title: Community spread of extended-spectrum β-lactamase-producing bacteria detected in social insurance hospitals throughout Japan.
abstract: We surveyed the status of community-acquired infections involving four extended-spectrum β-lactamase (ESBL)-producing bacteria (Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis) isolated from clinical specimens from 11 social insurance hospitals in Japan in 2012. These are member hospitals of the Japan Community Healthcare Organization, an independent administrative hospital organization. The isolation rates for E. coli, K. pneumoniae, K. oxytoca, and P. mirabilis were 14.0% (165/1176), 3.3% (16/480), 3.1% (4/130), and 15.9% (17/107), respectively. The CTX-M-9 group, the most frequently detected genotype, was found in 77.0% (127/165) of E. coli and 43.8% (7/16) of K. pneumoniae isolates. Among K. oxytoca isolates, 75% (3/4) were the CTX-M-1 group, and all 17 P. mirabilis strains were the CTX-M-2 group. ESBL-producing bacteria isolation rates in each hospital ranged from 5.8% to 21.5% (median 9.5%), and the proportion of community-acquired infections among ESBL-producing bacteria isolates ranged from 1.6% to 30.8% (median 11.4%) in each hospital. Overall, the rates of ESBL-producing bacterial infection in all community-acquired infections and in all hospital infections were 10.6% (115/1081) and 10.7% (87/812), respectively. The ESBL-producing bacteria are not limited to certain regions or hospitals but are spreading in communities throughout Japan.
authors.affiliation: Japan Community Healthcare Organization (JCHO) Gunma Chuo Hospital, Department of Clinical Laboratory, 1-7-13 Kouncho, Maebashi, Gunma 371-0025, Japan. Electronic address: mm.mayu28@gmail.com.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Shibasaki
authors.affiliation: Department of Clinical Laboratory Science, Tenri Health Care University, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Komatsu
authors.affiliation: JCHO Shiga Hospital, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Sueyoshi
authors.affiliation: JCHO Hoshigaoka Medical Center, Japan.
authors.forename: Misaho
authors.initials: M
authors.lastname: Maeda
authors.affiliation: JCHO Saitama Medical Center, Japan.
authors.forename: Takae
authors.initials: T
authors.lastname: Uchida
authors.affiliation: JCHO Tokyo Joto Hospital, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yonezawa
authors.affiliation: JCHO Chukyo Hospital, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Inagaki
authors.affiliation: JCHO Tokyo Yamate Medical Center, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Omi
authors.affiliation: JCHO Hokkaido Hospital, Japan.
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Matsumoto
authors.affiliation: JCHO Tokyo Yamate Medical Center, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Murotani
authors.affiliation: JCHO Chukyo Hospital, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Iwamoto
authors.affiliation: JCHO Yokkaichi Hazu Medical Center, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kodaka
authors.affiliation: JCHO Yokkaichi Hazu Medical Center, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Kieda
authors.affiliation: JCHO Ritsurin Hospital, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Tokiwa
authors.affiliation: JCHO Isahaya General Hospital, Japan.
authors.forename: Bunji
authors.initials: B
authors.lastname: Masuwa
authors.affiliation: JCHO Kumamoto General Hospital, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Kinoshita
authors.affiliation: JCHO Sendai Hospital, Japan.
authors.forename: Kazuei
authors.initials: K
authors.lastname: Saito
authors.affiliation: JCHO Yokkaichi Hazu Medical Center, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Katou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D017714:Community-Acquired Infections / Q000382:microbiology*; D016172:DNA Fingerprinting; D004755:Enterobacteriaceae / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D005838:Genotype; D006764:Hospitals, Community; D006801:Humans; D007223:Infant; D007564:Japan; D008875:Middle Aged; D012943:Social Security; D055815:Young Adult; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001618:beta-Lactamases
keywords: ESBL; Enterobacteriaceae; PCR; Surveillance