郎, 貫井陽子
  • Organizer: 第67回日本化学療法学会学術集会
• [Presentation] アデノシン三リン酸[ＡＴＰ]測定による歯科ユニット周囲の環境汚染の評価 (2019)
  • Author(s): 島眞理, 鶴岡広美, 砂川光宏, 貫井陽子
  • Organizer: 第34回日本環境感染学会総会
• [Presentation] エピネットサーベイランスを活用した針刺し、切創防止活動の報告 (2019)
  • Author(s): 島眞理, 相曽啓史, 羽田野義郎, 貫井陽子.
  • Organizer: 第34回日本環境感染学会総会
• [Presentation] 血液培養陽性例への抗菌薬適正使用でみえてくるものは (2019)
  • Author(s): 相曽啓史, 渋谷有香, 貫井陽子
  • Organizer: 第34回日本環境感染学会総会
• [Presentation] 本邦初のNDM-5 メタロβラクタマーゼ産生大腸菌ST167による感染事例 (2019)
  • Author(s): 貫井陽子, 羽田野義郎, 相曽啓史, 齋藤良一, 東田修二, 小池竜司.
  • Organizer: 第93回日本感染症学会総会・学術集会
• [Presentation] 薬剤耐性(AMR)アクションプランに向けた入院内服抗菌薬使用状況動向調査法の検討 (2019)
  • Author(s): 森脇 睦子, 鳥羽 三佳代, 相曽 啓史, 貫井 陽子, 伏見 清秀
  • Organizer: 日本医療マネジメント学会
• [Book] 救急・集中治療領域における感染症診療 (2019)
  • Author(s): 貫井 陽子
  • Total Pages: 206
  • Publisher: 克誠堂出版