Risk factors for fecal carriage of IMP-6-producing Enterobacteriaceae at a long-term care hospital in Japan: A follow-up report from the northern Osaka multicentre study group

Hideharu Hagiya, Norihisa Yamamoto, Ryuji Kawahara, Yukihiro Akeda, Rathina Kumar Shanmugakani, Akiko Ueda, Isao Nishi, Rumiko Asada, Hisao Yoshida, Kazunori Tomono

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2 Citations (Scopus)


The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing at medical institutions in Japan without even noticing. Recently, we performed a point prevalence survey for CRE carriage at a medical facility in northern Osaka that demonstrated an unexpectedly high prevalence of blaIMP-6-positive CRE, particularly at long-term care hospitals (LTCH). To identify the risk factors for CRE carriage, we collected clinical data of patients at a representative LTCH. Of 140 patients who were included in this study, 27 (19.3%) were colonized with metallo-beta-lactamase (IMP-6) producers. Pulsed-field gel electrophoresis of the IMP-6 producing Enterobacteriaceae suggested a non-clonal transmission of Escherichia coli, while a clonal spread was shown for Klebsiella pneumoniae. Risk factors for CRE colonization were a longer stay at the hospital stay and a lower independence state, as measured by Norton scales. We propose that a paradigm shift in infection control, inciting a coordinated regional effort to involve LTCHs, should be discussed in the aging society of Japan.

Original languageEnglish
Pages (from-to)769-772
Number of pages4
JournalJournal of Infection and Chemotherapy
Issue number9
Publication statusPublished - Sep 2018
Externally publishedYes



  • Aging society
  • Antimicrobial resistance
  • Carbapenem-resistant Enterobacteriaceae
  • Carbapenemase-producing Enterobacteriaceae
  • Metallo-beta-lactamase

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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