活動事例紹介
Cooperation of the Infection Control Center with Internal and External Institutions
Infection Control Center, Healthcare Safety Management Division, Department of Hospital Quality and Safety Management
Infection Control Center
The Infection Control Center at Osaka Medical and Pharmaceutical University Hospital provides information and guidance on infection control, such as the proper hand- hygiene technique, how to use personal protective equipment (PPE) and the appropriate microbiological examination and use of antibiotics . In addition to holding workshops and sharing information through various channels, staff members offer on-site advice to prevent the spread of nosocomial infections. To ensure continual improvement in infection control practices, the center meticulously monitors several key indicators. The usage of antibiotics and disinfectant , the number of microbiological examinations performed, the number of detected antimicrobial resistant (AMR) bacteria and the number of the occurrence of infectious diseases are investigated, and the results are made use of to improve fu rther infection control.
Cooperation with local government and healthcare providers
Osaka Medical and Pharmaceutical University Hospital has established the Infection Control Network of Hokusetsu Medical Society, recognizing that community collaboration is crucial for effective infection control. This comprehensive network incorporates local health centers, general and psychiatric hospitals, and clinics, significantly enhancing infection management throughout the region. As the founding institution, the hospital takes the lead in providing advanced treatment protocols and disseminates vital infection-related information from government sources and the Japanese Association of Private Medical Schools. Moreover, it offers essential education and guidance to smaller healthcare facilities through peer evaluation and knowledge exchange, addressing their common challenges of limited resources and expertise in infection control practices.
In terms of surveillance, we encourage local hospitals and clinics to participate in the Ministry of Health, Labour and Welfare’s Japan Nosocomial Infections Surveillance (JANIS) program, as well as the Japan Surveillance for Infection Prevention and Healthcare Epidemiology (J-SIPHE) system. This participation enables feedback for infection control to be provided by conducting more functional and efficient investigations. In addition to providing support during outbreaks of infectious diseases, such as COVID-19, at local hospitals and clinics, we investigate AMR bacteria and the usage of antibiotics, disinfectant alcohol, and PPE within each hospital and provide feedback on the results, thereby improving infection control throughout the region. Highly AMR bacteria are now being brought into hospitals from the community, highlighting the limitations of conventional bacteriological testing methods . In response, we have genetically analyzed the highly AMR bacteria detected within the network and are addressing them in cooperation with public health centers . The National Action Plan on AMR also underscores the importance of local cooperation, and our hospital’s initiatives have been acknowledged as best practices by academic societies on infection control and the Infection Control Committee of the Japanese Association of Private Medical Schools.
Crisis management in infection control and risk preparedness for future unforeseen events
– Responses to emerging and re-emerging infectious diseases –
After the 2009 influenza pandemic, Takatsuki City developed an action plan in accordance with the Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response. The plan called for major hospitals to establish outpatient clinics for individuals returning from overseas or those who had contact with infected persons. Leveraging our university’s experience with simulations to prepare for future novel influenza outbreaks, which were conducted with Takatsuki City Public Health Center in 2019, several such outpatient clinics were swiftly established during the COVID-19 pandemic in 2020 in the Mishima medical care area. They facilitated the smooth execution of PCR tests, and the initiative was highly praised by health centers. Securing hospital admissions for pregnant women with COVID-19 was often challenging due to their higher risk of developing severe symptoms. In response to a request from Osaka Prefecture, our hospital treated approximately 200 COVID-19 positive pregnant patients in a specialized ward, run primarily by the obstetrics department. We managed natural childbirth for 86 positive pregnant women, while many hospitals opted for elective cesarean sections due to COVID-19 complications. This approach also received high acclaim. The Infection Control Center introduced a system to fully support infection control and medical treatment in this ward.
Promotion of appropriate infectious disease care and leadership in antimicrobial resistance prevention
Our hospital employs a system staffed by infectious disease specialists and pharmacists with specialized and certified qualifications. We provide extensive support and initiatives for the proper use of antimicrobial drugs, aiming to prevent the emergence ofAMR bacteria. We offer consultations on infectious diseases and provide expert advice tailored to each patient’s case. For instances of positive blood culture cases, multidrug-resistant bacteria cases and ICU cases, we adopt an active support approach. Specifically, for cases requiring the long-term use of broad-spectrum antibiotics, such as carbapenems, we provide support from the early stage to optimize treatment for courses lasting five days or more. Furthermore, we regularly monitor the use of antimicrobial agents, assess rates of conducting pre-treatment culture and multiple sets of blood cultures, and their contamination and positivity rates, and provide feedback on these metrics. This practice ensures appropriate antimicrobial use and facilitates a rapid response. Our swift diagnostic support utilizing the latest technologies, including mass spectrometry and automated genetic analyzers, aids in earlier diagnosis and the initiation of appropriate treatment. We are in the process of developing guidelines to standardize the treatment of infectious diseases within our hospital. In terms of education, we conduct internal workshops at least twice a year to disseminate knowledge about the appropriate use of antimicrobial agents and offer educational programs for residents, thus contributing to improving infection control and the quality of treatment throughout the hospital.
Future efforts
The challenges to further improving outpatient infection control are AMR bacteria and emerging or re-emerging infectious diseases. In today’s globalized society, we witnessed the COVID-19 pandemic emerge merely a decade after the influenza pandemic of 2009. With numerous upcoming mass gatherings in Japan, such as Expo 2025 Osaka, Kansai, the surge in inbound tourism necessitates enhanced control measures for a variety of infectious diseases. These include measles, tuberculosis, Neisseria meningitidis, and antimicrobial-resistant Enterobacteriaceae. Our hospital will strive to improve the quality of infection control across the region to contribute to the local community.
【Diagram of Infection Control Network of Hokusetsu Medical Society of Doctors’ Association (160 facilities ) as of August 2024】
【北摂四医師会 感染対策ネットワーク図（合計１６０施設） 2024年8月現在】
| 北摂四医師会感染対策ネットワーク | Infection Control Network of Hokusetsu Medical Society of Doctors’ Association |
| 高槻市医師会 | Takatsuki Medical Association |
| 茨木市医師会 | Ibaraki Medical Association |
| 摂津市医師会 | Settsu Medical Association |
| 茨木保健所 | Ibaraki Health Center |
| 連携 | Cooperation |
| 重点 | Referral |
| 受入 | Admission |
| 協力 | Support |
| 外来 25 |
Outpatient 25 |
| 外来 7 |
Outpatient 7 |
| 外来 | Outpatient |
| 11 | 11 |
| 外来 17 |
Outpatient 17 |
| 外来 15 |
Outpatient 15 |
| 済生会茨木 | Saiseikai Ibaraki |
| 友紘会 | Yukoukai |
| 藍野 | Aino |
| 摂津ひかり | Settsu Hikari |
| みどりヶ丘 | Midorigaoka |
| オレンジホスピタル | Orange Hospital |
| 茨木 | Ibaraki |
| 高槻病院 | Takatsuki General Hospital |
| 東和会いばらき | Towakai Ibaraki |
| 摂津医誠会 | Settsu Iseikai |
| うえだ下田部 | Ueda Shimotanabe |
| 第一東和会 | Daiichi Towakai |
| 北大阪ほうせんか | North Osaka Housenka |
| 三康 | Sanko |
| 高槻日赤 | Takatsuki Red Cross |
| 谷川記念 | Tanigawa Memorial |
| 水無瀬 | Minase |
| 北摂 | Hokusetsu |
| 三島南 | Mishima-minami |
| 富田町 | Tondacho |
| 大阪医科薬科大学病院 | Osaka Medical and Pharmaceutical University Hospital |
| 第二東和会 | Daini Towakai |
| 藤田胃腸科 | Fujita |
| 愛仁会リハビリ | Aijinkai Rehabilitation |
| 新阿武山 | Shin-Abuyama |
| 感染対策向上加算1病院 6施設 |
Hospitals eligible for Type 1 additional reimbursement to enhance infection control: 6 facilities |
| 感染対策向上加算2病院： 10施設 | Hospitals eligible for Type 2 additional |
| 3病院：10施設 | reimbursement to enhance infection control: 1 0 facilities; Type 3: 10 facilities |
| 感染対策向上加算外来： 135施設 | Outpatient clinics eligible for additional reimbursement to enhance infection control: 135 facilities |
| 加算1病院と加算2, 3病院との連携 | Cooperation between Type 1 hospital and Type 2 or 3 hospital |
| 加算1病院と加算1病院との連携 | Cooperation between Type 1 hospitals |
| 全160 施設 | Total of 160 facilities |