Article ID: JJID.2019.498
Emergence and spread of multidrug-resistant organisms (MDRO) is an urgent social problem. We carried out an epidemiological survey to clarify the geographic characteristics and factors influencing the prevalence of MDRO. Data regarding the prevalence of MDRO in 47 prefectures in Japan was extracted from the Japanese Nosocomial Infection Surveillance, a nationwide database for infection control. Potential factors influencing MDRO were selected from pharmacological, medical service-, infection control-, food-related, environmental and social categories considering the characteristics of each organism, and correlations between them and MDRO prevalence were analyzed. Statistics for potential factors were data from public domains. The use of antibiotics correlated with the prevalence of PRSP, 3 rd- generation cephalosporin- and fluoroquinolone-resistant E. coli and MRSA. Negative correlations between the consumption of foods that facilitate the growth of lactic acid bacteria such as kelp and fermented soy beans and the prevalence of 3 rd-generation cephalosporin- and fluoroquinolone-resistant E. coli suggested an association between intestinal microflora and MDRO colonization. In addition to the use of antibiotics, lifestyle, food culture and social factors such as tobacco smoking, average temperature, prevalence of three-generation households, ratio of elderlies, average length of tourist stay, chicken consumption, fermented bean consumption, and medical service conditions could modify MDRO prevalence.
