| Project/Area Number |
18K16179
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 54030:Infectious disease medicine-related
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| Research Institution | Kumamoto University |
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Principal Investigator |
Migiyama Yohei 熊本大学, 大学院生命科学研究部(医), 特定研究員 (20779178)
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| Project Period (FY) |
2018-04-01 – 2022-03-31
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| Project Status |
Completed (Fiscal Year 2021)
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| Budget Amount *help |
¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000)
Fiscal Year 2021: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2019: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
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| Keywords | 緑膿菌 / 難治性気道感染症 / 抗菌薬適正使用 / 薬剤耐性菌 / クオラムセンシング |
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| Outline of Final Research Achievements |
We collected and analyzed data of mechanically ventilated ICU patients with Pseudomonas aeruginosa isolated from respiratory specimens, and investigated factors related to the efficacy of antibiotic therapy. The results showed that the clinical course of respiratory infection differed depending on the density of Pseudomonas aeruginosa, with particularly high density (greater than or equal to 10^7 cfu/mL) of Pseudomonas aeruginosa causing a strong inflammatory response and worsening chest x-ray findings. In ventilator-associated tracheobronchitis antibiotic, antibiotic therapy was associated with improved weaning from mechanical ventilation only when high density of Pseudomonas aeruginosa were detected. Our study found hyperglycemia, prolonged mechanical ventilation, and the use of non-antipseudomonal cephalosporins as the risk factors for high density of Pseudomonas aeruginosa.
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| Academic Significance and Societal Importance of the Research Achievements |
緑膿菌はクオラムセンシング機構を介し、その菌量に応じて病原性を大きく変化させている。本研究はこれに着目し、緑膿菌気道感染に対して抗菌薬使用を考慮すべき菌量や、重篤な高菌量感染になるリスク因子について解析した。現在、薬剤耐性菌の増加が医療システムを脅かす深刻な問題となっている。緑膿菌は抗菌薬への多様な耐性機序を有しており、重症患者の下気道に容易に定着するため、抗菌薬使用の判断が難しい場合が多い。本研究で得られた結果は、緑膿菌気道感染症へのより効果的な抗菌薬使用法の開発や薬剤耐性菌を減少させるためのさらなる臨床研究に繋がるものと期待される。
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