著者
黒木 俊郎 八木田 健司 藪内 英子 縣 邦雄 石間 智生 勝部 泰次 遠藤 卓郎
出版者
一般社団法人 日本感染症学会
雑誌
感染症学雑誌 (ISSN:03875911)
巻号頁・発行日
vol.72, no.10, pp.1050-1055, 1998-10-20 (Released:2011-09-07)
参考文献数
20
被引用文献数
14 12

神奈川県下の12温泉施設30浴槽の浴槽水中のLegionella属菌と自由生活性アメーバの生息実態を調査した. 11施設の21浴槽 (21/30: 70.0%) からLegionella pneumopkilaが101CFU/100ml (6施設7浴槽: 23.3%), 102CFU/100ml (7方缶設10浴槽: 33.3%) および103CFU/100ml (2施設4浴槽: 13.3%) の菌数で検出された.決定できたL. pneumopkilaの血清群は3, 4, 5, 6群で4群株が最も検出頻度が高かった.アメーバは11施設の22浴槽 (22/30: 73.3%) から5属が検出され, その主なものはNaegleria属 (7施設14浴槽: 46.7%), Plalyamoeba属 (7施設10浴槽: 33.3%), Acanthamoeba属 (3施設3浴槽: 10.0%) であった.Legionella属菌の宿主アメーバのいずれかが検出された浴槽は合わせて9施設の17浴槽 (17/30: 56.7%) であった.温泉のいずれの水質においてもLegionella属菌あるいは自由生活性アメーバが高率に検出されたが, 標本数が少ないため生息と水質との間の関係の有無は判断できなかった.今回の調査ではNaegleria lovaniensisが13浴槽から分離された. 原発性アメーバ性髄膜脳炎の病原体であるNaegleria fowleriはN.lovaniensisと生息環境を同じくすることが知られており, わが国にも存在することが確認されていることから, 今後とも十分な監視が必要である.
著者
烏谷 竜哉 黒木 俊郎 大谷 勝実 山口 誠一 佐々木 美江 齊藤 志保子 藤田 雅弘 杉山 寛治 中嶋 洋 村上 光一 田栗 利紹 藏元 強 倉 文明 八木田 健司 泉山 信司 前川 純子 山崎 利雄 縣 邦雄 井上 博雄
出版者
一般社団法人 日本感染症学会
雑誌
感染症学雑誌 (ISSN:03875911)
巻号頁・発行日
vol.83, no.1, pp.36-44, 2009-01-20 (Released:2016-02-15)
参考文献数
19
被引用文献数
3 6

2005 年6 月~2006 年12 月の期間,全国の循環系を持たない掛け流し式温泉182 施設を対象に,レジオネラ属菌等の病原微生物汚染調査を行い,29.5%(119/403)の試料からレジオネラ属菌を検出した.採取地点別の検出率は浴槽が39.4%と最も高く,貯湯槽23.8%,湯口22.3%,源泉8.3%と続いた.陽性試料の平均菌数(幾何平均値)は66CFU/100mL で,採取地点による有意差は認められなかったが,菌数の最高値は源泉,貯湯槽,湯口でそれぞれ180,670,4,000CFU/100mL と増加し,浴槽では6,800CFU/100mL に達した.陽性試料の84.7%からLegionella pneumophila が分離され,血清群(SG)別ではSG 1,5,6 がそれぞれ22,21,22%と同程度の検出率であった.レジオネラ属菌の汚染に関与する構造設備及び保守管理の特徴を明らかにするため,浴槽と湯口上流側とに分けて,多重ロジスティック回帰分析を行った.浴槽での汚染リスクは,湯口水がレジオネラに汚染されている場合(OR=6.98,95%CI=2.14~22.8)及び浴槽容量が5m3 以上の場合(OR=2.74,95%CI=1.28~5.89)に高く,pH 6.0未満(OR=0.12,95%CI=0.02~0.63)では低下した.同様に,湯口上流ではpH 6.0未満(OR=0.06,95%CI=0.01~0.48)及び55℃以上(OR=0.10,95%CI=0.01~0.77)でレジオネラ汚染を抑制した.レジオネラ属菌以外の病原微生物として抗酸菌,大腸菌,緑膿菌及び黄色ブドウ球菌を検査し,汚染の実態を明らかにした.
著者
松井 昂介 尹 漢勝 八木田 健司 西山 明 山梨 啓友 高橋 健介 有吉 紅也
出版者
一般社団法人 日本感染症学会
雑誌
感染症学雑誌 (ISSN:03875911)
巻号頁・発行日
vol.95, no.6, pp.407-412, 2021-11-20 (Released:2022-01-28)
参考文献数
20

Balamuthia mandrillaris is one of the free-living amoebae that causes potentially fatal cutaneous and central nervous system infection. Both the diagnosis and treatment are challenging, especially when the central nervous system is involved. Herein, we report a case of granulomatous amoebic encephalitis caused by B. mandrillaris, in a patient who presented with subcutaneous lesions. A 55-year-old patient with a history of ANCA-associated vasculitis who was on maintenance dialysis was referred to our hospital for investigation and treatment of an intracranial lesion. He had had multiple subcutaneous nodules for nine months before the referral, which had been histopathologically diagnosed about a month prior to the referral as granulomatosis with polyangiitis. Brain MRI showed a space-occupying lesion with surrounding edema in the left occipital lobe. Brain biopsy was performed, and the histopathological diagnosis was epithelioid cell granuloma; no pathogen could be identified. Suspecting either deterioration of granulomatosis with polyangiitis or infection, the patient was started on treatment with a corticosteroid and several antibiotics, antifungal, and antiprotozoal agents. However, the intracranial lesion continued to progress despite all the treatment, and the patient died on the 33rd hospital day. Further investigation at the National Institute of Infectious Diseases revealed B. mandrillaris infection in both the subcutaneous and intracranial lesions. From our experience of this case, we suggest that B. mandrillaris infection be included in the differential diagnosis in patients presenting with cutaneous granulomatous lesions of unknown cause; early diagnosis, before the amoeba invades the central nervous system, is of critical importance.
著者
藪内 英子 山本 啓之 遠藤 卓郎 八木田 健司 守尾 輝彦
出版者
Japanese Society of Environmental Infections
雑誌
環境感染 (ISSN:09183337)
巻号頁・発行日
vol.13, no.2, pp.137-140, 1998-04-30 (Released:2010-07-21)
参考文献数
14

On 9 March 1996, a 57-year-old Japanese drunken male drown in a public bath in Tokyo. He was transferred to a emergency hospital and recovered. After his discharge on 11 March by walking, he became febrile at night. Next day, because of high fever and dyspnea, he came to the medical attention, and was immediately hospitalized under the diagnosis of acute pneumonia. Although bacteriological, serological examinations and chemotherapy for suspected Legionella pneumonia, definite diagnosis was not obtained and the patient died on 6 April. Culture of the autopsied lung tissue yielded colonies of Legionella pneumophila serogroup (SG) 6, and reexamined serum antibody titer against. L. pneumophila serogroup 6 was 1: 1024 by microplate agglutination test.Examinations for legionellae and their host amobae in the water of 22 bath tubs of 6 public bath facilities located in the area including the facility concerned were carried out on 22 April without notification in advance. Free residual chlorine concentrations of the 22 bath water were from 0.1 to more than 5 mg/L, and water from 2 bath tubs (0.1%) of low chlorine level were legionellae-positive. Host amoebae for legionellae were detected from 10 bath tubs of 5 facilities.Though Naegleria was detected, the bath water where the patient drowned was negative for viable legionellae by repeated trials of culture, 3 times intraperitonal passages of guinea pigs, and coculture with amoebae. The 16S rRNA gene specific for legionellae was detected from the bath water by nested PCR method using primers, 225A-854B and 448A-854B. After filtration of 10 ml bath water, the membrane filter was stained by indirect fluorescent antibody (IFA) method. Rodshaped organisms trapped on the membrane filter were IFA-positive against L. pneumophila SG 6, same with the isolates from lug tissue, and their presumptive number in bath water was estimated as 102-103/ml. Based on the results of nested PCR and IFA staining of rod-shaped bacteria trapped on the membrane filter, the bath water was regarded as contained with viable legionellae due to unknown reason and could be the source of infection when the patient was drowned.