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A statistical information site that deepens the understanding of AMR (drug resistance) and one health

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Trend surveillance of antimicrobial-resistant Mycobacterium tuberculosis

1) Overview

A registered tuberculosis patient information system is a part of NESID including: new tuberculosis patients and latent tuberclosis patients who are registered from January 1 to December 31 of a registration year; and all tuberculosis patients who are registered as of December 31 of the calender year. In principle, information in this system pertains to tuberculosis patients, and focuses on the number of incidence case and incidence rate, the number of patients with tubercosis, treatment status, the number of deaths from tuberculosis, and so on. Information regarding tuberculosis bacillus as the causal bacteria is limited to the smear positive ratio, the number of culture-positive patients, drug- susceptibility testing data, and so on. Though limited, this report exclusively provides routine national information regarding antimicrobial-resistant tuberculosis bacillus.

2) Survey methods

Based on the registered tuberculosis patient information, the results of drug-susceptibility testing in newly registered patients with culture-positive pulmonary tuberculosis are aggregated. The entry of this information item used to be optional, before the Ordinance for the Partial Revision of the Enforcement Regulation of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases (MHLW Ordinance No. 101 of 2015, effective May 21, 2015) added "the results of drug-susceptibility testing" under "Conditions of disease" in Item 4, Paragraph 1, Article 27-8.

3) System

When physicians diagnose and report a tubercolosis case to Public Health Center collect, corresponding public health nurses collect detailed information from patients and physicians. Drug-susceptibility testing data are considered to be collected mostly from hospital and commercial laboratories. Those individual data are entered by Public Health Centers across Japan into NESID.

4) Prospect

The surveillance based on the registered tuberculosis patient information system contains the susceptibility results of newly registered patients with culture-positive pulmonary tuberculosis, as reported from all medical institutions. Therefore, data are considered nationally representative. Improvement in the entry rate of drug-susceptibility testing results (approximately 75% at present); the establishment of a system for nationwide quality assurance for drug- susceptibility testing; and the quality control of data entry are warranted.