WordNet

impervious to being affected; "resistant to the effects of heat"; "resistant to persuasion"
spherical Gram-positive parasitic bacteria that tend to form irregular colonies; some cause boils or septicemia or infections (同)staphylococci, staph
inflammation of the colon (同)inflammatory_bowel_disease
antibiotic drug of the penicillin family used in the treatment of certain staphylococcal infections

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Protection from Clostridium difficile infection in CD4 T Cell- and polymeric immunoglobulin receptor-deficient mice.

Johnston PF1, Gerding DN, Knight KL.
Infection and immunity.Infect Immun.2014 Feb;82(2):522-31. doi: 10.1128/IAI.01273-13. Epub 2013 Nov 11.
Clostridium difficile rivals methicillin-resistant Staphylococcus aureus as the primary hospital-acquired infection. C. difficile infection (CDI) caused by toxins A and/or B can manifest as mild diarrhea to life-threatening pseudomembranous colitis. Although most patients recover fully from CDI, ~20
PMID 24478068

Prognosis following emergency surgery for ulcerative colitis in elderly patients.

Ikeuchi H1, Uchino M, Matsuoka H, Bando T, Hirata A, Takesue Y, Tomita N, Matsumoto T.
Surgery today.Surg Today.2014 Jan;44(1):39-43. doi: 10.1007/s00595-013-0563-z. Epub 2013 Apr 4.
PURPOSE: Since 2000, the incidence of ulcerative colitis (UC) in patients over 60 years old has been rapidly increasing. We reviewed our surgical experience of elderly patients with UC treated at our hospital.METHODS: Patients aged 60 years or older at the time of surgery were defined as "elderly"
PMID 23553422

Crohn's disease complicated by intestinal infection with methicillin-resistant Staphylococcus aureus.

Bettenworth D1, Nowacki TM, Friedrich A, Becker K, Wessling J, Heidemann J.
World journal of gastroenterology : WJG.World J Gastroenterol.2013 Jul 21;19(27):4418-21. doi: 10.3748/wjg.v19.i27.4418.
We report on a 24-year-old male patient with history of bloody diarrhea, abdominal pain and vomiting. Endoscopy revealed massive ulcerative discontinuous proctosigmoiditis with deep, sharply demarcated epithelial denudations and enterotoxigenic methicillin-resistant Staphylococcus aureus (MRSA) was
PMID 23885156

高島英隆,奥山祐右,榎泰之,吉田憲正,藤本荘太郎
日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 53(2), 283-289, 2011-02-20
73歳男性．胸膜炎に対し，抗菌剤投与中，悪寒を伴う多量の水様下痢が出現した．腹部造影CT，内視鏡検査にて小腸，大腸に著明な炎症所見を認めた．便培養検査にてMRSA腸炎と診断し，塩酸バンコマイシンの投与を行うも，繰り返す多量の小腸出血をコントロールできず，発症から2カ月で死亡した．抗菌剤投与による菌交代現象を契機とし，急激な転帰を辿ったMRSA小腸・大腸炎を経験した．文献的考察を含め報告する．
NAID 10028052927

A patient who survived total colonic type ulcerative colitis complicated by toxic megacolon, disseminated intravascular coagulation, methicillin-resistant Staphylococcus aureus infection and bilateral femoral phlebothrombosis

ARAI HAJIME,HANAI HIROYUKI,FURUTA TAKAHISA,SATO YOSHIHIKO,YAMADA MASAMI,KANEKO EIZO,BABA SHOZO,SUGIMURA HARUHIKO
Journal of gastroenterology 34(3), 395-399, 1999-06-01
NAID 10011143287

IRE.698を参考にしつつ

バンコマイシンは最後の切り札として温存すべきである。米国ではバンコマイシン使用は厳重に管理されている。日本の臨床ではどうであろうか。抗菌薬に投資開発のリソースをつぎ込んでいる企業はかつてより少なくなってきている。細菌の進化をなるべく遅くするために、抗菌薬をもっと丁寧に使わなければならない。
かつては「MRSA腸炎」と疑診しただけでバンコマイシンを使用しており、経験的治療としては正しいかも知れないが、抗菌薬の適正利用とはほど遠い。