Neurological Surgery 脳神経外科34巻2号

2006年02月発行

症例

脳室腹腔短絡術後にバンコマイシン耐性腸球菌による髄膜炎を合併した2例

著者： 佐藤公俊¹ 岡秀宏¹ 宇津木聡¹ 清水曉¹ 鈴木祥生¹ 山田勝¹ 藤井清孝¹

所属機関： ¹北里大学医学部脳神経外科

ページ範囲：P.203 - P.207

Ⅰ．は じ め に

　腸球菌はヒトや動物の腸管の常在菌であり，健常人に対する病原性は必ずしも高くないが，易感染者のいる病院内では日和見感染症の起炎菌となり得る⁵⁾．

　さらにバンコマイシン耐性腸球菌（vancomycin resistant enterococci：VRE）感染症は現在のところ適切な治療薬がないため，一度感染症になると死亡率は高く，その感染予防対策は最重要課題のひとつとなっている⁵⁾．

　現在までに14例^6,15-18)のVRE髄膜炎例が報告されているが，それらの多くは脳神経外科手術後や抗生物質使用経験などをもつ院内感染である^6,15,16,18)．今回われわれは，日本ではまだ稀であるVRE感染により髄膜炎を合併した脳室腹腔短絡 （VPシャント）術後の2例を経験し，その感染の拡大を予防できたので，院内感染の予防方法を含め文献的考察を加え報告する．

参考文献

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