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zoom RSS 新たな多剤耐性「超細菌」による感染が3州で見つかる/米国医療事情

<<   作成日時 : 2010/09/14 23:38   >>

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 驚くべき新たな遺伝子によりほとんどすべての抗生物質に抵抗力がある細菌による感染が3つの州で起きた。米国とカナダの全ての例が、インドで最近治療を受けた人たちである。この遺伝子は消化管や尿路の感染を起こす細菌に見つかっている。よくある細菌に入り込み広範な薬剤耐性を与え危険な「超細菌」を作り出す。
 米国では今年カリフォルニア、マサチューセッツ、イリノイで見つかり、3種類の細菌が関係し、3つの異なるメカニズムが遺伝子形成に関係している。
 カリフォルニアの女性はインドで自動車事故に巻き込まれ病院での治療が必要だった。イリノイの男性は持病があり尿道カテーテルを使っていて、インドを旅行する間に、遺伝子に感染したと考えられる。マサチューセッツのケースでは、癌の手術と化学療法を受け、米国に旅行に来たインドの女性がいた。
 効果的な治療法はあるだろうか? 何人かには1950-60年代に使われ腎障害がでるため評判が良くなかったポリミキシンが使用された。カナダの2症例には抗生物質の組み合わせを使用した。
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病院コンピューター入力機器の多剤耐性菌汚染/キーボード・マウス MRSA 緑膿菌 アシネトバクター
http://kurie.at.webry.info/201009/article_9.html
病院内携帯電話による多剤耐性アシネトバクター汚染/医療用PHS 多剤耐性菌
http://kurie.at.webry.info/201009/article_8.html
新たな超薬剤耐性菌の広がり NDM-1
http://kurie.at.webry.info/201009/article_4.html
駆血帯による院内感染の危険
http://kurie.at.webry.info/200708/article_22.html
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New Drug-Resistant Superbugs Found in 3 States
New gene that turns any bacteria into drug-resistant superbugs is found in 3 states, Canada
By MARILYNN MARCHIONE AP Medical Writer
BOSTON September 13, 2010 (AP)
http://abcnews.go.com/Health/Germs/wirestory?id=11626067
画像An infectious-disease nightmare is unfolding: Bacteria that have been made resistant to nearly all antibiotics by an alarming new gene have sickened people in three states and are popping up all over the world, health officials reported Monday.

The U.S. cases and two others in Canada all involve people who had recently received medical care in India, where the problem is widespread. A British medical journal revealed the risk last month in an article describing dozens of cases in Britain in people who had gone to India for medical procedures.

How many deaths the gene may have caused is unknown; there is no central tracking of such cases. So far, the gene has mostly been found in bacteria that cause gut or urinary infections.

Scientists have long feared this ― a very adaptable gene that hitches onto many types of common germs and confers broad drug resistance, creating dangerous "superbugs."

"It's a great concern," because drug resistance has been rising and few new antibiotics are in development, said Dr. M. Lindsay Grayson, director of infectious diseases at the University of Melbourne in Australia. "It's just a matter of time" until the gene spreads more widely person-to-person, he said.

Grayson heads an American Society for Microbiology conference in Boston, which was buzzing with reports of the gene, called NDM-1 and named for New Delhi.

The U.S. cases occurred this year in people from California, Massachusetts and Illinois, said Brandi Limbago, a lab chief at the Centers for Disease Control and Prevention. Three types of bacteria were involved, and three different mechanisms let the gene become part of them.

"We want physicians to look for it," especially in patients who have traveled recently to India or Pakistan, she said.

What can people do?

Don't add to the drug resistance problem, experts say. Don't pressure your doctors for antibiotics if they say they aren't needed, use the ones you are given properly, and try to avoid infections by washing your hands.

The gene is carried by bacteria that can spread hand-to-mouth, which makes good hygiene very important.
PHOTO A new superbug from India thought to be resistant to nearly every known antibiotic poses a global threat, scientists warned Monday, urging health authorities to track the bacteria.
An computer artwork depicting MRSA bacteria is shown. A new superbug from India thought to be resistant to nearly every known antibiotic poses a global threat, scientists warned Monday, urging health authorities to track the bacteria.
(PASIEKA/Getty Images)

It's also why health officials are so concerned about where the threat is coming from, said Dr. Patrice Nordmann, a microbiology professor at South-Paris Medical School. India is an overpopulated country that overuses antibiotics and has widespread diarrheal disease and many people without clean water.

"The ingredients are there" for widespread transmission, he said. "It's going to spread by plane all over the world."

The U.S. patients were not related. The California woman needed hospital care after being in a car accident in India. The Illinois man had pre-existing medical problems and a urinary catheter, and is thought to have contracted an infection with the gene while traveling in India. The case from Massachusetts involved a woman from India who had surgery and chemotherapy for cancer there and then traveled to the U.S.

Lab tests showed their germs were not killed by the types of drugs normally used to treat drug-resistant infections, including "the last-resort class of antibiotics that physicians go to," Limbago said.

She did not know how the three patients were treated, but all survived.

Doctors have tried treating some of these cases with combinations of antibiotics, hoping that will be more effective than individual ones are. Some have resorted to using polymyxins ― antibiotics used in the 1950s and '60s that were unpopular because they can harm the kidneys.

The two Canadian cases were treated with a combination of antibiotics, said Dr. Johann Pitout of the University of Calgary in Alberta, Canada. One case was in Alberta, the other in British Columbia.

Both patients had medical emergencies while traveling in India. They developed urinary infections that were discovered to have the resistance gene once they returned home to Canada, Pitout said.

The CDC advises any hospitals that find such cases to put the patient in medical isolation, check the patient's close contacts for possible infection, and look for more infections in the hospital.

Any case "should raise an alarm," Limbago said.

―――

Online:

Conference: www.icaac.org

Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


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新たな多剤耐性「超細菌」による感染が3州で見つかる/米国医療事情 医師の一分/BIGLOBEウェブリブログ
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