同: セラチア・マルセッセンス
関: Serratia marcescens

first aid step1 2006 p.133,162,168

腸内細菌科セラチア属

USMLE

Q book p.191 26

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/09/06 00:38:41」(JST)

wiki en

Serratia marcescens (/sɛˈreɪʃjə mɑː(r)ˈsɛs.sɛnz/)^[2] is a species of rod-shaped Gram negative bacterium in the family Enterobacteriaceae. A human pathogen, S. marcescens is involved in hospital-acquired infections (HAIs), particularly catheter-associated bacteremia, urinary tract infections and wound infections,^[3]^[4] and is responsible for 1.4% of HAI cases in the United States.^[5] It is commonly found in the respiratory and urinary tracts of hospitalized adults and in the gastrointestinal system of children. Due to its abundant presence in the environment, and its preference for damp conditions, S. marcescens is commonly found growing in bathrooms (especially on tile grout, shower corners, toilet water line, and basin), where it manifests as a pink, pink-orange, or orange discoloration and slimy film feeding off phosphorus-containing materials or fatty substances such as soap and shampoo residue.

Once established, complete eradication of the organism is often difficult, but can be accomplished by application of a bleach-based disinfectant. Rinsing and drying surfaces after use can also prevent the establishment of the bacterium by removing its food source and making the environment less hospitable.

S. marcescens may also be found in environments such as dirt, supposedly "sterile" places, and the subgingival biofilm of teeth. Due to this, and because S. marcescens produces a reddish-orange tripyrrole pigment called prodigiosin, it may cause staining of the teeth. The biochemical pathway for the production of prodigiosin by S. marcescens is unknown except for the final two steps. In these steps, a monopyrrole and a bipyrrole undergo a condensation reaction by way of an enzyme to form prodigiosin.

Identification

S. marcescens is a motile organism and can grow in temperatures ranging from 5–40 °C and in pH levels ranging from 5 to 9. It is differentiated from other Gram-negative bacteria by its ability to perform casein hydrolysis, which allows it to produce extracellular metalloproteinases which are believed to function in cell-to-extracellular matrix interactions. S. marcescens also exhibits tryptophan and citrate degradation. One of the end products of tryptophan degradation is pyruvic acid, which is then incorporated into different metabolic processes of S. marcescens. A final product of citrate degradation is carbon. Thus, S. marcescens can rely on citrate as a carbon source. In identifying the organism, one may also perform a methyl red test, which determines if a microorganism performs mixed-acid fermentation. S. marcescens results in a negative test. Another determination of S. marcescens is its capability to produce lactic acid by oxidative and fermentative metabolism. Therefore, it is said that S. marcescens is lactic acid O/F+.^[6]

Test	Result^[7]
Gram stain	-
Oxidase	-
Indole production	-
Methyl Red	>70% -
Voges-Proskaeur	+
Citrate (Simmons)	+
Hydrogen sulfide production	-
Urea hydrolysis	>70% -
Phenylalanine deaminase	-
Lysine decarboxylase	+
Motility	+
Gelatin hydrolysis, 22 °C	+
Acid from lactose	-
Acid from glucose	+
Acid from maltose	+
Acid from mannitol	+
Acid from sucrose	+
Nitrate reduction	+ (to nitrite)
Deoxyribonuclease, 25 °C	+
Lipase	+
Pigment	some biovars produce red
Catalase production (24h)	+

Pathogenicity

The antibiogram of S. marcescens on Mueller-Hinton agar.

In humans, S. marcescens can cause infection in several sites, including the urinary tract, respiratory tract, wounds,^[5] and the eye, where it may cause conjunctivitis, keratitis, endophthalmitis, and tear duct infections.^[8] It is also a rare cause of endocarditis and osteomyelitis (particularly in people who use intravenous drugs recreationally), pneumonia, and meningitis.^[4]^[5] Most S. marcescens strains are resistant to several antibiotics because of the presence of R-factors, which are a type of plasmid that carry one or more genes that encode resistance; all are considered intrinsically resistant to ampicillin, macrolides, and first-generation cephalosporins (such as cephalexin).^[4]

In elkhorn coral, S. marcescens is the cause of the disease known as white pox disease.^[9] In silkworms, S. marcescens can also cause a lethal disease, especially in association with other pathogens.^[10]

In research laboratories employing Drosophila fruit flies, infection of them with S. marcescens is common. It manifests as a pink discoloration or plaque in or on larvae, pupae, or the usually starch and sugar-based food (especially when improperly prepared).

A rare clinical form of gastroenteritis occurring in early infancy caused by infection with S. marcescens. The red color of the diaper can be mistaken for hematuria (blood in the urine) which may cause unnecessary investigations by the physicians.^[11]

S. marcescens causes cucurbit yellow vine disease, leading to sometimes serious losses in melon fields.^[12]

History

Possible role in medieval miracles

"Bloody bread": S. marcescens growing on bread

Because of its red pigmentation, caused by expression of the pigment prodigiosin,^[13] and its ability to grow on bread, S. marcescens has been evoked as a naturalistic explanation of medieval accounts of the "miraculous" appearance of blood on the Corporal of Bolsena.^[13] This followed celebration of a Mass at Bolsena in 1263, led by a Bohemian priest who had doubts concerning transubstantiation, or the turning of bread and wine into the Body and Blood of Christ during the Mass. During the Mass, the Eucharist appeared to bleed and each time the priest wiped away the blood, more would appear.^[13] While Serratia possibly could generate a single appearance of red pigment, it is unclear how it could have generated more pigment after each wiping, leaving this proposed explanation open to doubt. This event is celebrated in a fresco in the Apostolic Palace in the Vatican City, painted by Raphael.^[14]

Discovery

S. marcescens was discovered in 1819 by Venetian pharmacist Bartolomeo Bizio, as the cause of an episode of blood-red discoloration of polenta in the city of Padua.^[15] Bizio named the organism four years later in honor of Serafino Serrati, a physicist who developed an early steamboat; the epithet marcescens (Latin for "decaying") was chosen because of the pigment's rapid deterioration (Bizio's observations led him to believe that the organism decayed into a mucilage-like substance upon reaching maturity).^[16] Serratia was later renamed Monas prodigiosus and Bacillus prodigiosus before Bizio's original name was restored in the 1920s.^[15]

Uses and misuse

Role in biowarfare testing

Until the 1950s, S. marcescens was erroneously believed to be a nonpathogenic "saprophyte",^[5] and its reddish coloration was used in school experiments to track infections. During the Cold War, it was used as a simulant in biological warfare testing by the U.S. military^[17] which studied it in field tests as a substitute for the tularemia bacterium, which was being weaponized at the time.

On 26 and 27 September 1950, the U.S. Navy conducted a secret experiment named "Operation Sea-Spray" in which some S. marcescens was released by bursting balloons of it over urban areas of the San Francisco Bay Area in California. Although the Navy later claimed the bacteria were harmless, beginning on September 29, 11 patients at a local hospital developed very rare, serious urinary tract infections, and one of these individuals, Edward J. Nevin, died.^[18] Cases of pneumonia in San Francisco also increased after S. marcescens was released.^[19]^[20] (That the simulant bacteria caused these infections and death has never been conclusively established. Nevin's son and grandson lost a lawsuit they brought against the government between 1981 and 1983.^[21]) The bacterium was also combined with phenol and an anthrax simulant and sprayed across south Dorset by US and UK military scientists as part of the DICE trials which ran from 1971 to 1975.^[22]

Since 1950, S. marcescens has steadily increased as a cause of human infection, with many strains resistant to multiple antibiotics.^[3] The first indications of problems with the influenza vaccine produced by Chiron Corporation in 2004 involved S. marcescens contamination.

Contaminated injectables

In early 2008, the U.S. Food and Drug Administration issued a nationwide recall of one lot of Pre-Filled Heparin Lock Flush Solution USP.^[23] The heparin IV flush syringes had been found to be contaminated with S. marcescens, which resulted in patient infections. The Centers for Disease Control and Prevention confirmed growth of S. marcescens from several unopened syringes of this product.

S. marcescens has also been linked to 19 cases in Alabama hospitals in 2011, including 10 deaths.^[24] All of the patients involved were receiving total parenteral nutrition at the time, and this is being investigated as a possible source of the outbreak.^[25]

Ground water flow tracing

Because of its ability to be grown on agar plates into even, well coloured lawns, and the existence of a phage specific to S. marscecens, it has been used to trace water flows in Karst limestone systems. Known quantities of phage are injected into a fixed point in the Karst water system and the outflow of interest are monitored by conventional small volume sampling at fixed time intervals. In the laboratory, the samples are poured onto pre-grown S. marscecens lawns and incubated. Colourless plaques in the lawns indicate the presence of phage. The method was claimed to be sensitive at very high dilutions because of the ability to detect single phage particles.^[26]^[27]

References

^ "Genus Serratia". List of Prokaryotic Names with Standing in Nomenclature (LPSN). Retrieved 6 June 2016.
^ Hicks, Randall. "Pronunciation Guide to microorganisms" (PDF). University of Minnesota.
^ ^a ^b Hejazi A; Falkiner FR (1997). "Serratia marcescens". J Med Microbiol. 46 (11): 903–12. doi:10.1099/00222615-46-11-903. PMID 9368530.
^ ^a ^b ^c Auwaerter P (8 October 2007). "Serratia species". Point-of-Care Information Technology ABX Guide. Johns Hopkins University. Retrieved 13 December 2008. Freely available with registration.
^ ^a ^b ^c ^d Serratia at eMedicine
^ "Serratia". Soil Microbiology, Environmental Microbiology BIOL/CEEE/CSES 4684. Virginia Tech. 2004. Archived from the original on 6 April 2005.
^ Bergey's Manuals of Determinative Bacteriology, by John G. Holt, 9th ed. Lippincott Williams & Wilkins, 15 January 1994. p. 217
^ "Serratia Marcescens seton implant infection & orbital cellulitis". EyeRounds.org. Retrieved 6 April 2006.
^ Patterson KL, Porter JW, Ritchie KB, et al. (June 2002). "The etiology of white pox, a lethal disease of the Caribbean elkhorn coral, Acropora palmata". Proc Natl Acad Sci USA. 99 (13): 8725–30. doi:10.1073/pnas.092260099. PMC 124366. PMID 12077296.
^ Vasantharajan VN, Munirathnamma N (1978). "Studies on Silkworm Diseases III - Epizootiology of a Septicemic Disease of Silkworms Caused by Serratia marcescens". Journal of the Indian Institute of Science. 60 (4). Retrieved 14 July 2016.
^ The Red Diaper Syndrome. Rev Chil Paediatr. 1960 Jul;31:335-9
^ "Cucurbit Yellow Vine Disease (CYVD) In Connecticut". University of Connecticut Integrated Pest Management. Archived from the original on 25 May 2012.
^ ^a ^b ^c Bennett JW; Bentley R (2000). "Seeing red: The story of prodigiosin". Adv Appl Microbiol. 47: 1–32. doi:10.1016/S0065-2164(00)47000-0. ISBN 978-0-12-002647-0. PMID 12876793.
^ "The Mass at Bolsena by Raphael". Vatican Museums. Retrieved 3 May 2006.
^ ^a ^b Sehdev PS; Donnenberg MS (October 1999). "Arcanum: The 19th-century Italian pharmacist pictured here was the first to characterize what are now known to be bacteria of the genus Serratia". Clin Infect Dis. 29 (4): 770, 925. doi:10.1086/520431. PMID 10589885.
^ Bizio's original report was translated into English in 1924, and published in the Journal of Bacteriology. See Merlino CP (November 1924). "Bartolomeo Bizio's Letter to the most Eminent Priest, Angelo Bellani, Concerning the Phenomenon of the Red Colored Polenta". J Bacteriol. 9 (6): 527–43. PMC 379088. PMID 16559067.
^ "How the U.S. Government Exposed Thousands of Americans to Lethal Bacteria to Test Biological Warfare". Democracy Now!. 13 July 2005. Retrieved 6 June 2016.
^ "Serratia has dark history in region". SFGate. 31 October 2004. Retrieved 14 July 2016.
^ Cole, Leonard A. (1988). Clouds of Secrecy: The Army's Germ-Warfare Tests Over Populated Areas. (Foreword by Alan Cranston.). Totowa, New Jersey: Rowman & Littlefield. ISBN 0-8476-7579-3.
^ Regis, Ed. The Biology of Doom : America's Secret Germ Warfare Project. Diane Publishing Company. ISBN 0-7567-5686-3.
^ Cole, Op. cit., pp. 85-104.
^ Barnett, Antony (2002-04-21). "Millions were in germ war tests". The Guardian. Retrieved 27 October 2012.
^ AM2 PAT, Inc. Issues Nationwide Recall of Pre-Filled Heparin Lock Flush Solution USP (5 mL in 12 mL Syringes)
^ Nisbet, Robert (30 March 2011). "Drip Feeds Linked To US Hospital Deaths". Retrieved 31 March 2011.
^ "CDC And ADPH Investigate Outbreak At Alabama Hospitals; Products Recalled". FDA. Retrieved 31 March 2011.
^ Jofre J. Goldscheider N; Drew D, eds. Methods in Karst Hydrology. International Association of Hydrogeologists -IAWPRC. pp. 138–139.
^ Horan N J; Naylor P J (November 1988). Water Pollution Control in Asia -The potential of bacteriophage to act as tracers of water movement. Pergamon Press. pp. 700–704. ISBN 0 08 036884 0.

External links

"Serratia marcescens". NCBI Taxonomy Browser. 615.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. セラチア種による感染症 infections due to serratia species
2. 血管内カテーテル感染症の疫学、病因、および微生物学 epidemiology pathogenesis and microbiology of intravascular catheter infections
3. Gram-negative bacillary meningitis: Treatment
4. グラム陰性桿菌性髄膜炎：疫学、臨床的特徴、および診断 gram negative bacillary meningitis epidemiology clinical features and diagnosis
5. 慢性肉芽腫性疾患：病因、臨床症状、および診断 chronic granulomatous disease pathogenesis clinical manifestations and diagnosis

English Journal

Scavenger deterrent factor (SDF) from symbiotic bacteria of entomopathogenic nematodes.

Gulcu B, Hazir S, Kaya HK.SourceDuzce University, Faculty of Arts and Science, Department of Biology, 81620 Duzce, Turkey.
Journal of invertebrate pathology.J Invertebr Pathol.2012 Jul;110(3):326-33. Epub 2012 Mar 22.
Entomopathogenic nematodes (EPNs) in the genera Steinernema and Heterorhabditis are symbiotically associated with bacteria in the genera Xenorhabdus and Photorhabdus, respectively. The symbiotic bacteria produce a chemical compound(s) that deterred ants from feeding on nematode-killed insects (i.e.,
PMID 22446508

Inter-laboratory comparison of different rapid methods for the detection of bacterial contamination in platelet concentrates.

Vollmer T, Hinse D, Schottstedt V, Bux J, Tapernon K, Sibrowski W, Knabbe C, Dreier J.SourceInstitut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Bad Oeynhausen, Germany DRK-Blutspendedienst West, Zentrallabor Hagen, Germany Institut für Transfusionsmedizin und Transplantationsimmunologie, Universitätsklinikum Münster, Münster, Germany.
Vox sanguinis.Vox Sang.2012 Jul;103(1):1-9. doi: 10.1111/j.1423-0410.2011.01572.x. Epub 2011 Dec 8.
Background Bacterial contamination of platelet concentrates still represents a major risk in transfusion medicine, and a variety of screening methods have been available to improve the safety of PCs. In the present study, the analytical quality of three different rapid screening methods (BactiFlo
PMID 22150778

Japanese Journal

Development of natural anti-tumor drugs by microorganisms

Chang Chia-Che,Chen Wei-Chuan,Ho Tsing-Fen,Wu Ho-Shing,Wei Yu-Hong
Journal of bioscience and bioengineering 111(5), 501-511, 2011-05
… Prodigiosin (PG) is a natural red pigment produced by microorganisms, i.e., Serratia marcescens and other gram-negative bacteria. … marcescens. …
NAID 110008661194

Chitinase from Autographa californica Multiple Nucleopolyhedrovirus: Rapid Purification from Sf-9 Medium and Mode of Action

FUKAMIZO Tamo,SATO Hirokazu,MIZUHARA Mamiko,OHNUMA Takayuki,GOTOH Takeshi,HIWATASHI Kazuyuki,TAKAHASHI Saori
Bioscience, Biotechnology, and Biochemistry 75(9), 1763-1769, 2011
… The mode of action was similar to that of Serratia marcescens chitinase A (SmChiA), the amino acid sequence of which is 60.5% homologous to that of the AcMNPV enzyme. …
NAID 130000940075

Adaptor protein is essential for insect cytokine signaling in hemocytes

Oda Yasunori,Matsumoto Hitoshi,Kurakake Maiko,Ochiai Masanori,Ohnishi Atsushi,Hayakawa Yoichi
Proceedings of the National Academy of Sciences of the United States of America 107(36), 15862-15867, 2010-09-07
… P77 RNAi larvae also showed significantly higher mortality than control larvae following infection with Serratia marcescens, thus indicating that P77 is essential for GBP to mediate a normal innate cellular immunity in insects. …
NAID 80021284424

Serratia marcescens 2170 のCBP21欠損株の構築とその性質

川見寿子,臼井公人,鈴木一史,武藤亜紀子,関水和久,渡邉剛志
キチン・キトサン研究 = Chitin and chitosan research 16(2), 202, 2010-06-01
NAID 10026999674

Related Pictures

★リンクテーブル★

リンク元	「髄膜炎」「腸内細菌科」「耐性菌」「尿路感染症」「日和見感染菌」

「髄膜炎」

Serratia marcescens
	S. marcescens on an XLD agar plate
Scientific classification
Domain:	Bacteria
Phylum:	Proteobacteria
Class:	Gamma Proteobacteria
Order:	Enterobacteriales
Family:	Enterobacteriaceae
Genus:	Serratia
Species:	S. marcescens
Binomial name
	Serratia marcescens; Bizio 1823

　　[★]

英: meningitis
同: 脳脊髄膜炎、
関: 蛋白細胞解離

病因

感染症(細菌、ウイルス、真菌など)、悪性腫瘍の浸潤　→　髄膜の炎症

分類

病原体

細菌性髄膜炎

菌血症→脳脈絡叢→髄腔
菌体成分(LPSなど)→BBB, 上衣細胞、脳細胞の障害。神経膠細胞による炎症サイトカインの分泌

無菌性髄膜炎

血行性、あるいは神経軸索によりウイルスが髄腔に波及。

細菌性髄膜炎：様々
ウイルス性髄膜炎：コクサッキーウイルス、エコーウイルス、ムンプスウイルス、単純ヘルペスウイルス、風疹ウイルス、麻疹ウイルス、水痘・帯状疱疹ウイルス
真菌性髄膜炎：クリプトコッカス髄膜炎
結核性髄膜炎：結核菌
梅毒性髄膜炎：梅毒菌

臨床経過

宿主要因と髄膜炎に関わる病原体

頻度・年齢階層が資料によって異なるため混乱しないように注意。

YN.J-137改変

4ヶ月未満	B群溶連菌(50%)	大腸菌(25%)	インフルエンザ菌(20%)	リステリア菌(1%)
4ヶ月～6歳未満	インフルエンザ菌(70%)	肺炎球菌(25%)
6歳～50歳未満	肺炎球菌(65%)	インフルエンザ菌(10%)	髄膜炎菌
50歳以上	肺炎球菌(80%)	黄色ブドウ球菌
免疫不全者	クレブシエラ	連鎖球菌	緑膿菌	黄色ブドウ球菌	真菌

first aid step1 2006 p.161

Newborn (0–6 mos)	Children (6 mos–6 yrs)	6–60 yrs	60 yrs +
Streptococcus agalactiae	Streptococcus pneumoniae	Neisseria meningitidis	Streptococcus pneumoniae
Escherichia coli	Neisseria meningitidis	Enteroviruses	Gram-negative rods
Listeria	Haemophilus influenzae type B	Streptococcus pneumoniae	Listeria
	Enteroviruses	HSV

HIV: Cryptococcus, CMV, toxoplasmosis (brain abscess), JC virus (PML)

incidence of H. influenzae meningitis has ↓ greatly with introduction of H. influenzae vaccine in last 10–15 years.

CBT QB vol2 p.562

	1位	2位	3位
新生児	大腸菌	B群溶連菌	リステリア菌
小児期(6歳以下)	インフルエンザ菌	肺炎球菌
成人	肺炎球菌	髄膜炎菌

IMD.1042

年齢	病原体
3ヶ月未満	B群溶連菌	大腸菌	リステリア菌
3ヶ月以上の乳小児	インフルエンザ菌	肺炎球菌
成人	肺炎球菌	髄膜炎菌
高齢者	肺炎球菌	グラム陰性桿菌	リステリア菌

小児細菌性髄膜炎起炎菌(PED.606)

		<3か月	3か月≦
グラム陽性	球菌	Streptococcus agalactiae Streptococcus pneumoniae Staphylococcus Enterococcus faecalis	Streptococcus pneumoniae(PSSP/PISP/PRSP)
グラム陽性	桿菌	Listeria monocytogenes	Listeria monocytogenes
グラム陰性	球菌	Neisseria meningitidis	Neisseria meningitidis
グラム陰性	桿菌	Escherichia coli Enterobacter cloacae Serratia marcescens	Haemophilus influenzae type b

新生児

Streptococcus agalactiaeは産道感染
Escherichia coliもおそらく産道感染

新生児と老人

Listeria monocytogenesは産道感染するので新生児に多い。新生児と老人に多いのは通性細胞内寄生菌で細胞性免疫の弱い宿主に感染やすいため？

乳児～幼児

Haemophilus influenzae type B

乳児～大人

Enteroviruses
Neisseria meningitidis

小児～大人

Herpes simplex virus

乳児～老人

Streptococcus pneumoniae

老人

グラム陰性桿菌は老人

髄膜炎の鑑別

	細菌性髄膜炎	ウイルス性髄膜炎	結核性髄膜炎	真菌性髄膜炎	癌性髄膜炎
外観	混濁	clear	水様～キサントクロミー日光微塵	clear～日光微塵	clear～キサントクロミー
圧 70-180 (mmH2O)	↑↑ 200～800以上	↑ 200～300	↑ 200～800	↑ 200～800	↑ 200～300
細胞 0-5 (/mm3)	500～数百万	10～1,000	25～1,000	25～1,000	25～500
細胞 0-5 (/mm3)	好中球	リンパ球	リンパ球	リンパ球	好中球
タンパク 15-45 mg/dl	↑↑ 50～1,500	↑ 正常～100	↑ 50～500	↑ 100～500	↑ 50～500
糖 50-80 mg/dl	↓↓ 0～40	→ 正常	↓↓ ～40	↓↓ ～40	↓ ～40

予後不良因子

入院時の状態に依存する：痙攣、意識レベルの変化、低血圧 (IRE.407)

国試

100F048

「腸内細菌科」

　　[★]

英: Enterobacteriaceae
関: 細菌

代表的なもの８つを覚ておく！

エンテロバクター属 Enterobacter
エシェリキア属  Escherichia
クレブシエラ属 Klebsiella
プロテウス属 Proteus
サルモネラ属 Salmonella
セラチア属 Serratia
シゲラ属 Shigella
エルシニア属 Yersinia

腸内細菌科 (SMB.163)

属	菌種	日和見感染菌	感染症
Citrobacter	Citrobacter freundii		尿路感染、骨髄炎、下痢
Edwardsiella	Edwardsiella tarda	○	腸管外感染症
Enterobacter	Enterobacter aerogenes	○	肺炎、尿路感染
	Enterobacter cloacae
	Enterobacter gergoviae
	Enterobacter sakazakii		新生児敗血症、髄膜炎
Escherichia	Escherichia coli		下痢、腸炎、腸管外感染症(尿路感染症、骨髄炎)
Hafnia	Hafnia alvei		腸管外感染症
Klebsiella	Klebsiella oxytoca		下痢
Klebsiella	Klebsiella pneumoniae	○	肺炎、尿路感染
Kluyvera	Kluyvera ascorbata	○
Kluyvera	Kluyvera cryocrescens	○
Morganella	Morganella morganii		尿路感染症
Proteus	Proteus mirabilis	○	尿路感染症
Proteus	Proteus vulgaris	○	尿路感染症
Providencia	Providencia alcalifaciens		尿路感染症、下痢
	Providencia rettgeri		尿路感染症、下痢
	Providencia stuartii		尿路感染症
Salmonella	Salmonella enterica		腸チフス、急性胃腸炎(食中毒)
Serratia	Serratia liquefaciens	○
Serratia	Serratia marcescens	○
Shigella	Shigella boydii		細菌性赤痢
	Shigella dysenteriae
	Shigella flexneri
	Shigella sonnei
Yersinia	Yersinia enterocolitica		急性胃腸炎(食中毒)、回腸末端炎、結節性紅斑
	Yersinia pestis		ペスト
	Yersinia pseudotuberculosis		腸間膜リンパ節炎、関節炎

「耐性菌」

　　[★]

英: resistant bacterium
同: 薬剤耐性菌 drug resistance bacterium drug resistant bacterium
関: 菌交代症、R因子

医療系の雑誌より(日経カデット11月？)

表1抗菌薬投与後に出現する可能性か高い耐性菌

系統	前投与抗菌薬	抗菌薬投与後に高頻度に検出される細菌
		自然耐性菌	獲得耐性菌
ペニシリン系	アンピシリン	Klebsiella pneumoniae	大腸菌、黄色ブドウ球菌(MSSA、MRSA)
	ピベラシリン		緑膿菌
セフエム系(第1・2世代)	セフアゾリン、セフォチアム	緑膿菌、腸球菌	黄色ブドウ球菌(MRSA)、大腸菌
セフエム系(第3世代)	セフ卜リアキソン	腸球菌	黄色ブドウ球菌(MRSA)、緑膿菌、大腸菌
	セフタジジム
	セフエビム
カルバペネム系	メロペネム	Stenotrophomonas maltophilia	黄色ブドウ球菌(MRSA)、緑膿菌
	イミペネム
アミノグリコシド系	アミカシン	腸球菌、嫌気性菌	緑膿菌, Serratia marcescens
	トブラマイシン	レンサ球菌、肺炎球菌
マクロライド系	クラリスロマイシン	腸内細菌科	黄色ブドウ球菌、肺炎球菌、化膿性レンサ球菌
	アジスロマシン
テトラサイクリン系	ミノサイクリン	Proteus mirabilis	黄色ブドウ球菌(MRSA)、Brukholderia cepacia、Acinetobacter baumannii
		Morganella morganii
		Providencia rettgeri
キノロン系	レポフロキサシン	レンサ球菌	黄色ブドウ球菌(MRSA、大腸菌、緑膿菌

表2主な耐性菌と治療薬

主な耐性菌	治療薬
緑膿菌	アズトレオナム+ブラマイシン、シプロフロキサシン(感性株)、(コリスチン)
メチシリン耐性黄色ブドウ球菌(MRSA)	バンコマイシン、テイコプラ二ン、アルベカシン、リネゾリド、(ST合剤、リファンピシン)
ESBLs産生大腸菌	ドリペネム、メロペネム、イミペネム、アミカシン、ST合剤
グルコース非発酵性グラム陰性桿菌	ミノサイクリン、ピベラシリン、アンピシリン+スルバクタム、クロラムフェニコール、ST合剤、(コリスチン)
バンコマイシン耐性腸球菌	テイコプラ二ン(VanB型)、リネゾリド、キヌプリスチン/ダルホプリスチン
（）は多分保険適用かないか、日本では未発売

「尿路感染症」

　　[★]

英: urinary tract infection, UTI, urinary tract infections, UTIs
関: 尿路感染

定義

尿路(腎、尿管、膀胱、尿道など)の感染症。尿道炎は別に取り扱われるらしい

疫学

尿路感染症は特に女性に多く、30歳になるまでに4人に1人が罹患。
入院患者の1/3は尿路感染症であり、さらにその3/4以上は膀胱カテーテルを留置されいる患者で起こる。

分類

背景

一般細菌の上行性感染によって起こることがほとんどであり、
単純性尿路感染症：尿路に明らかな基礎疾患がない。

急性、20-30歳代の女性に多い

複雑性尿路感染症：尿路に感染を起こしやすくなる基礎疾患がある。

慢性、高齢の男性に多い

部位

上部尿路感染症：腎盂腎炎
下部尿路感染症：膀胱炎

病因

特異性尿路感染症
非特異性尿路感染症

一般的な尿路感染症

病原体

SMB.607

外来患者

院内感染患者

first aid p.162

Ambulatory..E. coli (50-80%), Klebsiella (8-10%).

Staphylococcus saprophyticus (10-30%) is the 2nd most common cause of UTI in young ambulatory women.

Hospital..E. coli, Proteus, Klebsiella, Serratia,Pseudomonas.

感染経路

外尿道口からの上行性感染

病因

冷え、過度の排尿自制、尿流の停滞、経尿道的操作など

症状

腎盂腎炎：発熱、腰痛など、
膀胱炎では頻尿、排尿痛、残尿感、頻尿など

小児科 SPE.615

年長児：

上部：発熱、腰痛
下部：排尿痛、頻尿、尿の混濁

乳幼児：発熱、嘔吐、下痢、食欲不振など非特異的な全身症状
新生児：乳幼児の症状　＋　脱水、体重減少、黄疸など。

検査

尿検査

尿：混濁
尿沈渣：1視野(400倍)5個以上の白血球(膿尿)
尿培養：1ml中10^5個以上の細菌　←　中間尿の定量培養

症状(頻尿、排泄痛、残尿感)ががあれば、これ以下の菌数でも病因的意義がある。

治療

「日和見感染菌」

　　[★]

関: 日和見感染、日和見感染症

腸内細菌科

属	菌種	感染症
Edwardsiella	Edwardsiella tarda	腸管外感染症
Enterobacter	Enterobacter aerogenes	肺炎、尿路感染
	Enterobacter cloacae
	Enterobacter gergoviae
Klebsiella	Klebsiella pneumoniae	肺炎、尿路感染
Kluyvera	Kluyvera ascorbata
Kluyvera	Kluyvera cryocrescens
Proteus	Proteus mirabilis	尿路感染症
Proteus	Proteus vulgaris	尿路感染症
Serratia	Serratia liquefaciens
Serratia	Serratia marcescens

[1] "Genus Serratia". List of Prokaryotic Names with Standing in Nomenclature (LPSN). Retrieved 6 June 2016.

[2] Hicks, Randall. "Pronunciation Guide to microorganisms" (PDF). University of Minnesota.

[Hejazi_1997-3] Hejazi A; Falkiner FR (1997). "Serratia marcescens". J Med Microbiol. 46 (11): 903–12. doi:10.1099/00222615-46-11-903. PMID 9368530.

[POC-IT-4] Auwaerter P (8 October 2007). "Serratia species". Point-of-Care Information Technology ABX Guide. Johns Hopkins University. Retrieved 13 December 2008. Freely available with registration.

[Medscape-5] Serratia at eMedicine

[6] "Serratia". Soil Microbiology, Environmental Microbiology BIOL/CEEE/CSES 4684. Virginia Tech. 2004. Archived from the original on 6 April 2005.

[7] Bergey's Manuals of Determinative Bacteriology, by John G. Holt, 9th ed. Lippincott Williams & Wilkins, 15 January 1994. p. 217

[8] "Serratia Marcescens seton implant infection & orbital cellulitis". EyeRounds.org. Retrieved 6 April 2006.

[9] Patterson KL, Porter JW, Ritchie KB, et al. (June 2002). "The etiology of white pox, a lethal disease of the Caribbean elkhorn coral, Acropora palmata". Proc Natl Acad Sci USA. 99 (13): 8725–30. doi:10.1073/pnas.092260099. PMC 124366. PMID 12077296.

[10] Vasantharajan VN, Munirathnamma N (1978). "Studies on Silkworm Diseases III - Epizootiology of a Septicemic Disease of Silkworms Caused by Serratia marcescens". Journal of the Indian Institute of Science. 60 (4). Retrieved 14 July 2016.

[11] The Red Diaper Syndrome. Rev Chil Paediatr. 1960 Jul;31:335-9

[12] "Cucurbit Yellow Vine Disease (CYVD) In Connecticut". University of Connecticut Integrated Pest Management. Archived from the original on 25 May 2012.

[Bennett2000-13] Bennett JW; Bentley R (2000). "Seeing red: The story of prodigiosin". Adv Appl Microbiol. 47: 1–32. doi:10.1016/S0065-2164(00)47000-0. ISBN 978-0-12-002647-0. PMID 12876793.

[Vatican_Raphael-14] "The Mass at Bolsena by Raphael". Vatican Museums. Retrieved 3 May 2006.

[Sehdev-15] Sehdev PS; Donnenberg MS (October 1999). "Arcanum: The 19th-century Italian pharmacist pictured here was the first to characterize what are now known to be bacteria of the genus Serratia". Clin Infect Dis. 29 (4): 770, 925. doi:10.1086/520431. PMID 10589885.

[16] Bizio's original report was translated into English in 1924, and published in the Journal of Bacteriology. See Merlino CP (November 1924). "Bartolomeo Bizio's Letter to the most Eminent Priest, Angelo Bellani, Concerning the Phenomenon of the Red Colored Polenta". J Bacteriol. 9 (6): 527–43. PMC 379088. PMID 16559067.

[17] "How the U.S. Government Exposed Thousands of Americans to Lethal Bacteria to Test Biological Warfare". Democracy Now!. 13 July 2005. Retrieved 6 June 2016.

[18] "Serratia has dark history in region". SFGate. 31 October 2004. Retrieved 14 July 2016.

[19] Cole, Leonard A. (1988). Clouds of Secrecy: The Army's Germ-Warfare Tests Over Populated Areas. (Foreword by Alan Cranston.). Totowa, New Jersey: Rowman & Littlefield. ISBN 0-8476-7579-3.

[20] Regis, Ed. The Biology of Doom : America's Secret Germ Warfare Project. Diane Publishing Company. ISBN 0-7567-5686-3.

[21] Cole, Op. cit., pp. 85-104.

[22] Barnett, Antony (2002-04-21). "Millions were in germ war tests". The Guardian. Retrieved 27 October 2012.

[23] AM2 PAT, Inc. Issues Nationwide Recall of Pre-Filled Heparin Lock Flush Solution USP (5 mL in 12 mL Syringes)

[24] Nisbet, Robert (30 March 2011). "Drip Feeds Linked To US Hospital Deaths". Retrieved 31 March 2011.

[25] "CDC And ADPH Investigate Outbreak At Alabama Hospitals; Products Recalled". FDA. Retrieved 31 March 2011.

[26] Jofre J. Goldscheider N; Drew D, eds. Methods in Karst Hydrology. International Association of Hydrogeologists -IAWPRC. pp. 138–139.

[27] Horan N J; Naylor P J (November 1988). Water Pollution Control in Asia -The potential of bacteriophage to act as tracers of water movement. Pergamon Press. pp. 700–704. ISBN 0 08 036884 0.

Serratia marcescens

S. marcescens on an XLD agar plate
Scientific classification
Domain:	Bacteria
Phylum:	Proteobacteria
Class:	Gamma Proteobacteria
Order:	Enterobacteriales
Family:	Enterobacteriaceae
Genus:	Serratia
Species:	S. marcescens
Binomial name
*Serratia marcescens* Bizio 1823^[1]

匿名

検索

案内

Serratia marcescens