| 院内感染の疑いで９人死亡 帝京大病院、４６人感染確認 |
9 Die at Teikyo University Hospital, 46 Confirmed Infection Cases; a Hospital-Acquired Infection Suspected |
| 2010年9月3日 |
September 3rd, 2010 |
| 帝京大学医学部付属病院（東京都板橋区）は３日、複数の抗生剤が効きにくい多剤耐性の細菌アシネトバクターによる院内感染が起き、１日までに４６人 が感染したと発表した。 |
(September 3rd, 2010): It was announced today by the Faculty of Medicine, Teikyo University that, at a hospital attached to the university (located in Tokyo’s Itabashi Ward), there has been a hospital-acquired infectious outbreak involving multidrug-resistant Acinetobacter, a difficult-to-treat bacterial infection, with some 46 confirmed cases recorded at the hospital as of September 1st, 2010. |
| ほぼ全員が血液や腎臓などに重い病気をもっていた。 |
Of the patients identified as being infected, almost all suffered from serious hematic and renal disorders, etc. |
| ２７人が亡くなり、このうち９人は感染と死亡との因果関係を否定できないとい う。 |
Of these, 27 have subsequently died, with Acinetobacter being unable to be dismissed as a contributory mortality factor in some 9 of these cases. |
| 厚生労働省によると、この菌による院内感染では過去最大の規模になるという。 |
Based on information forthcoming from the Ministry of Health, Labour and Welfare (MHLW), this event represents the largest-ever hospital-acquired infectious outbreak involving Acinetobacter. |
| 感染したほとんどの患者の菌は特徴が似ていることから、ほぼ院内感染によるものとみられる。 |
Based on the similarity of the bacteria present among infected patients, there seems little doubt that the outbreak represents a hospital-acquired infection, it afflicting some 27 male and 19 female patients, these people ranging in age from 35 to 92 years old. |
| ６０代以上が７割を 超える。 |
Of the patients, more than 70% were aged 60 years old or more, many exhibiting reduced levels of immunity due to the impact of serious conditions such as hematic and cardiovascular disorders. |
| 血液や循環器に重い病気を患って免疫力が低下している人が多い。 |
According to the hospital’s internal research, in addition to the 9 deaths for which Acinetobacter cannot be dismissed as contributory factor, in a further 12 deaths contributory mortality factors including illness have been identified. |
| 病院の調査では、９人のほか、１２人は持病などが原因で死亡。 |
Meanwhile, the cause of death in the other 6 cases remains unclear. |
| 残り６人は因果関係 が不明だという。 |
According to the hospital’s explanations, from April to May of this year, Acinetobacter was identified as being present among approximately 10 inpatients admitted to the hospital’s internal medicine wards. |
| 病院の説明によると、４月から５月に、内科系病棟で約１０人の患者から菌が検出された。 |
By way of response, these inpatients were subsequently shifted to private treatment rooms while the aforementioned wards were temporarily closed. |
| 病院は、感染者を個室で管理し、病棟を一時閉鎖。 |
The hospital’s Infections Control Committee was also abreast of the situation and had commenced its own investigations. |
| 部局をまたがるスタッフでつくる感染制御委員会も事態を把握し調査を始めた。 |
When reexaminations of both patient records and collected cultures were conducted by the hospital, it was understood that between August of last year and September of the current year, some 46 patients had been infected by Acinetobacter, with 11 locations within the hospital being identified. |
| 患者が確認されたのは１１カ所。 |
The first death was recorded in October of last year. |
| 最初の死亡者は昨年１０月。 |
Moreover, while the source of infection in that case was not identified, it seems to confirm the thesis that multiple routes of infection are possible. |
| 感染源は特定できていないが、複数のルートがある可能性が認められるという。 |
Of the patients infected, 2 individuals were transferred to neighboring healthcare institutions, with 1 of these subsequently being identified as suffering from a hospital-acquired infection. |
| 感染患者のうち近くの医療機関に２人が転院。 |
In fact, around February of this year, a bacterial pathogen was detected among random hospital patients, this leading the Infections Control Department of the hospital to issue a formal written warning as to “the possibility of a hospital-acquired infection.” However, due to a lack of reporting from different departments within the hospital as to their detection of bacterial pathogens, there was a lack of awareness vis-à-vis the possibility of the hospital being confronted by such an outbreak. |
| １人には院内感染の事実は伏せていたという。 |
Moreover, as a result of investigations conducted since May, it is now understood that, due to a degree of treatment efficacy being noted when combating infection cases with certain antibiotic agents, there were instances of infection-incidence reports not being submitted by attending doctors. |
| 実は２月ごろ、院内で散発的に患者から菌が検出され、病院の感染制御部が「院内感染の可能性に注意を」という警告文書を出したという。 |
Meanwhile, in responding to multidrug-resistant Acinetobacter hospital-acquired infections, in January of last year the MHLW requested that all prefectural governments notify it of any such events. |
| しかし、各部から は菌検出の報告はあがらず、病院は集団感染の疑いがあると認識しなかった。 |
Accordingly, the MHLW was advised of the current instance on the 2nd of this month. |
| 一部の抗生剤は効いたため、担当医が報告をあげなかったことが、５月以降の調査 でわかった。 |
With regard to why the hospital was so late in its reporting of this event, Dr. Shigeho Morita, the medical director of the hospital, gave the following comment: “At the time of the outbreak, we had our hands full in devoting 100% of our energies to the treatment of our patients.” |
| 厚生労働省は都道府県に対し、多剤耐性アシネトバクターが病院内で発生した場合に報告を求める通知を昨年１月に出しているが今回、報告は今月２日だ。 |
Assistant Professor Kazuhiro Tateda of the Faculty of Medicine, Toyo University (Microbiology/Infectious Diseases), offered the following comment: “In both North America and Europe, from the perspective of policy-formulation in response to hospital-acquired infections, there is an understanding that due consideration needs to be given to this pathogen. Moreover, here in Japan the dangers of such infections are also well understood. This being said, it needs to be asked as to why this infection was allowed to spread to the extent that it did.” |
| 舘田（たてだ）一博・東邦大医学部准教授（微生物・感染症学）は「欧米では院内感染対策上、この菌に注意が必要とされており日本でも怖さが知られている。なぜここまで広がってしまったのか」と指摘する。 |
Concerning Acinetobacter hospital-acquired infections, Fukuoka University Hospital (Fukuoka City) experienced an outbreak that lasted from the autumn of 2008 through to January of 2009. |
| アシネトバクターの院内感染では、２００８年秋～０９年１月に福岡大病院（福岡市）で２６人が感染し４人が死亡した例がある。 |
In that case 26 patients contracted the infection and 4 subsequently died. |
| このときは、韓国で手術を受けた患者から菌が検出され、ここから感染が広がった可能性がある。 |
The presence of the pathogen was first detected in a patient who had previously undergone a surgical procedure in South Korea, with the possibility being that the pathogen subsequently spread to others. |
