臨床整形外科53巻2号

2018年02月発行

整形外科基礎

抗菌薬の濃度が浮遊生菌数とバイオフィルム形成に及ぼす影響

著者： 小関弘展¹ 依田周² 梶山史郎² 樋口隆志¹ 砂川伸也¹ 尾﨑誠²

所属機関： ¹長崎大学大学院医歯薬学総合研究科運動障害リハビリテーション学分野 ²長崎大学大学院医歯薬学総合研究科整形外科学

ページ範囲：P.151 - P.156

　生体金属材料が存在する環境において，抗菌薬の濃度が表皮ブドウ球菌の浮遊生菌数とバイオフィルム形成に与える影響を評価した．最小発育阻止濃度(MIC)以上のセファゾリンとバンコマイシンは，浮遊生菌数と生体金属材料表面のバイオフィルム被覆率を低下させた．しかし，MIC未満では浮遊生菌数は減少傾向を示したものの，バイオフィルムの範囲は拡大する傾向を示した．低濃度の抗菌薬は生体金属材料表面におけるバイオフィルム形成を促進するため，インプラント関連感染症を難治化させる要因となりかねない．

参考文献

1) Mack D, Davies AP, Harris LG, et al. Microbial interactions in Staphylococcus epidermidis biofilms. Anal Bioanal Chem 2007;387:399-408.

2) Kajiyama S, Tsurumoto T, Osaki M, et al. Quantitative analysis of Staphylococcus epidermidis biofilm on the surface of biomaterial. J Orthop Sci 2009;14:769-75.

3) Yang L, Liu Y, Wu H, et al. Combating biofilms. FEMS Immunol Med Microbiol 2012;65:146-57.

4) Stewart PS, Costerton JW. Antibiotic resistance of bacteria in biofilms. Lancet 2001;358:135-8.

5) Lewis K. Persister cells, dormancy and infectious disease. Nat Rev Microbiol 2007;5:48-56.

6) Arciola CR, Campoccia D, Speziale P, et al. Biofilm formation in Staphylococcus implant infections. A review of molecular mechanisms and implications for biofilm-resistant materials. Biomaterials 2012;33:5967-82.

7) Katsikogianni M, Missirlis YF. Concise review of mechanisms of bacterial adhesion to biomaterials and of techniques used in estimating bacteria-material interactions. Eur Cell Mater 2004;8:37-57.

8) Yoda I, Koseki H, Tomita M, et al. Effect of surface roughness of biomaterials on Staphylococcus epidermidis adhesion. BMC microbiol 2014;14:234.

9) Smith K, Gould KA, Ramage G, et al. Influence of tigecycline on expression of virulence factors in biofilm-associated cells of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2010;54:380-7.

10) 佐藤まみ，中山二郎．グラム陽性細菌のクオラムセンシング研究の最前線．Can we control bacterial consensus?日乳酸菌会誌2010；21：95-106．

11) 小野恒子，村上　圭，三宅洋一郎．Pseudomonas aeruginosaのバイオフィルム形成と抗菌薬抵抗性に関与する遺伝子ネットワーク．日細菌誌2012；67：227-43．

12) 志田崇之，小関弘展，依田　周・他．チタン系人工材料の表面粗さと表皮ブドウ球菌付着量の関係．日骨関節感染会誌2014；27：91-4．

13) Akiyama H, Hoshino A, Iida H, et al. A pilot project for the Japan arthroplasty register. J Orthop Sci 2012;17:358-69.

14) Phillips CB, Barrett JA, Losina E, et al. Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement. J Bone Joint Surg Am 2003;85:20-6.

15) Spangehl MJ, Masri BA, O'Connell JX, et al. Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am 1999;81:672-83.

16) Wymenga AB, van Horn JR, Theeuwes A, et al. Perioperative factors associated with septic arthritis after arthroplasty. Prospective multicenter study of 362 knee and 2,651 hip operations. Acta Orthop Scand 1992;63:665-71.

17) Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm 2013;70:195-283.

18) 山崎隆志，小久保吉恭，村上元昭．脊椎インストゥルメンテーション手術におけるバンコマイシンの予防投与の試み．整形外科2010；61：255-9．

19) Odenholt I. Pharmacodynamic effects of subinhibitory antibiotic concentrations. Int J Antimicrob Agents 2001;17:1-8.

20) Ng M, Epstein SB, Callahan MT, et al. Induction of MRSA biofilm by low-dose β-lactam antibiotics:specificity, prevalence and dose-response effects. Dose Response 2014;12:152-61.

21) Mlynek KD, Callahan MT, Shimkevitch AV, et al. Effects of low-dose amoxicillin on Staphylococcus aureus USA300 biofilms. Antimicrob Agents Chemother 2016;60:2639-51.

22) Patel R. Biofilms and antimicrobial resistance. Clin Orthop Relat Res 2005;437:41-7.

23) Reiter KC, Sant'Anna FH, d'Azevedo PA. Upregulation of icaA, atlE and aap genes by linezolid but not vancomycin in Staphylococcus epidermidis RP62A biofilms. Int J Antimicrob Agents 2014;43:248-53.