THE JAPANESE JOURNAL OF ANTIBIOTICS 65 2 Apr NTT NTT

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1 Apr THE JAPANESE JOURNAL OF ANTIBIOTICS IDSA

2 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 2 Apr NTT NTT

3 Apr THE JAPANESE JOURNAL OF ANTIBIOTICS MRSA 1 VISA VRSA Vancomycin-intermediate Staphylococcus aureus VISA Vancomycin-resistant S. aureus VRSA 2 VISA MIC 4 8 mg/l vana VISA 1996 VRSA MIC 16 mg/l vanavrsa rpob VISA rpob rpob RNA rpob MRSA 96% VISA 8 VISA MRSA rpob VISA Mu3 grar* grar* Mu3graR* VISA 4 mg/l mg/l 2 2 rpob Fig. 1.VISA Mu3graR* rpob

4 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 2 Apr Table 1. rpob VISA Mu3graR* 52 Fig. 1 rpob Mu3graR* rpob Mu3graR* RpoB MIC MIC MIC grar* MIC rpob MIC grar* rpob MIC rpob Table 1 rpob 3tness cost rpob tness costrpob grar* rpob tness cost 4 rpob MRSA MRSA 1 Staphylococcal cassette chromosome mec SCCmec -

5 Apr THE JAPANESE JOURNAL OF ANTIBIOTICS Penicillin-binding protein PBP MRSA MSSA 2 PBP2PBP2 - MRSA - PBP2' meca MRSA MSSA SCCmec meca SCCmec mec ccr Cassette Chromosome Recombinase2 Fig. 2. SCCmec Fig. 3.SCCmec mec Fig. 2 mec meca SCCmec 10 mec 4 A D meca Fig. 3 ccr SCCmec ccr mec 2 meca mec 1 mvas truncated mvas mvas mvas Staphylococcus eurettii mvas mec SCCmec A mec nucleotide identity 99Fig. 4 meca S. eurettii 44 S. sciuri S. eurettii Macrococcus Macrococcus mec meca - blaz blazm blar1 blar1m mecam meca Tn6045 Tn6045 Macrococcus meca

6 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 2 Apr Fig. 4. SCCmec mec Staphylococcus eurettii Fig. 5. mec Tn6045 Macrococcus caseolyticus mec - meca Tn6045 Macrococcus caseolyticus ccr

7 Apr THE JAPANESE JOURNAL OF ANTIBIOTICS mec ccr SCCmec MRSA Fig. 5 3 Macrococcus meca meca S. eurettii meca meca SCCmec SCCmec MRSA MRSA -

8

9 Apr THE JAPANESE JOURNAL OF ANTIBIOTICS IDSA Infectious Diseases Society of America IDSA MASCC 2CT -D C 500/ mm 3 MASCC /mm 3 8 Fig. 1 MASCC 21 Table 1 MASCC MDS AML CRP 2 Fig. 1.

10 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 2 Apr Table 1. MASCC A-II 1 empirical therapy preemptive therapy targeted therapy 4 7 CT -D-PCR 2 A-III CORDONNIER 3 RCT 97.3% 95.1% 9.1% vs 2.7%2 35 Fig. 2 IDSA A-I B-III CT

11 Apr THE JAPANESE JOURNAL OF ANTIBIOTICS Fig. 2. Empirical vs. Preemptive vs. Candida Aspergillus B-II Fig. 3, Fig. 4 4 Fig. 3 3 CT

12 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 2 Apr Fig. 3. Fig. 4.

13 Apr THE JAPANESE JOURNAL OF ANTIBIOTICS / CT, MRI 30 B B B 4 B-III Fig. 5 IDSA IDSA HSCT A-I Fig. 5.

14 THE JAPANESE JOURNAL OF ANTIBIOTICS 65 2 Apr posaconazole AML/MDS 13 posaconazole B-I posaconazole IDSA 2008 A-I IDSA A-I B 2 B B 2 B IDSA A-I 3 IDSA IDSA 2010 posaconazole 1 FREIFELD, A. G.; E. J. BOW, K. A. SEPKOWITZ, et al.: Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of America. Clin. Infect. Dis : e56 e93, NAKAGAWA, Y.; K. SUZUKI & T. MASAOKA: Evaluation of the risk factors for febrile neutropenia associated with hematological malignancy. J. Infect. Chemother : , CORDONNIER, C.; C. PAUTAS, S. MAURY, et al.: Empirical versus preemptive antifungal therapy for high-risk, febrile, neutropenic patients: a randomized, controlled trial. Clin. Infect. Dis : , PAPPAS, P. G.; C. A. KAUFFMAN, D. ANDES, et al.: Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin. Infect. Dis. 48: , 2009

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Rinku General Medical Center Rinku General Medical Center 4860 100 1620 Ann Intern Med. 1966; 64: 328 40 CHOP 63 1 83 J Clin Oncol. 1998; 16: 20065-69 Febrile Neutropenia IDSA(Infectious Diseases Society of America) 2002 Guidelines

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