| 特集名 | 透析室の環境整備 -- 院内感染を含めて | |
|---|---|---|
| 題名 | ［各論］透析室の感染対策 -- 透析施設の全国アンケート調査より | |
| 発刊年月 | 2004年 07月 | |
| 著者 | 菊地 勘 | 東京女子医科大学第四内科 |
| 著者 | 秋葉 隆 | 東京女子医科大学血液浄化療法科 |
| 【 要旨 】 | 平成16年4月に日本透析医学会と日本透析医会は，血液透析患者が透析施設でC型肝炎ウイルス (HCV) に感染するおそれがあるとして，薬剤の管理の徹底などを求める緊急勧告を全国約3,500カ所の血液透析施設に送付し，注意を促した．厚生労働省の研究班の調査では，血液透析患者の年当りのHCV新規感染率は2.2％と驚くべき高率であり，一部施設で感染防御を徹底していないことが原因として，感染対策の重要性が指摘された．厚生労働科学研究費補助金で行われた，血液透析施設におけるC型肝炎感染事故 (含：透析事故) 防止体制の確立に関するアンケート結果によると，感染マニュアルの作成や委員会活動は行われているものの，感染症への認識や知識はまだまだ不十分であることがわかった． 血液透析患者のHCV感染者を放置すること，およびHCV感染者を増加させることは，患者の予後を悪化させる重大な行為であると同時に，病院運営にも影響する重大な行為であり，感染症対策は重要となる． |
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| Theme | Environmental Arrangements of Hemodialysis Room -- including In-hospital Infection | |
|---|---|---|
| Title | Prevention of infection in hemodialysis | |
| Author | Kan Kikuchi | Department of 4th Internal Medicine, Kidney Center, Tokyo Women's Medical University |
| Author | Takashi Akiba | Department of Blood Purification, Kidney Center, Tokyo Women's Medical University |
| [ Summary ] | The Japanese Association of Dialysis Physicians and the Japanese Society of Dialysis Therapy released an urgent bulletin to all dialysis facilities, (over 3500) in Japan, saying that dialysis patients were at high risk from the hepatitis C virus, and recommend complete management of drug use etc. in April of this year. In the investigation carried out by the research team sponsored by the Ministry of Health, Labor and Welfare, the prevalence HCV infection per year in dialysis patients was at a surprisingly high rate of 2.2%. This was mainly due to staffs not performing safe procedures in a limited number of facilities. The answers on the questionnaire for prevention of the hepatitis C infection and dialysis accidents, sponsored by the Ministry of Health, Labor and Welfare, indicated that the manual for prevention of hospital infections was in use and committees for hospital infection prevention were active. However, in hemodialysis facilities there was poor recognition and knowledge of the prevention of infectious diseases. The rates of hospital infection with HCV must be delt with. We also established guidelines the treatment of HCV infected dialysis patients who might lose their chances for kidney transplantation due to chronic liver infection. The prevention of hospital infection could contribute to the establishment of good facility quality and outcomes. |
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