Table 39. Usage of medical devices by patients using antimicrobials [Multiple answers] n=170 *Missing
values: 2
Type of medical device

Number of people (%)

Peripheral route
Self-inserted/indwelling bladder catheter
Gastrostomy tube
Nasogastric tube
Dialysis catheter
Tracheostomy tube

33 (19.4%)
33 (19.4%)
23 (13.5%)
12 ( 7.1%)
3 ( 1.8%)
2 ( 1.2%)

Colostomy equipment

2 ( 1.2%)

Nephrostomy/cystostomy tube

1 ( 0.6%)

Other (sputum suction tube, ureteral stent/enterostomy tube)

3 ( 1.8%)

Not using a medical device

86 (50.6%)

Total

170

Table 40. Focus of infection undergoing treatment [Multiple answers] n=153 *Missing values: 1
Focus of infection or diagnosis
Urinary tract infection

Number of people (%)
78 (51.0%)

Pneumonia

37 (24.2%)

Upper respiratory tract infection

15 ( 9.8%)

Bronchitis

9 ( 5.9%)

Cellulitis

7 ( 4.6%)

Gastroenteritis

2 ( 1.3%)

Unknown

7 ( 4.6%)

Other

12 ( 7.8%)

Breakdown of the 12 cases listed as “Other”: 2 pharyngitis, 2 epidermal cyst, 2 toe inflammation, 1 pressure ulcers on the right second and
third toe joints, 1 vaginitis, 1 inflammation of the remaining dental root, 1 suspected bile duct calculus, 1 suspected palmoplantar pustulosis,
1 details unclear

ii Welfare facilities for the elderly requiring long-term care (special nursing homes for the aged)
The center randomly selected 1,500 welfare facilities for the elderly requiring long-term care from among the
members of the Japanese Council of Senior Citizens Welfare Service and conducted a point prevalence survey
(PPS). Responses were received from 139 facilities (a response rate of 9.3%). The majority of responses came
from conventional facilities with mostly multibed rooms (73.0%) and unit-style facilities where small groups of
around 10 people share communal living areas, but have their own rooms (36.5%).
A total of 9,044 patients were admitted to the facilities on the day the survey was carried out. Of these, 94 (1.0%)
were using antimicrobials. Individual data was received for 80 patients. The median age of the patients was 90.0
years (IQR: 85, 93), while the median age of male patients was 80.5 years (IQR: 76, 90) and that of female patients
was 92.0 years (IQR: 87, 93). The top three medical devices being used by patients were peripheral routes (inserted
to treat infection), which were used by 12 people (17.1%), indwelling urethral catheters, which were used by 6
people (8.6%), and gastrostomy tubes, which were used by 4 people (5.7%). A total of 49 people (70.0%) were
not using any medical devices.
The top focuses of infection were urinary tract infections, affecting 23 people (31.17%); pneumonia, affecting
11 people (14.9 %); and upper respiratory tract infections, affecting 9 people (12.2%). The main antimicrobials
used to treat urinary tract infections were oral quinolones, while the main ones used for pneumonia were injectable
third-generation cephalosporins. Residents were being treated for the infection by the physician deployed by the
facility (appointed physician) or at outpatient consultations. Going forward, it will be necessary to promote
antimicrobial stewardship through the use of the Manual of Antimicrobial Stewardship, among others.

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