Between April 2006 and March 2009, research into extended-spectrum β-lactamase (hereafter ESBL)-producing organisms at eight facilities in the eastern region of Hiroshima prefecture showed increases in both the number of detection and isolation rates year by year. There are also indications of a correlation between the isolation rates of ESBL-producing organisms and the antimicrobial usage density of third-generation cephem medicines. In addition, Escherichia coli accounted for 92.7% of the bacterial strains in the examination materials: urine, sputum, and stool in descending order. When the multivariate classification was analyzed after the questionnaire surveys from the eight facilities, as the isolation rates of ESBL-producing organisms exceeded 5%, it was found that more than 200 beds were provided, in addition to a bacteriological examination room, and a screening test was practiced, ICT rounds enforced, and the hospital functional evaluation had not been assessed. Through this study, it became possible to improve the detection of the ESBL-producing organisms and an opportunity was created to practice infection control at these facilities, and other neighborhood facilities based on the surveillance data. It is thought that the approach that was applied is necessary for prevention and infection control in district facilities in the future.
