臨床婦人科産科75巻8号

2021年08月発行

今月の臨床 エキスパートに聞く 耐性菌と院内感染―産婦人科医に必要な基礎知識 産婦人科診療時に耐性菌が検出された際の対応

―【新生児】―NICU・新生児室での耐性菌対策

著者： 八木哲也¹

所属機関： ¹名古屋大学医学部附属病院中央感染制御部

ページ範囲：P.770 - P.776

●NICUでは，耐性菌対策においては，ゾーニングや環境管理のルール遵守が非常に難しい．

●CDCからMRSAを含む黄色ブドウ球菌対策のガイドラインが発出され，その概要を紹介した．

●近年NICUにおいても薬剤耐性グラム陰性菌が問題となってきており，今後感染対策や抗菌薬適正使用の知見の集積が望まれる．

参考文献

1）Zervou FN, et al : MRSA colonization and risk of infection in the neonatal and pediatric ICU : a meta-analysis. Pediatrics 133 : e1015-e1023, 2014

colonization and infection on neonates in intensive care units. Infect Control Hosp Epidemiol 31 : 177-182, 2010

infections in the neonatal intensive care unit : an observational cohort study. Infect Control Hosp Epidemiol 31 : 558-560, 2010

infection in neonatal intensive care units : data from the National Nosocomial Infections Surveillance System, 1995-2004. Pediatr Infect Dis J 28 : 577-581, 2009

5）Nübel U, et al : MRSA transmission on a neonatal intensive care unit : epidemiological and genome-based phylogenetic analyses. PLoS One 8 : e54898, 2013

nasal colonization in a level III neonatal intensive care unit : incidence and risk factors. Am J Infect Control 43 : 476-481, 2015

strains in the neonatal intensive care unit : an infection prevention and patient safety challenge. Clin Microbiol Infect 22 : 645.e1-645.e8, 2016

8）Li Q-F, et al : Impact of relocation and environmental cleaning on reducing the incidence of healthcare-associated infection in NICU. World J Pediatr 13 : 217-221, 2017

transmission and infection in a neonatal intensive care unit. Infect Control Hosp Epidemiol 40 : 1123-1127, 2019

10）Hensel KO, et al : Nursing staff fluctuation and pathogenic burden in the NICU -effective outbreak management and the underestimated relevance of non-resistant strains. Sci Rep 7 : 45104, 2017

infections in the neonatal intensive care unit. Infect Control Hosp Epidemiol 37 : 381-387, 2016

12）Popoola VO, et al : MRSA transmission and infections in a neonatal intensive care unit despite active surveillance cultures and decolonization―Challenges for infection prevention. Infect Control Hosp Epidemiol 35 : 412-418, 2014

infections in a level IV neonatal intensive care unit. J Perinatol 40 : 1644-1651, 2020

14）Pierce R, et al : Bacterial infections in neonates following mupirocin-based MRSA decolonization : a multicenter cohort study. Infect Control Hosp Epidemiol 38 : 930-936, 2017

on admission to neonatal intensive care units in Hong Kong : A cost-effectiveness analysis. Infect Control Hosp Epidemiol 33 : 1024-1030, 2012

16）Reich PJ, et al : Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit : an infection prevention and patient safety challenge. Clin Microbiol Infect 22 : 645.e1-645.e8, 2016

transmission in a Japanese neonatal intensive care unit. J Hosp Infect 84 : 66-70, 2013

on transmission to neonates in the intensive care unit. A randomized clinical trial. JAMA 323 : 319-328, 2020

19）Giuffrè M, et al : The increasing challenge of multidrug-resistant gram-negative bacilli. Results of a 5-year active surveillance program in a neonatal intensive care unit. Medicine（Baltimore） 95 : e3016, 2016

20）Tsai M-H, et al : Clinical and molecular characteristics of neonatal extended-spectrum β-lactamase-producing gram-negative bacteremia : A 12-year case-control-control study of a referral center in Taiwan. PLoS One 11（8）: e0159744, 2016

21）Stapleton PJM, et al : Outbreaks of extended spectrum beta-lactamase producing Enterobacteriaceae in neonatal intensive care units : a systematic review. Arch Dis Child Fetal Neonatal Ed 101 : F72-F78, 2016

22）Tsai M-H, et al : Risk factors and outcomes for multidrug-resistant gram-negative bacteremia in the NICU. Pediatrics 133 ; e322, 2014

23）Kitano T, et al : A simple and feasible antimicrobial stewardship program in a neonatal intensive care unit of a Japanese community hospital. J Infect Chemother 25 : 860-865, 2019