| Budget Amount *help |
¥4,030,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥330,000)
Fiscal Year 2007: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2006: ¥2,600,000 (Direct Cost: ¥2,600,000)
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| Research Abstract |
Further analyses of the 1st year results and reviews of the previous studies on traumatic wound infection were done. According to a report by Indonesia University (2004), one of commonly isolated bacteria from infected wounds in Jakarta was Staphylococcus aureus (14%). Japan Disaster Relief (JDR) medical team selected beta-lactam penicillins as 1st line antimicrobials under an assumption that the causative bacteria of wound infections were mainly S. aureus. On the contrary, there were several studies reported that traumatic wound cases submerged in water were infected with Aeromonads. However, Aeromonads are rarely considered as one of infectious agents when Japanese doctors start empirical therapy for such cases. Major reasons for the difficulty in such practice are: wound infections caused by Aeromonas spp. Are similar to those by S. aureus, and most of Aeromonads are resistant to beta-lactam penicillins. Therefore, by making Gram staining available, it will be possible to provide appropriate antimicrobial therapy at early timing. Further, the result of analyses of water samples collected from aquatic environment and qualitative data obtained from tsunami survivors at Banda Aceh suggested that the survivors been repeatedly exposed to pathogens, Aeromonas spp., Klebsiela spp., Vibrio spp. When they were bathing at shelters.
Through this study researchers recommend a empirical therapy, i.e., where clinical microbiological are not available: the initial use of beta-lactam penicillins for 3 days for S. aureus, followed by new quinolones if the first antimicrobial is not effective under an assumption that the etiological agents are Gram-negative bacilli or beta-lactam penicillins resistant bacteria. Finally it is highly recommended that medical relief team such as JDR should equip for Gram staining and keep enough amounts of new quinolones.
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