| 特集名 | 感染性腸炎 | |
|---|---|---|
| 題名 | ［各論］細菌感染と腸炎 (1) 2類感染症と腸炎 | |
| 発刊年月 | 2004年 07月 | |
| 著者 | 林 繁和 | 名古屋掖済会病院消化器科 |
| 【 要旨 】 | 2類感染症のうち腸管感染症として細菌性赤痢，コレラ，腸チフス，パラチフスをとりあげた．これらは環境衛生の改善により激減したが，近年では海外渡航者の増加により輸入感染症として注目されている．しかし国内の集団発生例も今なおみられ，輸入食品による事例も多い．細菌性赤痢やコレラは近年軽症化しており，診断には便培養が不可欠である．腸チフス，パラチフスは腸炎症状に乏しいが，不明熱と流行地への渡航歴があれば早めに便，血液，骨髄，胆汁からの培養を行う．治療には抗菌薬の投与が必要でTC，CP，ABPC，ST合剤などは耐性菌が増えておりニューキノロン系薬が第一選択薬であるが，最近，細菌性赤痢や腸チフスでニューキノロン低感受性菌が報告されているので注意したい． | |
| Theme | Infectious Enterocolitis | |
|---|---|---|
| Title | Second Category of Infectious Diseases and Enterocolitis | |
| Author | Shigekazu Hayashi | Department of Gastroenterology, Nagoya Ekisaikai Hospital |
| [ Summary ] | In this study, we investigated four intestinal infectious diseases, i. e., shigellosis, cholera, typhoid fever and paratyphoid fever, which are in the second category of infectious diseases. These diseases have markedly decreased in Japan because of improvements in public hygiene and are now attracting attention as imported infectious diseases, accompanied by an increase in the number of travelers going abroad. However, mass outbreaks of these diseases still occur in Japan. Many cases are also caused by imported food. Because the clinical symptoms of shigellosis and cholera have become milder, fecal culture tests are essential, and also, because typhoid fever and paratyphoid fever show little gastrointestinal symptoms, a suspected person who has a fever of unknown origin and a history of traveling abroad to an epidemic area must be tested for cultures in the feces, blood, bone marrow and bile as soon as possible. Antibacterials are used for the treatment of these diseases. However, the number of strains that are resistant to antibacterials, including tetracyclines, chloramphenicols, ampicillins, and sulfamethoxazole-trimethoprim combinations, are increasing, and recently, even strains of shigellosis and typhoid fever that have low sensitivity to new quinolones, the first choice agent for these diseases, have begun to be developed. |
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