| 特集名 | 透析患者における難治性感染症 -- 最新の診断と治療 | |
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| 題名 | 多剤耐性緑膿菌・腸球菌感染症 | |
| 発刊年月 | 2006年 02月 | |
| 著者 | 朝野 和典 | 大阪大学医学部附属病院感染制御部 |
| 【 要旨 】 | 多剤耐性菌は，多くの場合，院内感染として感染伝播するため，最善の治療は予防である．感染対策の基本は，標準予防策と接触感染予防策の徹底，適正抗菌薬使用と，医療器具の適切な消毒である．また，継続したサーベイランスも院内感染の状況を把握し，アウトブレイクを察知するために必要である． 透析患者では，迅速で適切な抗菌薬の選択が予後に関わる．抗菌薬治療は，薬剤感受性成績を参考に有効な薬剤を用いるが，耐性菌治療には十分な用量が必要で，薬剤の血中濃度のモニタリングを行うことが有効な治療に結びつく． |
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| Theme | Intractable Infection in Hemodialysis Patients -- Current Diagnosis and Treatment | |
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| Title | Multi-drug resistant Pseudomonas aeruginosa and Enterococci | |
| Author | Kazunori Tomono | Infection Control Team, School of Medicine, Osaka University |
| [ Summary ] | Mulin-drug resistant organisms tend to spread in healthcare settings, and the treatment for multi-drug resistant bacterial infections is prevention. The recommendations for preventing transmission of infectious agents in healthcare settings are the standard precautions, surveillance, judicious antimicrobial use and decontamination of medical equipment. As Pseudomonas aeruginosa and Enterococci are virulent organisms that are susceptible to only a limited number of antibiotic agents, infections caused by this organism are difficult to cure and often require combination therapy. The increasing resistance of P. aeruginosa and Enteroccoci are growing threats to the clinical management of health care associated infections. Prompt and intensive chemotherapy is recommended for hemodialysis patients, because their conditions will become more serious when treatment for infection is delayed. To achieve effective antimicrobial chemotherapy, it is necessary to use information from drug susceptibility tests and therapeutic drug monitoung (TDM). |
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