MRSA感染症 治療ガイドライン - chemotherapy.or.jp

1 MRS A MRSA 2017 MRSA 2017 .indd 12017/05/22 14:35:42 MRSA MRSA 2017 MRSA IV / MSD

2 Meiji Seika MRSA 2013 MRSA 2014 8 MRSA 2014 2 MRSA 2016 AMR MRSA MRSA MRSA MRSA MRSA 2015 MRSA MRSA MRSA ABKarbekacin DAPdaptomycin LZDlinezolid TEIC teicoplanin VCMvancomycin AZTaztreonam

3 CEZcefazolin CLDM clindamycin DOXY doxycycline FAfusidic acid FOMfosfomycin FRPM faropenem GMgentamicin LVFX levofloxacin MINO minocycline MUPmupirocin NDFX nadifloxacin NFPC nafcillin QPR/DPRquinupristin/dalfopristin / RFPrifampicin SBT/ABPC sulbactam/ampicillin / STsulfamethoxazole-trimethoprim TCtetracycline TGCtigecycline TOBtobramycin ABUasymptomatic bacteriuria AUCarea under the blood concentration time curve BALbronchoalveolar lavage CA-MRSA community acquired MRSA MRSACDCC enters for Disease Control and Prevention CLSIC linical and Laboratory Standards Institute CNScoagulase negative staphylococcus COPDC hronic Obstructive Pulmonary Disease COREThe Cubicin Outcomes Registry and Experience CPISC linical pulmonary infection score cSSTI complicated skin and soft tissue infection ETexfoliative toxin MRSA EUCASTE uropean Committee on Antimicrobial Susceptibil-ity Testing HA-MRSA hospital-acquired methicillin-resistant Staphylococ-cus aureus MRSAHCAPH ealthcare Associated Pneumonia IDSAI nfectious Diseases Society of America JANISJ apan Nosocomial Infection Surveillance JHAISJ apan Healthcare Associated Infections SurveillanceLA-MRSA livestock-associated

4 MRSA MRSAMIC minimal minimum inhibitory concentrationminimally inhibitory concentration MRCNS methicillin-resistant coagulase negative staphylococci MRSA methicillin-resistant Staphylococcus aureus MRSE methicillin-resistant Staphylococcus epidermidis MSSA methicillin-susceptible Staphylococcus aureus NHCAPN ursing and Healthcare Associated Pneumonia NTEDN eonatal TSS-like Exanthematous Disease TSS PCRpolymerase chain reaction PSBprotected specimen brush PVLP anton-Valentine leukocidin SIRS systemic inflammatory response syndrome SSIsurgical site infections SSSSS taphylococcal Scalded Skin Syndrome TSST-1toxic shock syndrome toxin 1 1 VAPventilator-associated pneumonia VISA vancomycin-intermediate resistant Staphylococcus aureus A I1 B II C III MRSA I MRSA a.

5 1b ..5II MRSA ..13 III MRSA ..16IV MRSA ..20V MRSA ..25VI MRSA a ..32b ..39c ..44d 1 ..49 2 ..58e ..65f ..70g ..87h ..95i ..100j ..108k ..115 VII MRSA TDM ..118 1 a VCM ..124b TEIC ..125c ABK ..128d LZD ..130e DAP ..132 MRSA I MRSA 1 MRSA methicillin-resistant Staphylococcus aureus 2 MRSA MRSA MRSA CA-MRSA community-acquired MRSA MRSA 3 MRSA MRSA 50 4 MRSA 5 CA-MRSA 6 CA-MRSA USA300 7 CA-MRSA PVL Panton-Valentine leukocidin Literature review MRSA 50 70 MRSA 1

6 JANIS MRSA Executive summaryI 1 MRSA 10 10 2 JANIS 2014 1 MRSA MRSA / 100 MRSA 3 MRSA VAP 3 MRSA MRSA 4 5 MRSA hospital-associated methicillin-resis-tant S. aureus HA-MRSA community-acquired methicillin-re-sistant S. aureus CA-MRSA MRSA LA-MRSA livestock-associated MRSA LA-MRSA HA-MRSA CA-MRSA MRSA HA-MRSA MRSA CA-MRSA 1 SCCmec I II III HA-MRSA IV V CA-MRSA SCCmec MRSA CA-MRSA HA-MRSA CA-MRSA I 1.

7 MRSA HA-MRSA CA-MRSA MRSA MRSA SCCmec type II type I, III type IV type V NewYork/JapanUSA300 PVL 2 MRSA 6 CA-MRSA HA-MRSA CA-MRSA 7 8 CA-MRSA 9 USA300 Panton-Valentine leukocidin PVL 10 USA300 CA-MRSA PVL 11 14 10 30 MRSA MRSA HA-MRSA CA-MRSA 15 1 2014 2015 (clsi2012).

8 Pdf2 Tanihara S, Suzuki S: Estimation of the incidence of MRSA patients: evaluation of a surveillance system using health insurance claim data. Epidemiol Infect 2016 144: 2260-73 2014 2015 Enomoto Y, Yokomura K, Hasegawa H, Ozawa Y, Matsui T, Suda T: Healthcare-associated pneumonia with positive respira-tory methicillin-resistant Staphylococcus aureus culture: Predictors of the true pathogenicity. Geriatr Gerontol Int 2016 Feb 5 [Epub ahead of print]5 Nagaoka K, Yanagihara K, Harada Y, Yamada K, Migiyama Y, Morinaga Y, et al: Predictors of the pathogenicity of methicil-lin-resistant Staphylococcus aureus nosocomial pneumonia. Respirology 2014; 19: 556-626 Montravers P, Snauwaert A, Welsch C: Current guidelines and recommendations for the management of skin and soft tissue infections.

9 Curr Opin Infect Dis 2016; 29: 131-87 Yamaguchi T, Nakamura I, Chiba K, Matsumoto T: Epidemiological and microbiological analysis of community-associated methicillin-resistant Staphylococcus aureus strains isolated from a Japanese hospital. Jpn J Infect Dis 2012; 65: 175-88 Inomata S, Yano H, Tokuda K, Kanamori H, Endo S, Ishizawa C, et al: Microbiological and molecular epidemiological analyses of community-associated methicillin-resistant Staphylococcus aureus at a tertiary care hospital in Japan. J Infect Chemother 2015; 21: 729-369 Karampela I, Poulakou G, Dimopoulos G: Community acquired methicillin resistant Staphylococcus aureus pneumonia: an update for the emergency and intensive care physician. Minerva Anestesiol 2012; 78: 930-4010 Glaser P, Martins-Sim es P, Villain A, Barbier M, Tristan A, Bouchier C, et al: Demography and Intercontinental Spread of the USA300 Community-Acquired Methicillin-Resistant Staphylococcus aureus Lineage.

10 MBio 2016; 7: e02183-1511 Mine Y, Higuchi W, Taira K, Nakasone I, Tateyama M, Yamamoto T, et al: Nosocomial outbreak of multidrug-resistant USA300 methicillin-resistant Staphylococcus aureus causing severe furuncles and carbuncles in Japan. J Dermatol 2011; 38: 1167-7112 Yamaguchi T, Okamura S, Miura Y, Koyama S, Yanagisawa H, Matsumoto T: Molecular Characterization of Community-As-sociated Methicillin-Resistant Staphylococcus aureus Isolated from Skin and Pus Samples of Outpatients in Japan. Microb Drug Resist 2015; 21: 441-713 Uehara Y, Ito T, Ogawa Y, Hirotaki S, Shoji T, Tame T, et al: Molecular epidemiologic study of community-associated methicil-lin-resistant Staphylococcus aureus with Panton-Valentine leukocidin gene among family members in Japan.