Comparison of national strategies to reduce meticillin-resistant Staphylococcus aureus infections in Japan and England

S Mizuno, M Iwami, S Kunisawa, N Naylor, K Yamashita, Y Kyratsis, G Meads, J A Otter, A H Holmes, Y Imanaka, R Ahmad

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)
20 Downloads (Pure)

Abstract

BACKGROUND: 

National responses to healthcare-associated infections vary between high-income countries, but, when analysed for contextual comparability, interventions can be assessed for transferability.

AIM: 

To identify learning from country-level approaches to addressing meticillin-resistant Staphylococcus aureus (MRSA) in Japan and England.

METHODS: 

A longitudinal analysis (2000-2017), comparing epidemiological trends and policy interventions. Data from 441 textual sources concerning infection prevention and control (IPC), surveillance, and antimicrobial stewardship interventions were systematically coded for: (a) type: mandatory requirements, recommendations, or national campaigns; (b) method: restrictive, persuasive, structural in nature; (c) level of implementation: macro (national), meso (organizational), micro (individual) levels. Healthcare organizational structures and role of media were also assessed.

FINDINGS: 

In England significant reduction has been achieved in number of reported MRSA bloodstream infections. In Japan, in spite of reductions, MRSA remains a predominant infection. Both countries face new threats in the emergence of drug-resistant Escherichia coli. England has focused on national mandatory and structural interventions, supported by a combination of outcomes-based incentives and punitive mechanisms, and multi-disciplinary IPC hospital teams. Japan has focused on (non-mandatory) recommendations and primarily persuasive interventions, supported by process-based incentives, with voluntary surveillance. Areas for development in Japan include resourcing of dedicated data management support and implementation of national campaigns for healthcare professionals and the public.

CONCLUSION: Policy interventions need to be relevant to local epidemiological trends, while acceptable within the health system, culture, and public expectations. Cross-national learning can help inform the right mix of interventions to create sustainable and resilient systems for future infection and economic challenges.

Original languageEnglish
Pages (from-to)280-298
Number of pages19
JournalJournal of Hospital Infection
Volume100
Issue number3
DOIs
Publication statusPublished - Nov 2018
Externally publishedYes

Bibliographical note

Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Fingerprint

Dive into the research topics of 'Comparison of national strategies to reduce meticillin-resistant Staphylococcus aureus infections in Japan and England'. Together they form a unique fingerprint.

Cite this