{"created":"2023-05-15T16:30:51.689051+00:00","id":2146,"links":{},"metadata":{"_buckets":{"deposit":"2c466f97-beaf-4b6a-abfb-adf09e1d393d"},"_deposit":{"created_by":2,"id":"2146","owners":[2],"pid":{"revision_id":0,"type":"depid","value":"2146"},"status":"published"},"_oai":{"id":"oai:nagasaki-u.repo.nii.ac.jp:00002146","sets":["29:30"]},"author_link":["9950","9949"],"item_2_alternative_title_19":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"New insights based on a microfloral analysis -the significance of anaerobes in respiratory infections"}]},"item_2_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2016-07","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"4","bibliographicPageEnd":"651","bibliographicPageStart":"647","bibliographicVolumeNumber":"64","bibliographic_titles":[{"bibliographic_title":"日本化学療法学会雑誌"},{"bibliographic_title":"Japanese Journal of Chemotherapy","bibliographic_titleLang":"en"}]}]},"item_2_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"肺炎は社会の高齢化を反映してその死亡者数は徐々に増加し，2011年に初めて本邦の死亡原因の第3位となった。肺炎による死亡者の95％以上が65歳以上の高齢者であり，入院を要する肺炎患者のうち，60歳代では約50％が誤嚥性肺炎と報告され，年代が上昇するごとにその割合は上昇すると報告されており，「高齢者肺炎」や「誤嚥性肺炎」の治療も重要となる。\n　肺炎の「治療」の第一歩として，原因菌の把握は抗菌薬の選択の面からもきわめて重要である。しかしながら，培養を中心とした従来法では十分に満足できるものではない。そこで，われわれは，これまで産業医科大学微生物学教室との共同研究で，呼吸器感染症患者の呼吸器検体について，培養に依存しない遺伝子工学的手法による網羅的な細菌叢の解析を行ってきた。細菌叢解析法とは細菌のみが保有する16S ribosomal RNA遺伝子をPCRで網羅的に増幅し，PCR産物のクローンライブラリーを作成した後に無作為に選択した96クローンの塩基配列を評価することで，その検体中の優占菌種を把握する手法である。\n　市中肺炎や医療ケア関連肺炎の気管支洗浄液を用いて細菌叢を解析したところ，既報の原因菌に加えて，嫌気性菌やレンサ球菌が多数認められたことを報告した。特に従来法において原因菌が不明であった症例では，嫌気性菌や口腔レンサ球菌が最優占菌種として検出された。さらに誤嚥リスクの有無による細菌叢の違いを後方視的に比較検討したところ，誤嚥リスク群では口腔レンサ球菌がより多く検出され，誤嚥リスクに最も関与が大きい可能性が見出された。一方で，以前から関連が指摘されていた嫌気性菌については，誤嚥のリスクの有無では検出率の差はみられなかった。\n　今回は，細菌叢解析を用いて，「高齢者肺炎」や「誤嚥性肺炎」を中心に，多方面から検討したデータを紹介し，呼吸器領域における嫌気性菌の位置づけについて概説する。","subitem_description_type":"Abstract"},{"subitem_description":"The mortality rate of pneumonia is gradually increasing concomitantly with the aging of the population in Japan, and pneumonia has been the third leading cause of death in Japan since 2011. It has been reported that over 95% of the deaths from pneumonia are elderly patients over 65 years of age. In addition, about 50% of hospitalized patients with pneumonia over 60 years of age have aspiration pneumonia, and the rate of aspiration increases with age. Therefore, proper treatment of pneumonia in the elderly and in cases of aspiration pneumonia is an important issue. Precise assessment of causative pathogens is extremely important for the first step towards an appropriate choice of antibiotics for the treatment of pneumonia. However, conventional cultivation methods are not totally adequate to estimate causative bacteria.\nWe have evaluated the bacterial flora in the respiratory samples obtained from patients with infectious diseases using the culture-independent molecular method, in collaboration with the Department of Microbiology, University of Occupational and Environmental Health, Japan. The microfloral analysis using the 16S rRNA gene was conducted as follows; a partial fragment of 16S rRNA gene (approximately 600 bp) was amplified with PCR using the universal primer pair and a clone library was constructed. Nucleotide sequences of 96 randomly chosen clones for each specimen were determined and the homology with our in-house database was assessed, then the percentages of detected bacterial phylotypes were identified.\nThis microfloral analysis of the bronchoalveolar lavage fluid obtained from patients with community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) has so far showed that anaerobes and oral bacteria were highly detected in addition to well-known pathogens of CAP or HCAP. Particularly in patients in whom no significant pathogens had been identified using conventional cultivation methods, anaerobes and oral bacteria were mainly detected as the predominant phylotypes by the microfloral analysis. In addition, oral streptococci were more frequently detected than anaerobes in CAP and HCAP patients with aspiration risk(s), indicating that oral streptococci were the most important in patients with aspiration pneumonia. Anaerobes have been reported as one of the important pathogens in patients with aspiration pneumonia, but there were no significant differences in anaerobe detection between patients with or without the risk of aspiration in our study.\nIn this review, I will talk about the significance of anaerobes in respiratory infections, especially in patients with \"elderly pneumonia\" and \"aspiration pneumonia\", based on the data of the microflora analysis.","subitem_description_type":"Abstract"}]},"item_2_description_63":{"attribute_name":"引用","attribute_value_mlt":[{"subitem_description":"日本化学療法学会雑誌, 64(4), pp.647-651; 2016","subitem_description_type":"Other"}]},"item_2_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"9950","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Mukae, Hiroshi"}]}]},"item_2_publisher_33":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"日本化学療法学会"}]},"item_2_rights_13":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"c 日本化学療法学会"},{"subitem_rights":"利用は著作権の範囲内に限られる"}]},"item_2_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"13407007","subitem_source_identifier_type":"ISSN"}]},"item_2_text_62":{"attribute_name":"出版者別言語","attribute_value_mlt":[{"subitem_text_value":"Japanese Society of Chemotherapy"}]},"item_2_version_type_16":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_ab4af688f83e57aa","subitem_version_type":"AM"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"迎, 寛"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-12-21"}],"displaytype":"detail","filename":"JJC64_647.pdf","filesize":[{"value":"633.5 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"JJC64_647.pdf","url":"https://nagasaki-u.repo.nii.ac.jp/record/2146/files/JJC64_647.pdf"},"version_id":"dee12de7-1c68-4d89-a553-46d5f65c0dd2"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"pneumonia","subitem_subject_scheme":"Other"},{"subitem_subject":"16S ribosomal RNA","subitem_subject_scheme":"Other"},{"subitem_subject":"clone library","subitem_subject_scheme":"Other"},{"subitem_subject":"anaerobes","subitem_subject_scheme":"Other"},{"subitem_subject":"Streptococcus","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"肺炎診療：細菌叢解析でわかった新たな知見～呼吸器感染症における嫌気性菌の役割","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"肺炎診療：細菌叢解析でわかった新たな知見～呼吸器感染症における嫌気性菌の役割"}]},"item_type_id":"2","owner":"2","path":["30"],"pubdate":{"attribute_name":"公開日","attribute_value":"2017-05-23"},"publish_date":"2017-05-23","publish_status":"0","recid":"2146","relation_version_is_last":true,"title":["肺炎診療：細菌叢解析でわかった新たな知見～呼吸器感染症における嫌気性菌の役割"],"weko_creator_id":"2","weko_shared_id":-1},"updated":"2023-05-16T03:52:06.788319+00:00"}