猫の飼育。血液透析患者における劇症性敗血症の潜在的リスク

Cat Rearing: A Potential Risk of Fulminant Sepsis Caused by in a Hemodialysis Patient.

• Jinichi Mori
• Kumi Oshima
• Tetsuya Tanimoto

抄録

は犬や猫の口腔内細菌叢にコロニー化した常在菌であり、免疫不全患者では咬傷を介して重篤な敗血症を引き起こす。これまでのところ、血液透析が感染のリスクとなることは報告されていない。高血圧の二次性末期腎疾患を持つ75歳の女性が突然敗血症性ショックを発症した。彼女は自宅で6匹の猫を飼育していたが、体に噛まれたり引っ掻かれたりした傷は発見されなかった。piperacillin-tazobactamで経験的に治療され，一時的に持続的な血液濾過を受けた．採血後5日目に血液培養で敗血症と診断された．この菌を標的とした抗生物質治療を4週間行ったところ敗血症は回復し、109日目の入院日に退院した。血液透析患者は、皮膚に穿刺があることや尿毒症に伴う免疫機能の低下により、血流に侵入しやすい。医師は、明らかな咬傷がなくても、犬や猫を飼育している血液透析患者の敗血症の原因として、この菌を考慮すべきです。

is a commensal organism colonized in oral flora of dogs and cats and causes severe sepsis through bite wound in immunocompromised patients. To date, hemodialysis has not been reported as a risk of infection. A 75-year-old woman with end-stage renal disease secondary to hypertension suddenly developed septic shock. She reared 6 cats in her home, but no bite or scratch wound was found on her body. She was empirically treated with piperacillin-tazobactam and temporally received continuous hemodiafiltration. On the fifth day after sampling, blood culture revealed as the cause of sepsis. After 4 weeks of antibiotic therapy targeting this organism, she recovered from the sepsis and was discharged on the 109th hospitalization day. Hemodialysis patients may be vulnerable to invasion into the blood stream by due to the presence of punctures in their skin and the impaired immune function associated with uremia. Physicians should consider this organism as a cause of sepsis in hemodialysis patients who rear dogs or cats even in the absence of apparent bite wounds.

Copyright © 2020 by S. Karger AG, Basel.