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肺炎球菌は呼吸器感染症の起炎菌として分離頻度の高い細菌であり,時に致命的ともなりえる侵襲性感染症の主要な起炎菌でもある.薬剤耐性肺炎球菌が世界的に問題となっている.いくつかの系統の薬剤に耐性化した肺炎球菌を多剤耐性肺炎球菌(MDRSP)と呼び,本稿ではその耐性メカニズム,特に“菌の質的変化による薬剤耐性化”の機構について述べた.多剤耐性菌の増加は,肺炎球菌感染症に対する治療薬,特に経口抗菌薬の選択肢を徐々に狭めてきている.感染症対策の基本は予防にあり,7価コンジュゲートワクチンの早期の定期接種化が望まれる.
Streptococcus pneumoniae is a major pathogen associated with respiratory tract infections(RTI)and also is a leading cause of invasive infections which contribute to morbidity and mortality. We here in described the mechanisms of multi-drug resistant S. pneumoniae(MDRSP), especially as to the drug resistance mediated by the qualitative changes of intrinsic substances in this microorganism. Based on the background, therapeutic choices for patients with pneumococcal disease have been gradually eroded by the increase of MDRSP, for particularly oral antimicrobial agents. Intervention of 7-valent pneumococcal conjugate vaccine is expected routinely to prevent the invasive infection.
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