薬剤耐性(AMR)対策アクションプラン - maff.go.jp

1 (AMR) National Action Plan on Antimicrobial Resistance 2016-2020 28 (AMR) (2016-2020) | 2 ..4 ..6 ..8 ..8 .. 11 AMR .. 12 (AMR) (2016-2020) .. 13 .. 13 .. 13 .. 15 .. 16 .. 19 .. 23 .. 24 .. 28 .. 30 .. 32 .. 34 .. 36 .. 37 .. 39 .. 41 .. 43.

2 44 .. 47 .. 50 .. 51 .. 53 (AMR) (2016-2020) | 3 .. 55 .. 57 .. 59 .. 61 .. 62 .. 64 .. 66 .. 67 .. 68 .. 68 .. 71 (AMR) (2016-2020) | 4 (Antimicrobial Resistance: AMR) 1928 1945 5 1940 1960 1980 (HAI) (MRSA) (VRE) (MDRP) (MDRA)

3 (WHO) 2011 2013 8 (G8 ) G 2014 (WHO) 2015 5 (AMR) 2 7 (G7 ) (WHO) 2016 (AMR) (2016-2020) | 5 (AMR) 2015 11 (AMR) 2015 9 11 AMR 27 12 24 2016 2 9 5 (AMR) (AMR) (2016-2020)

4 | 6 AMED Japan Agency for Medical Research and Development AMR Antimicrobial Resistance AMS Antimicrobial Stewardship AMU Antimicrobial Use ARG Antimicrobial-resistant Gene ARI Antimicrobial-resistant Infection ARO Antimicrobial-resistant Organism AST Antimicrobial Stewardship Team AUD Antimicrobial Use Density CAUTI Catheter-associated Urinary Tract Infection CCP Critical Control Point CDC Centers for Disease Prevention and Control CDI Clostridium difficile Infection CLABSI Central Line-associated Bloodstream Infection COI Conflict of Interest CRBSI Catheter-related Bloodstream Infection CRE Carbapenem-resistant Enterobacteriaceae DDD Defined Daily Dose DOT Days of Therapy DPC/PDPS Diagnosis Procedure Combination / Per-Diem Payment System ESBL Extended-spectrum beta-Lactamase EU European Union FAO Food and Agricultural Organization of the United Nations FETP-J Field Epidemiology Training Program Japan G7/G8 Group of Seven/Eight /8 GAIN Act Generating Antibiotics Incentives Now Act GCP Good Clinical Practice GHIT Fund Global Health Innovation Technology Fund GHSA Global Health Security Agenda GLASS Global Antimicrobial Resistance Surveillance System GloPID-R Global Research Collaboration for Infectious Disease Preparedness HACCP Hazard Analysis and Critical Control Point HAI Healthcare-associated Infection Hib Haemophilus influenzae type b b ICD Infection Control Doctor

5 ICH International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use EU ICT Infection Control Team ICU Intensive Care Unit IDES Infectious Disease Emergency Specialist (Training Program) IHR International Health Regulation IPC Infection Prevention and Control JACS Japan Antimicrobial Consumption Surveillance JANIS Japan Nosocomial Infections Surveillance JPIAMR Joint Programming Initiative on Antimicrobial Resistance JVARM Japanese Veterinary Antimicrobial Resistance Monitoring System (AMR) (2016-2020) | 7 MALDI-TOF MS Matrix-assisted Laser Desorption/Ionization Time Of Flight Mass Spectrometry MBL Metallo-beta-lactamase - - MDRA Multidrug-resistant Acinetobacter spp. MDRP Multidrug-resistant Pseudomonas aeruginosa MRC Medical Research Council MRSA Methicillin-resistant Staphylococcus aureus NCDs Non-Communicable Diseases NDB National Database for Prescription and National Health Check-up NESID National Epidemiological Surveillance of Infectious Disease NI Nosocomial Infection NICU Neonatal Intensive Care Unit NIH National Institutes of Health NTDs Neglected Tropical Diseases OECD Organisation for Economic Co-operation and Development OIE World Organisation for Animal Health PCR Polymerase Chain Reaction PCU Population-corrected Unit PHE Public Health Emergency PK/PD Pharmacokinetics/Pharmacodynamics PRSP Penicillin-resistant Streptococcus pneumonia SSI Surgical Site Infection TATFAR

6 Transatlantic Task Force on Antimicrobial Resistance UHC Universal Health Coverage VICH International Cooperation on Harmonisation of Technical Requirements for Registration of Veterinary Medicinal Products WAAW World Antibiotic Awareness Week WGS Whole Genome Sequencing WHO World Health Organization VAP Ventilator-associated Pneumonia VRE Vancomycin-resistant Enterococci VRSA Vancomycin-resistant Staphylococcus aureus (antimicrobials) (antibiotics) (AMR) (2016-2020) | 8 AMR 2010 1 2013 2 (EU) ( ) (MRSA) (PRSP) 3 (CRE) 3 4 1 Muraki Y, et al.

7 , Nationwide surveillance of antimicrobial consumption and resistance to Pseudomonas aeruginosa isolates at 203 Japanese hospitals in 2010. Infection. 2013; 41:415-23. 2 26 3 (JANIS) 4 ECDC AMR Surveillance report 2012, Muraki Y et. Infection. 2013; 41: 415-23. ( 2010 2013 ) 05101520253035 (AMR) (2016-2020) | 9 5 AMR ( ) 6 3 2014 3 ( ) 5 Antimicrobial Resistance.

8 Global report on Surveillance 2014, (WHO) 2014 6 0%20%40%60% 51% (%)0%20%40%60% 17% (%)0%20%40%60% 18% 3 (%)0%20%40% 48% (%) (AMR) (2016-2020) | 10 2013 7 * ** 2001-2014 8 7 25 JVARM , Animal Antimicrobial Resistance Annual Report 2013 (NARMS)

9 , Scientific Report of EFSA and ECDC EU Summary Report on Antimicrobial Resistance in Zoonotic and Indicator Bacteria from Humans, Animals and Food in 2013, DANMAP2013 - Use of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Food Animals, Food and Humans in Denmark 8 Report of the Japanese Veterinary Antimicrobial Resistance Monitoring System -2000 to 2007 Report of the Japanese Veterinary Antimicrobial Resistance Monitoring System -2008 to 2011- 0%40%80% % *0%40%80% 3 % 0%40%80% % **020406080100 (%) 3 (AMR) (2016-2020) | 11 (AMR) 1950 9 (NCDs) 1990 26 5 48 ( 26 5 49 ) 27 4 (AMED) (AMED) 26 7 1980 (MRSA) 1970 (MRSA)

10 1984 1987 58% 10 1996 4 2002 2004 2006 ( 18 84 ) 2000 JANIS 9 (1951 ) (1971 ) (1977 ) (1991 ) (1991 ) (1995 ) (2001 ) (2005 ) 10 , Methicillin resistant Staphylococcus aureus (MRSA) , . 2006; 13: 71-73. (AMR) (2016-2020) | 12 JANIS 2016 1 1859 (MRSA) (2009 ) (2014 ) 11 (OIE)