About JANIS
As written in our open-access review, Japan Nosocomial Infections Surveillance (JANIS) is a national surveillance program organized by the Ministry of Health, Labour and Welfare (MHLW) of Japan designed to provide basic information on the incidence and prevalence of nosocomial infections and antimicrobial-resistant bacteria in Japanese medical settings. JANIS was launched in 2000 with three divisions: the clinical laboratory (CL) division, antimicrobial-resistant bacterial infection (ARBI) division, and intensive care unit (ICU) division. Subsequently, two more divisions, the surgical site infection (SSI) and neonatal intensive care unit (NICU) divisions, were added in 2002. Further system renewal in 2007 allowed for dealing with all surveillance data online.
Although participation in JANIS is on a voluntary basis, there are currently more than 2,000 hospitals across Japan that are members of our surveillance system, enabling us to provide representative nation-level epidemiological data on nosocomial infections and antimicrobial-resistant bacteria.
The Five divisions of JANIS
JANIS consists of five divisions, and hospitals can choose which divisions to join, based on their need and capacity. In particular, the JANIS Clinical Laboratory (CL) division collects comprehensive specimen-based data from diagnostic microbiology laboratories of participating hospitals to monitor the isolation rate of 11 major bacteria and specific AMR bacteria, and creating antibiograms of approximately 20 bacterial species. Data in the JANIS web-database system are also annually tabulated and provided to the WHO Global Antimicrobial Resistance Surveillance System (GLASS).
Organization and Management
JANIS member hospitals
JANIS is a voluntary program, and there are neither legal obligations nor financial support for participation. Calls for participation are made on an annual basis and the list of JANIS member hospitals is available on the JANIS website. The number of hospitals participating in the JANIS Clinical Laboratory division has continued to increase, and as of February 2020, there were 2223 member hospitals, which account for more than 25% of all hospitals throughout the country.
Number of JANIS member hospitals by division as of February 2020
| division | Clinical Laboratory | Antimicrobial-Resistant Bacterial Infection | Surgical Site Infection | Intensive Care Unit | Neonatal Intensive Care Unit |
|---|---|---|---|---|---|
| No. of participating hospitals | 2223 | 958 | 885 | 181 | 117 |
Management of the JANIS system
JANIS is a project of the Guidance of Medical Service division in the Ministry of Health, Labour and Welfare of Japan. The JANIS management office is located in Antimicrobial Resistance Research Center in the National Institute of Infectious Diseases. The JANIS management office works on practical issues related to surveillance with the data management contractor.
The JANIS management committee consists of eight experts in associated fields such as hospital epidemiology, clinical infectious disease, surgical site infection, clinical laboratory medicine, and antimicrobial resistance. The committee reviews data collected by JANIS (e.g. annual report) and makes recommendations for improving the surveillance system.
Surveillance data and feedback information
JANIS member hospitals are required to submit surveillance data monthly, or once to twice a year, depending on division participation. Hospitals that do not submit surveillance data for a certain period of time are asked to withdraw from the surveillance program. The JANIS system provides two types of information, Open Report and Feedback Report.
| division | Clinical Laboratory | Antimicrobial-Resistant Bacterial Infection | Surgical Site Infection | Intensive Care Unit | Neonatal Intensive Care Unit | |
|---|---|---|---|---|---|---|
| Frequency of reporting | monthly | monthly | semi-annually | semi-annually | annually | |
| JANIS Open Report (for public) |
Monthly | | | | | | | | | | |
| Semi-annually | | | | | | | | | |
| Annually | | | | | | |
| JANIS Feedback Report (for member hospitals) |
Monthly | | | | | | | | |
| Semi-annually | | | | | | | | | |
| Annually | | | | | | |
- JANIS Open Report
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The goal of the JANIS Open Report is to provide national data on the incidence of nosocomial infections and the prevalence of drug-resistant bacteria in Japan. The Open Report is publicly available on the JANIS website.
- JANIS Feedback Report
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The Feedback Report is provided only to JANIS member hospitals that have submitted surveillance data. Each JANIS member hospital can access only its own Feedback Report, which consist of summaries on the incidence and prevalence of nosocomial infections or drug-resistance in each respective institution. JANIS member hospitals are expected to evaluate their infection control strategies using this Feedback Report. To facilitate this evaluation, the Feedback Report has figures on each institution's data plotted within box-plot graphs of all JANIS member hospital data.
