{"created":"2023-06-20T15:46:14.676902+00:00","id":836,"links":{},"metadata":{"_buckets":{"deposit":"c8c8f42c-8143-4fec-b181-db001a532b6e"},"_deposit":{"created_by":4,"id":"836","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"836"},"status":"published"},"_oai":{"id":"oai:uoeh-u.repo.nii.ac.jp:00000836","sets":["13:22:42"]},"author_link":["3438","3439","3446","3443","3447","3449","3445","3437","3436","3444","3440","3448","3441","3442"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-06-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"192","bibliographicPageStart":"185","bibliographicVolumeNumber":"41","bibliographic_titles":[{"bibliographic_title":" 産業医科大学雑誌"},{"bibliographic_title":"Journal of UOEH","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"我が国では，近年の高齢化に伴い肺炎患者数が増加している．大部分は誤嚥性肺炎であり，本邦の死因第三位である．誤嚥性肺炎の存在は，短期・長期予後を悪化させることが知られているが，現状では誤嚥性肺炎を正確に診断する基準や方法はない．実際に，現在問題となっているのは，自覚症状がなく反復・持続する不顕性誤嚥であることから，脳梗塞後遺症など誤嚥性肺炎の危険因子となる病態の有無により，誤嚥性肺炎を評価することが多い．また，誤嚥性肺炎の原因菌として嫌気性菌が多いことが広く信じられているが，主に1970年代の報告に基づいていると考えられる．これら1970年代の報告について，Marikらは，1）発症から時間が経過している症例が多く，肺化膿症や壊死性肺炎，膿胸併発例が多い，2）percutaneous transtracheal aspiration（PTA）の手技自体が誤嚥を誘発する，3）慢性アルコール中毒者や全身麻酔患者での検討が多い，4）1970年代は高齢者の口腔ケアが浸透していない，5）平均年齢が34-56歳と比較的若い，などの影響を指摘し，現在の肺炎の原因菌とは異なる可能性を指摘している．我々は，これまでの培養法を中心とした検討と比較して，嫌気性菌をはじめとした通常の培養法では検出が難しい細菌をより正確に同定することが可能である，細菌の16S ribosomal RNA（rRNA）遺伝子を用いた細菌叢解析によって，肺炎の病巣から直接検体を採取する方法で肺炎の原因菌検索を行った結果，誤嚥リスクを有する肺炎では，通常の喀痰培養法では過小評価されがちな口腔レンサ球菌が31.0%ともっとも多く検出され，逆に嫌気性菌は6.0%と低く，誤嚥性肺炎の原因菌として，嫌気性菌は過大評価されている可能性が示唆された．","subitem_description_type":"Abstract"},{"subitem_description":"The number of patients with pneumonia has been increasing as the population ages, and most fatal pneumonia cases are the elderly with aspiration pneumonia. Although aspiration pneumonia leads to poor short- and long-term prognosis, there have been no practical ways to diagnose it precisely. Persistent subclinical aspirationw without any subjective symptoms is problematic in clinical practice in patients with aspiration pneumonia, and physicians can only use aspiration risks such as brain infarction to diagnose aspiration pneumonia. Anaerobes have been believed to be major causative pathogens in aspiration pneumonia, based on data from the 1970’s. In relation to these data, Marik insisted that there is a possible overestimation of anaerobes because 1) the sampling of microbiologic specimens was in the late phase in the course of the illness, especially frequently after developing complications such as abscesses, necrotizing pneumonia, or empyema thoracis; 2) the organisms recovered by percutaneous transtracheal aspiration (PTA) sampling could have been contaminated by the aspiration of oropharyngeal flora during the PTA procedure or colonized in the trachea; and 3) many of the patients had chronic alcoholism or were under general anesthesia. In addition, 4) oral care was not common in the 1970s, and 5) the patients in these reports were relatively young. Molecular biological approaches using the 16S ribosomal RNA (rRNA) gene have recently been used, and have enabled us to detect more exact pathogens compared to conventional bacterial culture. Using the method with the detection of the 16S rRNA gene, we evaluated the bacterial phylotypes in bronchoalveolar lavage fluid in patients with aspiration pneumonia and found that oral streptococci were the most detected phylotypes (31.0%), while anaerobes were only 6.0%. Our results suggest that oral streptococci are important, and anaerobes may have been overestimated as causative pathogens in patients with aspiration pneumonia.","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"産業医科大学（産業医科大学学会）"}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"Journal of UOEH"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://www.jstage.jst.go.jp/browse/juoeh/41/2/_contents/-char/ja","subitem_relation_type_select":"URI"}},{"subitem_relation_name":[{"subitem_relation_name_text":"産業医科大学雑誌"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://www.uoeh-u.ac.jp/kouza/journal/i_2019-2j.html","subitem_relation_type_select":"URI"}}]},"item_10001_select_24":{"attribute_name":"記事区分","attribute_value_mlt":[{"subitem_select_item":"総説"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"ISSN 0387-821X(PRINT), ISSN 2187-2864(ONLINE)","subitem_source_identifier_type":"ISSN"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"赤田, 憲太朗"}],"nameIdentifiers":[{"nameIdentifier":"3436","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"野口, 真吾"}],"nameIdentifiers":[{"nameIdentifier":"3437","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"川波, 敏則"}],"nameIdentifiers":[{"nameIdentifier":"3438","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"畑, 亮輔"}],"nameIdentifiers":[{"nameIdentifier":"3439","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"内藤, 圭祐"}],"nameIdentifiers":[{"nameIdentifier":"3440","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"迎, 寛"}],"nameIdentifiers":[{"nameIdentifier":"3441","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"矢寺, 和博"}],"nameIdentifiers":[{"nameIdentifier":"3442","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Akata, Kentaro","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"3443","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Noguchi, Shingo","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"3444","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Kawanami, Toshinori","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"3445","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Hata, Ryosuke","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"3446","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Naito, Keisuke","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"3447","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Mukae, Hiroshi","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"3448","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Yatera, Kazuhiro","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"3449","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-12-31"}],"displaytype":"detail","filename":"S00041208.pdf","filesize":[{"value":"498.1 kB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"S00041208.pdf","url":"https://uoeh-u.repo.nii.ac.jp/record/836/files/S00041208.pdf"},"version_id":"f8c77fa8-db43-4e29-b2fd-a4ee96751c2a"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"誤嚥性肺炎","subitem_subject_scheme":"Other"},{"subitem_subject":"嫌気性菌","subitem_subject_scheme":"Other"},{"subitem_subject":"口腔レンサ球菌","subitem_subject_scheme":"Other"},{"subitem_subject":"16S ribosomal  RNA遺伝子","subitem_subject_scheme":"Other"},{"subitem_subject":"細菌叢解析","subitem_subject_scheme":"Other"},{"subitem_subject":"aspiration pneumonia","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"anaerobes","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"oral streptococci","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"16S ribosomal RNA gene","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"bacterial floral analysis","subitem_subject_language":"en","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":"誤嚥性肺炎の病態および原因菌について","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"誤嚥性肺炎の病態および原因菌について"},{"subitem_title":"Microbiology of Aspiration Pneumonia","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"4","path":["42"],"pubdate":{"attribute_name":"公開日","attribute_value":"2020-12-31"},"publish_date":"2020-12-31","publish_status":"0","recid":"836","relation_version_is_last":true,"title":["誤嚥性肺炎の病態および原因菌について"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-06-20T15:55:41.037177+00:00"}