title: [Central clinical laboratory and infection control team: an essential partnership controlling health care-associated infections].
abstract: Infection Control Committee (ICC) of Akita University Hospital was established in 1980's, when methicillin-resistant Staphylococcus aureus (MRSA) spread in teaching hospitals in Japan. After 20 years from the establishment of ICC, we needed to shake up some of the outdated infection control systems. Infection Control Team (ICT) was established in 2002 to reinforce ICC. ICT was consisted of five infection control doctors (ICD), two infection control nurses (ICN), two medical technicians in bacteriological division of clinical laboratory, one pharmacist and three administrative officials in the hospital. Monitoring of multiple drug-resistant pathogens, antibiotic use, surgical site infections and bloodstream infections are mandatory. Personnel training and educational activity are also required. After the establishment of ICT, inappropriate use of antibiotics and prevalence of MRSA were dramatically decreased. The hospital saved more than 30,000,000 yen annually. However, with a great regret, we experienced an outbreak of MRSA in a department of our hospital in 2003. MRSA infection was judged as a cause of death in three patients in the outbreak. MRSA was thought to transmit via medical personnel since pulsed-field gel electrophoresis revealed common genotype in 11 out of 15 patients studied. Prevention of healthcare-associated infections is a crucial in the management of hospitals. In this paper, we verified the efforts to control the outbreak and analyzed factors interfering infection control activities. A crucial role of a clinical laboratory in controlling healthcare associated infections was also discussed.
authors.affiliation: Infection Control Team, Akita University Hospital, Hondo.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kayaba
authors.forename: Masako
authors.initials: M
authors.lastname: Tobita
authors.forename: Noriko
authors.initials: N
authors.lastname: Tomita
authors.forename: Noriko
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Ryozo
authors.initials: R
authors.lastname: Fukui
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Saitoh
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Ueki
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Noriko
authors.initials: N
authors.lastname: Sakurada
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Chihara
mesh_terms: D000900:Anti-Bacterial Agents; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D004196:Disease Outbreaks; D016903:Drug Monitoring; D024901:Drug Resistance, Multiple, Bacterial; D017723:Drug Utilization Review; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000191:economics / Q000379:methods / Q000458:organization & administration; D007362:Intensive Care Units; D007564:Japan; D007755:Laboratories, Hospital; D016106:Methicillin Resistance; D010348:Patient Care Team; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control; D014640:Vancomycin
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin