7 ( ). 1. 2. 3. 4. 5. 6.
. 1. (C.difficile associated disease CDAD) 1) CDAD 60 72 2 CDAD Toxin CDAD 2) (1) C.difficile C.difficile (2) C.difficile (toxin A toxin B) toxin A toxin B (A+B+) toxin A toxin B (A-B+) (A-B-)A-B+ A+B+ 2003 (BI/NAP1/027 ) (3) CDAD 3 ( C.difficile ) () 5 10 10 toxin A IgG CDAD IgG CDAD 3) C.difficile 20 30% CDAD
4) CDAD (1) 20 25% 2 3 (2) CDAD CDAD MRSA C.difficile CDAD 5) (1) CDAD 0.02% 0.05% ( ) 0.02% 0.05% 2 C.difficile
2. 1) (ICA ) (BCYE ) 2) 1 24 4 5 6 ( ) - 3) - 4) 25 42 60 20 4 5) 4
3. 1) gold-standard -PCR -D- 2) OKT3 Aspergillus fumigatus Aspergillus flavus Aspergillus niger 3) ( ) ( )
4) PCR B B B 2 PCR CT 1 2 5) HEPA LAF(laminar air flow)
4. 1) (Bordet-Gengou) CSM(cyclodextrin solid medium) PT 4 (PCR LAMP ) 4 2) (Bordetella pertussis) (Bordetella parapertussis) 7 10 ( 5 21 ) DPT ( ) 20 30 3) ( ) 1 10 (staccato) (whoop) (reprise) 2 (whoop) 1 (CDC) ( )
4) (1) ( ) 7 21 ( ) 7 5) 2 ( ) (1) ( ) 1,600mg( 1,600mg 8 ) 14 800mg( 800mg 4 ) 7 ( 500mg 2 ) 5 5 7
6)
5. 1) 2) () 3) (1) ( ) (2) (3) 4) ( ) (200µg/kg 1 ) 7 10 10%( )
1 1 ( 10% (BB) ) ( ) 610 10%( ) 5) (1) ( ) 24 50 10 50
(2) 10
6. 1) CJD (definite) CJD (probable) ( ) 2 14-3-3 2 (possible) 2) (CJD) 1 100 1 CJD
3) (1) CJD 14 20 Web ( 20 ) ( 21 7 ) http://prion.umin.jp/guideline/index.html (2) 1% (3) ( ) CJD
IVH CJD CJD CJD CJD