上部消化管の内科的処置後に環境菌由来グラム陰性桿菌による菌血症を認めた2症例
上部消化管の内科的処置後に環境菌由来グラム陰性桿菌による菌血症を認めた2症例を経験した．症例1は頸部食道癌患者で胃管の挿入手技後にEnterobacter cloacaeによる菌血症を認めた．症例2は食道静脈瘤に対して内視鏡的静脈瘤結紮術および内視鏡的硬化療法の施行後に，それぞれE. cloacae, Asaia lannensisによる菌血症の2エピソードを認めた．上部消化管の内科的処置後に発熱や悪寒戦慄，血圧低下といった患者状態を認めたとき，真の菌血症を疑い血液培養を確実に採取した上で，抗菌薬の投与を検討する必要があると考えられた．...
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| Published in | 日本環境感染学会誌 Vol. 28; no. 2; pp. 109 - 113 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本環境感染学会
2013
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1882-532X 1883-2407 |
| DOI | 10.4058/jsei.28.109 |
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| Abstract | 上部消化管の内科的処置後に環境菌由来グラム陰性桿菌による菌血症を認めた2症例を経験した．症例1は頸部食道癌患者で胃管の挿入手技後にEnterobacter cloacaeによる菌血症を認めた．症例2は食道静脈瘤に対して内視鏡的静脈瘤結紮術および内視鏡的硬化療法の施行後に，それぞれE. cloacae, Asaia lannensisによる菌血症の2エピソードを認めた．上部消化管の内科的処置後に発熱や悪寒戦慄，血圧低下といった患者状態を認めたとき，真の菌血症を疑い血液培養を確実に採取した上で，抗菌薬の投与を検討する必要があると考えられた． |
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| AbstractList | 上部消化管の内科的処置後に環境菌由来グラム陰性桿菌による菌血症を認めた2症例を経験した．症例1は頸部食道癌患者で胃管の挿入手技後にEnterobacter cloacaeによる菌血症を認めた．症例2は食道静脈瘤に対して内視鏡的静脈瘤結紮術および内視鏡的硬化療法の施行後に，それぞれE. cloacae, Asaia lannensisによる菌血症の2エピソードを認めた．上部消化管の内科的処置後に発熱や悪寒戦慄，血圧低下といった患者状態を認めたとき，真の菌血症を疑い血液培養を確実に採取した上で，抗菌薬の投与を検討する必要があると考えられた． |
| Author | 曲渕, 裕樹 金子, ゆかり 永田, 正喜 永沢, 善三 草場, 耕二 福岡, 麻美 青木, 洋介 濱田, 洋平 |
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| References | 13) Mayhall CG, Lamb VA, Gayle WE, Haynes BW Jr.: Enterobacter cloacae septicemia in a burn center: epidemiology and control of an outbreak. J Infect Dis 1979; 139: 166–71. 8) Kato M, Kaise M, Obata T, Yonezawa J, Toyoizumi H, Yoshimura N, et al.: Bacteremia and endotoxemia after endoscopic submucosal dissection for gastric neoplasma: pilot study. Gastric Cancer 2012; 15(1): 15–20. 6) ASGE STANDARDS OF PRACTICE COMMITTEE, Banerjee S, Shen B, Baron TH, Nelson DB, Anderson MA, et al.: Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 2008; 67(6): 791–8. 17) Juretschko S, Bervers-May TK, Stovall SH: Nosocomial infection with Asaia lannensis in two paediatric patients with idiopathic dilated cardiomyopathy. J Med Microbiol 2010; 59: 848–52. 18) Abdel-Haq N, Savaşan S, Davis M, Asmar BI, Painter T, Salimnia H: Asaia lannaensis bloodstream infection in a child with cancer and bone marrow transplantation. J Med Microbiol 2009; 58: 974–6. 9) Lee TH, Hsueh PR, Yeh WC, Wang HP, Wang TH, Lin JT: Low frequency of bacteremia after endoscopic mucosal resection. Gastrointest Endosc 2000; 52(2): 223–5. 7) Itaba S, Iboshi Y, Nakamura K, Ogino H, Sumida Y, Aso A, et al.: Low-frequency of bacteremia after endoscopic submucosal dissection of the stomach. Dig Endosc 2011; 23: 69–72. 12) Wang CC, Chu ML, Ho LJ, Hwang RC: Analysis of plasmid pattern in pediatric intensive care unit outbreaks of nosocomial infection due to Enterobacter cloacae. J Hosp Infect 1991; 19: 33–40. 11) Cunha BA, Theoduris AC, Yannelli B: Enterobacter cloacae graft infection/bacteremia in a hemodialysis patient. Am J Infect Control 2000; 28: 181–3. 1) Seifert H: The clinical importance of microbiological findings in the diagnosis and management of bloodstream infections. Clin Infect Dis 2009; 48: S238–45. 10) 吉田眞一：腸内細菌科の細菌．吉田眞一，柳 雄介，吉開泰信編，戸田新細菌学第33版，南山堂，東京，2007, p. 531–62. 2) 大楠清文，江崎孝行：感染症診断における遺伝子解析技術の適応．日臨微誌 2008; 18(3): 163–76. 15) Johnson DH, Cunha BA: Infections in cirrhosis. Infect Dis Clin North Am 2001; 15(2): 363–71. 3) Chun J, Lee JH, Jung Y, Kim M, Kim S, Kim BK, et al.: EzTaxon: a web-based tool for the identification of prokaryotes based on 16S ribosomal RNA sequences. Int J Syst Evol Microbiol 2007; 57: 2259–61. 16) Yamada Y, Katsura K, Kawasaki H, Widyastuti Y, Saono S, Seki T, et al.: Asaia bogorensis gen. nov., sp. nov., an unusual acetic acid bacterium in the Alpha-Proteobacteria. Int J Syst Evol Microbiol 2000; 50: 823–9. 5) Malimas T, Yukphan P, Takahashi M, Kaneyasu M, Potacharoen W, Tanasupawat S, et al.: Asaia lannaensis sp. nov., a new acetic acid bacterium in the Alphaproteobacteria. Biosci Biotechnol Biochem 2008; 72(3): 666–71. 14) Black SR, Bonten MM, Weinstein RA: Enterobacteriaceae. In: Mayhall CG, ed. Hospital Epidemiology and Infection Control. 3rd ed. Lippincott Williams and Wilkins, Philadelphia, 2004, p. 545–74. 4) EzTaxon server 2.1 [Internet]. Jongsik Chun; c2007–10. Avaiable from: http://147.47.212.35:8080/index.jsp |
| References_xml | – reference: 18) Abdel-Haq N, Savaşan S, Davis M, Asmar BI, Painter T, Salimnia H: Asaia lannaensis bloodstream infection in a child with cancer and bone marrow transplantation. J Med Microbiol 2009; 58: 974–6. – reference: 16) Yamada Y, Katsura K, Kawasaki H, Widyastuti Y, Saono S, Seki T, et al.: Asaia bogorensis gen. nov., sp. nov., an unusual acetic acid bacterium in the Alpha-Proteobacteria. Int J Syst Evol Microbiol 2000; 50: 823–9. – reference: 4) EzTaxon server 2.1 [Internet]. Jongsik Chun; c2007–10. Avaiable from: http://147.47.212.35:8080/index.jsp – reference: 8) Kato M, Kaise M, Obata T, Yonezawa J, Toyoizumi H, Yoshimura N, et al.: Bacteremia and endotoxemia after endoscopic submucosal dissection for gastric neoplasma: pilot study. Gastric Cancer 2012; 15(1): 15–20. – reference: 10) 吉田眞一：腸内細菌科の細菌．吉田眞一，柳 雄介，吉開泰信編，戸田新細菌学第33版，南山堂，東京，2007, p. 531–62. – reference: 3) Chun J, Lee JH, Jung Y, Kim M, Kim S, Kim BK, et al.: EzTaxon: a web-based tool for the identification of prokaryotes based on 16S ribosomal RNA sequences. Int J Syst Evol Microbiol 2007; 57: 2259–61. – reference: 15) Johnson DH, Cunha BA: Infections in cirrhosis. Infect Dis Clin North Am 2001; 15(2): 363–71. – reference: 11) Cunha BA, Theoduris AC, Yannelli B: Enterobacter cloacae graft infection/bacteremia in a hemodialysis patient. Am J Infect Control 2000; 28: 181–3. – reference: 5) Malimas T, Yukphan P, Takahashi M, Kaneyasu M, Potacharoen W, Tanasupawat S, et al.: Asaia lannaensis sp. nov., a new acetic acid bacterium in the Alphaproteobacteria. Biosci Biotechnol Biochem 2008; 72(3): 666–71. – reference: 1) Seifert H: The clinical importance of microbiological findings in the diagnosis and management of bloodstream infections. Clin Infect Dis 2009; 48: S238–45. – reference: 12) Wang CC, Chu ML, Ho LJ, Hwang RC: Analysis of plasmid pattern in pediatric intensive care unit outbreaks of nosocomial infection due to Enterobacter cloacae. J Hosp Infect 1991; 19: 33–40. – reference: 9) Lee TH, Hsueh PR, Yeh WC, Wang HP, Wang TH, Lin JT: Low frequency of bacteremia after endoscopic mucosal resection. Gastrointest Endosc 2000; 52(2): 223–5. – reference: 17) Juretschko S, Bervers-May TK, Stovall SH: Nosocomial infection with Asaia lannensis in two paediatric patients with idiopathic dilated cardiomyopathy. J Med Microbiol 2010; 59: 848–52. – reference: 6) ASGE STANDARDS OF PRACTICE COMMITTEE, Banerjee S, Shen B, Baron TH, Nelson DB, Anderson MA, et al.: Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc 2008; 67(6): 791–8. – reference: 13) Mayhall CG, Lamb VA, Gayle WE, Haynes BW Jr.: Enterobacter cloacae septicemia in a burn center: epidemiology and control of an outbreak. J Infect Dis 1979; 139: 166–71. – reference: 2) 大楠清文，江崎孝行：感染症診断における遺伝子解析技術の適応．日臨微誌 2008; 18(3): 163–76. – reference: 7) Itaba S, Iboshi Y, Nakamura K, Ogino H, Sumida Y, Aso A, et al.: Low-frequency of bacteremia after endoscopic submucosal dissection of the stomach. Dig Endosc 2011; 23: 69–72. – reference: 14) Black SR, Bonten MM, Weinstein RA: Enterobacteriaceae. In: Mayhall CG, ed. Hospital Epidemiology and Infection Control. 3rd ed. Lippincott Williams and Wilkins, Philadelphia, 2004, p. 545–74. |
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| Snippet | 上部消化管の内科的処置後に環境菌由来グラム陰性桿菌による菌血症を認めた2症例を経験した．症例1は頸部食道癌患者で胃管の挿入手技後にEnterobacter cloacaeによる菌血症を認めた．症例2は食道静脈瘤に対して内視鏡的静脈瘤結紮術および内視鏡的硬化療法の施行後に，それぞれE. cloacae, Asaia... |
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| SubjectTerms | グラム陰性桿菌 上部消化管内視鏡検査 免疫抑制 菌血症 |
| Title | 上部消化管の内科的処置後に環境菌由来グラム陰性桿菌による菌血症を認めた2症例 |
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