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Table 1 Demographics and national surveillance systems of Taiwan, South Korea and Japan

From: Healthcare-associated infections in intensive care units in Taiwan, South Korea, and Japan: recent trends based on national surveillance reports

Parameter

Taiwan

South Korea

Japan

Country background

 Populationa

23,433,753b

50,746,659c

127,276,000d

 Income brackete

High income

High income

High income

 GDP, US dollars

571,736 millionf

1,530,750.92 milliong

4,872,136.95 milliong

 Share of GDP on national health expenditure

6.3%f

7.6%h

10.7%h

 Number of hospitalsa

486i

534j

7426k

 Surveillance system

Taiwan Nosocomial Infection Surveillance (TNIS)

Korean National Healthcare-associated Infection Surveillance System (KONIS)

Japan Nosocomial Infection Surveillance (JANIS)

 Year established

2001

2006

2000

 Authority

Centers for Disease Control, Ministry of Health and Welfare, Taiwan

Korea Centers for Disease Control and Prevention

Ministry of Health, Labor and Welfare, Japan

ICU Surveillancea

 Number of hospitals enrolled

103

96

143

 Number of ICUs enrolled

472

169

163

 Types of hospitals enrolled (total number in the country)

Medical Centers and Regional hospitals l (n = 103)

Bed size > 900, 700–899, 300–699 (n = 249)n

Bed size > 200 (n = 2100)

 Hospital coverage rate

21.2% (103/486)

18.0% (96/534)

1.9% (143/7426)

 Hospital participation ratem

100.0% (103/103)

38.6% (96/249)

6.8% (143/2100)

 Mandated standard ratio of infection control personnel

1 dedicated full-time certificated IC nurse per 300 beds (basic) or per 250 beds (optimal)

1 FTE qualified IC doctor per 500 beds (basic) or per 300 beds (optimal)o

For hospitals > 500 beds: 1 FTE IC medical technician (basic) or 1 dedicated full-time certificated IC medical technician (optimal); 1 FTE IC medical technician for hospitals with 300–499 beds (optimal)

1 dedicated full-time IC nurse per 200 beds (basic) or per 150 beds (optimal)n

1 qualified IC doctor per 300 beds

1 dedicated full-time certificated IC nurse (at > 0.8 FTE)p

1 part-time IC doctor (at > 0.5 FTE)

1 part-time IC medical technician and 1 part-time pharmacist (at > 0.5 FTE)

Additional manpower for antimicrobial stewardshipp

Healthcare-associated infection data provided

 Site-specific HAIs

UTI, BSI, HAP: episode per 1000 patient-day

UTI, BSI, HAP: episode per 1000 patient-day

UTI: episode per 1000 patient-day

 Device-associated HAIs

CAUTI, CLABSI, VAP: episode per 1000 device-day

CAUTI, CLABSI, VAP: episode per 1000 device-day

CLABSI, VAP: episode per 1000 patient-day

 Causative pathogens

Top 10 of the most common pathogens

99% of all the causative pathogens

Top 5 of the most common pathogensq

 Antimicrobial-resistant pathogens

MRSA, VRE, CRAB, CRPA, CRE, CREC, CRKP

MRSA, VRE, IRAB, IRPA, CefR-KP, CipR-KP, CefR-EC, CipR-EC

MRSA

  1. Abbreviations: BSI bloodstream infections, CAUTI catheter-associated urinary tract infection, CefR-EC cefotaxime-resistant Escherichia coli, CefR-KP cefotaxime-resistant Klebsiella pneumoniae, CipR-EC ciprofloxacin-resistant E. coli, CipR-KP ciprofloxacin-resistant K. pneumoniae, CLABSI central line-associated bloodstream infections, CRAB carbapanem (imipenem or meropenem)-resistant Acinetobacter baumannii, CRE carbapanem (imipenem, meropenem, or ertapenem)-resistant Enterobacteriaceae, CREC carbapanem (imipenem, meropenem, or ertapenem)-resistant E. coli, CRKP carbapanem (imipenem, meropenem, or ertapenem)-resistant K. pneumoniae, CRPA carbapanem (imipenem or meropenem)-resistant Pseudomonas aeruginosa, FTE full-time equivalent, GDP gross domestic product, HAI Healthcare-associated infections, HAP hospital-acquired pneumonia, IC infection control, IRAB imipenem-resistant A. baumannii, IRPA imipenem-resistant P. aerugonisa, MRSA methicillin-resistant Staphylococcus aureus, MSSA methicillin-susceptible S. aureus, UTI urinary tract infections, VAP ventilator-associated pneumonia, VRE vancomycin-resistant enterococci (Enterococcus faecalis or E. faecium)
  2. a2014 data
  3. bData retrieved from http://www1.stat.gov.tw/ct.asp?xItem=15408&CtNode=4692&mp=3. Assessed 14 April 2018.
  4. cData retrieved from https://data.worldbank.org/country/korea-rep. Assessed 14 April 2018
  5. dData retrieved from https://data.worldbank.org/country/japan?view=chart. Assessed 14 April 2018
  6. eData retrieved from World Bank Country and Lending Groups at https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups. Accessed 10 September 2018. For the current 2019 fiscal year, high-income economies are those with a gross national income per capita, calculated using the World Bank Atlas method of $12,056 or more
  7. f2016 data. Raw data NT dollars 17,152,093 million, converted to US dollars by ratio 30:1. Retrieved from https://www.mohw.gov.tw/lp-3781-2.html. Accessed 10 September 2018
  8. g2017 data based on World Bank national accounts data, and Organization for Economic Co-operation and Development (OECD) National Accounts data. Retrieved from https://data.worldbank.org/indicator/NY.GDP.MKTP.CD. Accessed 10 September 2018
  9. h2017 data based on Organization for Economic Co-operation and Development (OECD) estimated data for Japan and provisional data for Korea. Retrieved from https://stats.oecd.org/Index.aspx?DataSetCode=SHA. Accessed 10 September 2018
  10. iData retrieved from https://www.mohw.gov.tw/dl-40542-045687b7-aa43-458c-ab70-e8ff24c5b1b3.html. Accessed 10 September 2018
  11. jData retrieved from http://kosis.kr/eng/statisticsList/statisticsList_01List.jsp?vwcd=MT_ETITLE&parentId=D#SubCont. Accessed 10 September 2018
  12. kData retrieved from http://www.mhlw.go.jp/english/database/db-hh/2-2.html. Accessed 10 September 2018
  13. lThe data for Taiwan included medical centers and regional hospitals, which were classified according to hospital accreditation and covered only acute care hospitals
  14. mThe hospital coverage rate was calculated as the number of participating hospitals divided by the total number of hospitals in the same year in each country. The hospital participation rate was calculated as the number of participating hospitals divided by the total number of hospitals to be enrolled in each surveillance system
  15. nIn terms of surveillance, the requirement for participation in KONIS was 1 full-time infection control nurse over 200-bed size hospital. Regarding the mandatory personnel requirement, this regulation has been launched as a financial incentive program since 2016, as described in Additional file 2: Table S2
  16. oData available at https://www.cdc.gov.tw/professional/info.aspx?treeid=beac9c103df952c4&nowtreeid=bd387fa55fef03f0&tid=FED32554F2B55D11. Accessed September 10, 2018
  17. pInfection prevention and control incentive through reimbursement policies was revised in 2010, 2012 and 2018, as described in Additional file 2: Table S2. Since 2012, each hospital is reimbursed 1000 JPY (about 10 USD) per patient per admission if it fulfills the Ministry of Health, Labor and Welfare requirements which mandated one dedicated full-time certificated ICN (at > 0.8 FTE), one part-time ICD (at > 0.5 FTE), one part-time IC pharmacist and one part-time medical technician/microbiologist (at > 0.5 FTE). Since 2018, reimbursement policies per admission included three parts. It provides 3900 JPY (about 39 USD) per admission for infection prevention and control incentive at a major hospital, or 1000 JPY for a small hospital. Additional 1000 JPY was reimbursed if this hospital participates a local IPC network incentive. Another 1000 JPY was reimbursed for AS incentive. For hospitals with AS incentive, it mandates the following manpower in addition to 2012 requirements: one part-time doctor mainly for AS (at > 0.5 FTE), one full-time ICP either a certificated ICN or IC pharmacist or medical technician
  18. qMRSA and MSSA are listed as separate pathogens
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Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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