| 特集名 | CAPD出口部の新しいスキンケア | |
|---|---|---|
| 題名 | 総論 (1) 出口部感染の原因菌とその対策 | |
| 発刊年月 | 1997年 05月 | |
| 著者 | 中塩 哲士 | 聖マリアンナ医科大学内科学/臨床検査医学教室 |
| 【 要旨 】 | 慢性腎不全の治療法の一つに持続携行式腹膜透析(CAPD)が導入され治療効果，QOL の改善等の臨床的有用性が高いが，一方では出口部・トンネル感染，腹膜炎等の感染症が合併症として重要でドロップアウトの原因ともなっている．出口部からの微生物の付着・侵入・感染を制御するには宿主の易感染性状態をスコアー化し，出口部のステージ分類による早期診断，適切な対応が必要とされる．とくにヒト体内へ挿入・留置する医用器材表面でバイオフィルムが形成された場合，化学療法薬・生体内感染防御因子に対し高度の抵抗性を示し除去することが困難である．そのために微生物の付着・侵入しにくい素材，透析液，CAPDシステムおよび操作法の改善が望まれる． | |
| Theme | New Skin Care of Exit Site in CAPD | |
|---|---|---|
| Title | Exit-site infections in continuous ambulatory peritoneal dialysis patients | |
| Author | Satoshi Nakashio | Department of Internal Medicine and Laboratory Medicine, St. Marianna University School of Medicine |
| [ Summary ] | Exit-site infection and concomitant peritonitis have been the major complications and the most frequent cause of drop-out since continuous ambulatory peritoneal dialysis (CAPD) was introduced as an alternative for patients with end-stage renal failure. Gradual development in the innovation of catheters and devices to avoid ingress of microorganisms to the peritoneal cavity, at the intra-and periluminal level, was one of the elements that contributed to the morbidity and mortality of CAPD treatment. The use of medical devices has created serious problems related to nosocominal bacterial infections, since such devices are frequently colonized by various species of bacteria which form a biofilm. Within the biofilm glycocalyx, bacteria are shielded from antibiotics, antibodies and surfactants. Early diagnosis as well as early treatment of periluminal infection has the potential to decrease the frequency of peritonitis and exit-site infections. |
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