第24回日本臨床微生物学会総会 本日の講演内容 教育講演 「 …

1 1 E-mail: 2013 2 2 24 I (BC) (BC , 9 Helicobacter cinaedi9 Campylobacter fetus9 Campylobacter lari9 Anaerobiospirillumsucciniciproducens9 Desulfovibrio desulfuricans9 Brachyspira pilosicoliHelicobacter cinaediHelicobacter cinaediHelicobacter cinaedi 2 Helicobacter cinaedi9 9 4 10 ), 9 9 ( )9 , 9 Campylobacter fetusCampylobacter fetus 9 , , ( , , )942 C 9 CET(S),NA(R) 9 , , , 9 , 36 5 2315g 12 39 (WBC31,300/ l 18,816/mm3 685mg/dl 3mg/dl) ABPC CTX MEPM 13 17 MRI 24 12 23 MRI T1 senseGd 3 Campylobacter lari 3D 2 * 2 4 BACTEC)

2 Campylobacter lari Anaerobiospirillum succiniciproducens Anaerobiospirillum succiniciproducensDesulfovibrio desulfuricans MBDesulfovibrio desulfuricansMB 4 4 Brachyspira pilosicoliBrachyspira pilosicoli9 9 9 9 , , (+)9 , ( )9 6 15 9 , 9 Brachyspira pilosicoli KK 1,500 -1,000 -500 -400 -300 -200 -100 -(bp)PCR Brachyspira DNA M F1 F2 N F1 F2 N M F1 F2 N F1 F2 NF1: DNA 2 F2: DNA 50 N: M: Molecular size marker40 Cycles, Sample DNA;5 l,Reaction mix; 50 l K 823-bp( )198-bp( )354-bp( )655-bp( ) hyodysenteriaeB.

3 PilosicoliLawsonia intracellularis H. cinaedi C. fetus C. jejuni C. lariD. desulfuricansA. succinici-producensB. pilosicoli / w ( ) C. upsaliensis w 5 9 Leptotrichia trevisanii9 Streptobacillus moniliformis9 Capnocytophaga canimorsusLeptotrichia trevisaniiBacT/ alert SN 38h Leptotrichia trevisanii Leptotrichia trevisaniiLeptotrichia buccalis Leptotrichia trevisaniiLeptotrichia sp. 6 Streptobacillus moniliformisStreptobacillus moniliformisStreptobacillus moniliformisStreptobacillus moniliformis 45.

4 ER . 2 IV .4 , , . 38 C , , , , , . BACTEC BD 92F 93F 2 4 , 93F 2 , , 5 8 CO2, . , P-108 Streptobacillus moniliformis720 rat bite fever ABPC Streptobacillus moniliformis Streptobacillus moniliformis8 Capnocytophaga canimorsus9 (CO2 )9 9 , SC 9 9 / ( 30%)9 , , , 9 9 03-5285-1111 2622 X 44 , 2008 11 3 , , K Capnocytophaga canimorsusCapnocytophaga canimorsusC.

5 CanimorsusC. canimorsusC. C. cynodegmicynodegmiC. C. ochraceaochraceaC. C. sputigenasputigenaC. C. gingivalisgingivalisC. C. granulosagranulosaC. C. haemolyticahaemolyticaC. C. leadbetterileadbetteri Capnocytophaga 9 Capnocytophaga sputigena 9 Mycobacterium ulcernas9 Corynebacterium kroppenstedtii9 Actinomyces odontolyticus9 Streptococcus gallolyticus9 Bordetella holmesii9 Bartonella quintana9 Cardiobacterium valvalmMycobacterium ulcerans9 ( 6 10W)9 25 32 C9 (Buruli )9 DDH M. marinum 9 M. shinshuense M. ulcerans 9 ) 9 CAM+REP+LVFX?

6 2007 5 9 2003 , , 2007 5 , (73 ) 8 25 C35 C1046 2008 12 46 2009 6 31 2008 2 31 2008 3 11 2010 4 13 2010 3 50 2010 3 (8 )2011 1 M. marinumM. ulceransM. marinum(15 M. ulcerans(30 Corynebacterium kroppenstedtii9 (1998 )9 2 4 9 ( )9 9 (1% Tween20/80 )9 ( )9 Corynebacterium kroppenstedtii 35 C 72h CO2 API Coryne , 2040104 (C. argentoratense, % ID , T ) 11 HK RS) TSAII 10 Actinomyces odontolyticus Ex-smoker 10 15 35 14 1 22 4 4 3 38 167cm 53kg C 123/75mmHg 100/ SpO 94% (68 ) X H22/4/4) H22/7/15) CT H22/4/6)

7 121,500 -1,000 -600 -500 -400 -300 -200 -(bp)PCR LaneS: DNA N: M: Molecular size marker40 Cycles, Sample DNA;5 l,Reaction mix; 50 l675-bp (16S rRNA )M N S >gi|12641603|emb| |Actinomyces odontolyticus16S rRNA gene, strain CCUG 34689 Identities = 614/619 ( )TGGCTGAGTGCGGTAGGGGAGACTGGAACTCCTGGTGTA GCGGTGGAATGCGCAGATATCAGGAAGAACACCGGTGGCG AAGGCGGGTCTCTGGGCCGTTACTGACGCTGAGGAGCGAA AGCGTGGGGAGCGAACAGGATTAGATACCCTGGTAGTCCA CGCTGTAAACGTTGGGCACTAGGTGTGGGGGCCACCCGTG GTTTCTGCGCCGTAGCTAACGCTTTAAGTGCCCCGCCTGG GGAGTACGGCCGCAAGGCTAAAACTCAAAGGAATTGACGG GGGCCCGCACAAGCGGCGGAGCATGCGGATTAATTCGATG CAACGCGAAGAACCTTACCAAGGCTTGACATGCACGGCGG CGCTGCAGAGATGTGGTGGCATTTGGTTGGTCGTGTGCAG GTGGTGCATGGTTGTCGTCAGCTCGTGTCGTGAGATGTTG GGTTAAGTCCCGCAACGAGCGCAACCCTTGCCCTATGTTG CCAGCACGTTGTGGTGGGGACTCGTGGGGGACTGCCGGGG TTAACTCGGAGGAAGGTGGGGATGACGTCAAATCATCATG CCCCTTATGTCTTGGGCTTCACGCATGCTACAATGGTTGG TACAGAGGGTTGCGATATCGTGAGMT Vol.

8 40 (2):193-199, 2012 8, ( GA 37W5d,NVD,AP9/9,BBW 3092g) 18 9 1 Bartholomew&Mittwer 1000 1000 -streptococcus 2 rapid ID 32 STREP 626447014 id T Streptococcus bovisII 2006 Streptococcus gallolyticussubsp. pasteurianus 2007 Vitek2 : excellent identification Streptococcus gallolyticussubsp. pasteurianus16S RNA Streptococcus gallolyticussubsp. pasteurianus 13 Streptococcus gallolyticussubsp.

9 Pasteurianus9 (bovis group)9S. bovisbiotype II/292003 S. pasteurianus 9 Lancefield D NaCl 9 * , 9 *biotype I S. gallolyticussubsp. gallolyticusII/1 S. infantariusII/2 S. gallolyticussubsp. pasteurianas JCM 48:2247-2249, 2010 S. gallolyticus3 BTB BD 3 BD 3 14 1998 2005 2007 2008 2 5 2009 1 2 2 23% 2 5 MRI 2 9 70 , 31 PCR Lane V1: DNA V2: DNA 20 P: N: M.

10 Molecular size markerM V1 V2 P N V1 V2 P N V1 V2 P N V1 V2 P 1,500 -1,000 -500 -400 -300 -200 -100 -(bp)277 bp( )414 bp 70 , 298 bp Bartonellasp. (htrA)Bartonellasp. (16S rRNA)Bartonellasp. (pap31)16S rRNA 1,500 bp( )>gi|175866|gb| |ROCRR16 SABartonella quintana16S ribosomal RNAI dentities = 1410/1413 ( )AGAACGAACGCTGGCGGCAGGCTTAACACATGCAAGTCG AGCGCACTCTTTTAGAGTGAGCGGCAAACGGGTGAGTAAC GCGTGGGAATCTACCCATCTCTACGGAATAACACAGAGAA ATTTGTGCTAATACCGTATACGTCCCTCTGGGAGAAAGAT TTATCGGAGGTGGATGAGCCCGCGTTGGATTAGCTAGTTG GTGAGGTAAGGGCTCACCAAGGCGACGATCCATAGCTGGT CTGAGAGGATGATCAGCCACACTGGGACTGAGACACGGCC CAGACTCCTACGGGAGGCAGCAGTGGGGAATATTGGACAA TGGGGGCAACCCTGATCCAGCCATGCCGCGTGAGTGATGA AGGCCCTAGGGTTGTAAAGCTCTTTCACCGGTGAAGATAA TGACGTTAACCGGAGAAGAAGCCCCGGCTAACTTCGTGCC AGCAGCCGCGGTAATACGAAGGGGGCTAGCGTTGTTCGGA TTTACTGGGCGTAAAGCGCATGTAGGCGGATATTTAAGTC AGAGGTGAAATCCCAGGGCTCAACCCTGGAACTGCCTTTG ATACTGGATGTCTCGAGTGTGGAAGAGGTGAGTGGAATTC CGAGTGTAGAGGTAAAATTCGTAGATATTCGGAGGAACAC CAGTGGCGAAGGCGGCTCACTGGTCCATTACTGACGCTGA GGTGCGAAAGCGTGGGGAGCAAACAGGATTAGATACCCTG GTAGTCCACGCCGTAAACGATGAATGTTAGCCGTCGGGTG GTTTACTACTCGGTGGCGCAGCTAACGCGTTAAACATTCC GCCTGGGGAGTACGGTCGCAAGATTAAAACTCAAAGGAAT TGACGGGGGCCCGCACAAGCGGTGGAGCATGTGGTTTAAT TCGAAGCAACGCGCAGAACCTTACCAGCCCTTGACATCCC GATCGCGGAAGGTGGAGACACCCTCCTTCAGTTAGGCTGG ATCGGTGACAGGTGCTGCATGGCTGTCGTCAGCTCGTGTC GTGAGATGTTGGGTTAAGTCCCGCAACGAGCGCAACCCTC GCCCTTAGTTGCCATCATTAAGTTGGGCACTCTAGGGGGA CTGCCGGTGATAAGCCGAGAGGAAGGTGGGGATGACGTCA AGTCCTCATGGCCCTTACGGGCTGGGCTACACACGTGCTA CAATGGTGGTGACAGTGGGCAGCGAGACCGCGAGGTCGAG CTAATCTCCAAAAGCCATCTCAGTTCGGATTGCACTCTGC AACTCGAGTGCATGAAGTTGGAATCGCTAGTAATCGTGGA TCAGCATGCCACGGTGAATACGTTCCCGGGCCTTGTACAC ACCGCCCGTCACACCATGGGAGTTGGTTTTACCCGAAGGT GCTGTGCTAACCGCAAGGAGGCAGGCAACCACGGTAGGGT CAGCGACTGGGGTGAAGTCGV egetation( ) 72 , 1,500 -1,000 -500 -400 -300 -200 -100 -(bp)PCR Bartonella DNA M V1 N V1 N V1 NLane V1: DNA 5 N: M: Molecular size : :htrAI