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市中呼吸器感染症における非定型病原体の疫学調査


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Title: 市中呼吸器感染症における非定型病原体の疫学調査
Other Titles: Epidemiological survey on frequency of involvement of atypical pathogens in respiratory infections in outpatients
Authors: 平潟, 洋一 / 渡辺, 彰 / 二木, 芳人 / 青木, 信樹 / 河野, 茂
Authors (alternative): Hirakata, Yoichi / Watanabe, Akira / Niki, Yoshihito / Aoki, Nobuki / Kohno, Shigeru
Issue Date: Jan-2006
Publisher: 日本化学療法学会 / Japanese Society of Chemotherapy
Citation: 日本化学療法学会雑誌, 54(1), pp.25-30; 2006
Abstract: 呼吸器感染症の初診時における,非定型病原体(Chlamydophila pneumoniae,Chlamydophila psittaci,Mycoplasma pneumoniae,Legionella pneumophila)の関与率を血清抗体価および尿中抗原検出により検討した。 2003年4月から6月に全国4地域(長崎,岡山,新潟,仙台)の開業医院59施設を呼吸器感染症(肺炎,気管支炎,咽頭・喉頭炎,扁桃炎)で受診した20歳以上の初診外来患者532症例を解析対象とした。 非定型病原体の血清抗体価が陽性であったのは532例中99例(19%)であり,陽性率の内訳はC. pneumoniae 70例(13.2%),C. psittaci 12例(2.3%),C. pneumoniaeとC. psittaciの混合感染8例(1.5%),M. pneumoniae 8例(1.5%),M. pneumoniaeとC. psittaciの混合感染1例(0.2%)であった。L. pneumophilaは全例で血清抗体価は陰性で,尿中抗原も陰性であった。また,各疾患における非定型病原体陽性率は肺炎19.2%(5/26例),気管支炎19.9%(36/181例),咽頭・喉頭炎18.6%(39/210例),扁桃炎22.2%(12/54例),その他疾患が重複している症例では11.5%(7/61例)であった。非定型病原体ごとの年齢分布に明らかな差はみられなかった。C. psittaciの陽性率が4%と従来の報告に比べて高かったが,患者年齢,地域に一定の傾向はみられず鳥類飼育者は21例中2例のみであった。 / The frequency of the involvement of atypical microorganisms (Chlamydophila pneumoniae, Chlamydophila psittaci, Mycoplasma pneumoniae, and Legionella pneumophila) at the initial consultation for respiratory infections (pneumonia, bronchitis, pharyngolaryngitis and tonsillitis) was investigated by determining the serum antibody titers and urinary antigen levels of patients. The subjects were the outpatients aged 20 years or over who had made an initial consultation for a respiratory infection. Five hundred thirty-two patients who visited 59 practitioner offices in 4 districts of Japan (Nagasaki, Okayama, Niigata, and Sendai) between April 2003 and June 2003 were analyzed. Atypical microorganism were present in 99 patients (19%). The rates of positivity for each microorganism were 15% for C. pneumoniae, 4% for C. psittaci, 2% for M. pneumoniae and 0% for L. pneumophila. None of the patients tested positive for the urinary antigen of L. pneumophila. The rates of positive patients with atypical microorganisms according to disease were 19% for pneumonia, 20% for bronchitis, 19% for pharyngolaryngitis and 22% for tonsillitis; the rate was 11% for patients with two of these diseases. No tendency was observed with regard to the age distribution. The rate of C. psittaci positivity (4%) was higher than in previous reports, but no definite tendencies for age or geographic area were seen. Only two of the 21 positive patients were bird breeders. One in five patients with respiratory infections who visited a clinical practitioner's office tested positive for atypical microorganisms. Treatment drugs with good cell penetration and that cover atypical microorganisms should be selected for the treatment of respiratory infections.
Keywords: atypical pathogen / respiratory infection / epidemiological study
URI: http://hdl.handle.net/10069/26667
ISSN: 13407007
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/26667

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