臨牀透析 Vol.17 No.8(2-5)


特集名 透析患者における感染症学 ---- 診断と治療の進歩
題名 特殊な病態における感染症 (5) 呼吸管理中の患者
発刊年月 2001年 07月
著者 大薗 英一 春日部秀和第二病院
著者 栗原 怜 春日部秀和病院腎臓内科
【 要旨 】 呼吸管理中の患者は肺炎を発症するリスクが高く,感染症を契機に呼吸管理が行われた場合を除き,呼吸管理下の感染対策の要点はいかに発症を防ぐかにある.感染予防のための伝播経路対策として,気道処置前に医療スタッフが手洗い・手袋の付け替えを遵守することに加え,吸引チューブなど気道処置に関わるものは無菌的に扱い,単回使用にすべきである.
また透析患者の場合,黄色ブドウ球菌などグラム陽性球菌による呼吸器感染症の頻度が高く,感染症発症前から咽頭・鼻腔等,上気道のコロニー対策を行うことも重要と考えられる.
Theme Infections Diseases in Hemodialysis Patients -- the Progress of Diagnosis and Therapy
Title The key to infection control for dialysis patients with respiratory assistance devices
Author Eiichi Osono Kasukabe Shuwa Second Hospital
Author Satoshi Kurihara Kasukabe Shuwa Hospital
[ Summary ] In diaysis patients, pneumonia is the leading cause of death and Staphylococcus aureus is the most common pathogen seen in respiratory tract infections. As seen in the guidlines from the Center for Disease Control and Prevention(CDC) for infection control, the hands of care workers are the vehicles of pathogens transmitted to infection sites. Hand washing, as well as changing non-steriled disposable gloves should be performed before each time care is given for tracheal tubes or internal origins. While S. aureus frequentry colonize surgical wounds and decubitus and sometimes colonize in the upper respiratory tract, eradication of the colonies with mupirocin ointment and 0.2% gentian violet may also be useful to prevent infections at their origin. Since adequate antibiotic therapy can reduce the mortality associated with bacterial infections, it is important to predict the development of pathogens with local epidemiology and individual data about colonized organisms before exact detection of infectious pathogens can be performed.
戻る