臨床整形外科57巻4号

2022年04月発行

特集 骨軟部組織感染症Update

整形外科感染症における黄色ブドウ球菌感染とバイオフィルムのUpdate

著者： 崔賢民¹ 稲葉裕¹

所属機関： ¹横浜市立大学整形外科

ページ範囲：P.353 - P.359

整形外科感染症は，整形外科疾患の中でも診断・治療に難渋することが多い疾患である．黄色ブドウ球菌は最も頻度の高い整形外科感染症であり，黄色ブドウ球菌を用いた研究により，原因菌による皮質骨内侵入や宿主細胞内寄生，ヒト細胞に特異的な毒素の産生，免疫細胞や抗菌薬から細菌を保護する特殊な環境の形成が，診断・治療における難治化に関係していることが明らかとなってきた．黄色ブドウ球菌は強い接着因子を持つ菌であり，ほとんどの黄色ブドウ球菌感染でバイオフィルムが発症に関与している．バイオフィルムは段階的に成熟し，成熟したバイオフィルムは菌の拡散や毒素の産生により骨破壊や炎症を惹起する．特にバイオフィルムの成熟と感染の発症には，クオラムセンシングと呼ばれる細菌同士のシグナル伝達が重要な役割を持ち，整形外科感染症の難治化と大きく関係している．近年の整形外科感染の病態やバイオフィルム形成メカニズムに関する知見の進歩を知ることは，整形外科感染症の診断および治療の成績の向上に重要であると考える．

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