medicina52巻6号

2015年05月発行

特集 感染症診療　それ，ホント？ 入院編

グラム陽性球菌菌血症の場合，陰性確認の血液培養が必要ってホント？

著者： 関谷紀貴¹

所属機関： ¹がん・感染症センター都立駒込病院臨床検査科

ページ範囲：P.923 - P.925

ポイント
●グラム陽性球菌菌血症において，基本的には陰性確認の血液培養採取が勧められる．
●ただし，ルーチンの血液培養再検は避けて，患者ごとの丁寧なアセスメントに基づいて判断する．
●陰性確認の必要性は，感染性心内膜炎のリスク評価，治療期間の決定，治療方針の見直しの観点から考える．

参考文献

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2）Chu VH, et al：Emergence of coagulase-negative staphylococci as a cause of native valve endocarditis. Clin Infect Dis 46：232-242, 2008

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5）Mermel LA, et al：Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection；2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 49：1-45, 2009

6）Gould FK, et al：Guidelines for the diagnosis and antibiotic treatment of endocarditis in adults；A report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother 67：269-289, 2012

7）von Eiff C, et al：Pathogenesis of infections due to coagulase-negative staphylococci. Lancet Infect Dis 2：677-685, 2002

8）Cosgrove SE, et al：Management of methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis 46：S386-393, 2008