{"id":1220,"date":"2017-02-01T16:47:06","date_gmt":"2017-02-01T07:47:06","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1220"},"modified":"2017-02-01T16:47:06","modified_gmt":"2017-02-01T07:47:06","slug":"%e8%82%ba%e7%82%8e%e3%81%ae%e7%b5%8c%e9%81%8e%e3%81%ab%e3%81%a4%e3%81%84%e3%81%a6%e3%81%ae%e8%a8%98%e8%bf%b0%e7%a0%94%e7%a9%b6","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1220","title":{"rendered":"\u80ba\u708e\u306e\u7d4c\u904e\u306b\u3064\u3044\u3066\u306e\u8a18\u8ff0\u7814\u7a76"},"content":{"rendered":"

\u2015\u6587\u732e\u540d\u2015
\nJolien Teepe, Berna DL Broekbuizen, Katberine Lens et al. Disease Course of Lower Respiratory Tract Infection With a Bacterial Cause. Ann Fam Med 2016; 14 (6): 534-539.<\/p>\n

\u2015\u8981\u7d04\u2015
\n\u76ee\u7684\uff1a<\/strong>
\n\u3000\u2022 \u7d30\u83cc\u611f\u67d3\u306b\u7531\u6765\u3059\u308b\u54b3\u3068\u3001\u305d\u308c\u4ee5\u5916\u306e\u54b3\u306e\u7d4c\u904e\u306f\u7570\u306a\u308b\u3068\u601d\u308f\u308c\u308b\u304c\u3001\u5148\u884c\u6587\u732e\u306f\u4e4f\u3057\u3044\u3002
\n\u3000\u2022 \u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u306e\u73fe\u5834\u3067\u306f\u901a\u5e38\u7d30\u83cc\u691c\u67fb\u306f\u884c\u308f\u308c\u305a\u3001\u81e8\u5e8a\u7684\u306a\u5224\u65ad\u306e\u3082\u3068\u3067\u52a0\u7642\u304c\u884c\u308f\u308c\u308b\u3002\u73fe\u5834\u306e\u533b\u5e2b\u306f\u91cd\u75c7\u5316\u3059\u308b\u7d30\u83cc\u6027\u306e\u54b3\u3092\u898b\u843d\u3068\u3057\u305f\u304f
\n\u3000\u3000\u306a\u3044\u304c\u305f\u3081\u3001\u75c7\u72b6\u304c\u5f37\u3044\u5834\u5408\u306b\u6297\u83cc\u85ac\u3092\u51e6\u65b9\u3059\u308b\u3053\u3068\u304c\u3042\u308b\u3002\u3057\u304b\u3057\u3001\u3053\u3046\u3057\u305f\u5bfe\u5fdc\u3067\u306f\u526f\u4f5c\u7528\u306e\u767a\u75c7\u3001\u8010\u6027\u83cc\u306e\u51fa\u73fe\u3092\u62db\u3044\u3066\u3057\u307e\u3046\u3002
\n\u3000\u2022 \u6297\u83cc\u85ac\u306b\u3088\u308b\u6cbb\u7642\u3092\u53d7\u3051\u306a\u304b\u3063\u305f\u5834\u5408\u306e\u7d30\u83cc\u6027\u306e\u4e0b\u6c17\u9053\u611f\u67d3\uff08Lower Respiratory Tract Infection: LRTI\uff09\u306e\u7d4c\u904e\u306e\u7d4c\u904e\u304c\u660e\u3089\u304b\u306b\u306a\u308c\u3070\u3001
\n\u3000\u3000\u521d\u671f\u5bfe\u5fdc\u3068\u3057\u3066\u6ce8\u610f\u6df1\u304f\u7d4c\u904e\u3092\u307f\u305f\u308a\u3001\u60a3\u8005\u306e\u6cbb\u7642\u7d4c\u904e\u3092\u4e88\u6e2c\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u308b\u3088\u3046\u306b\u306a\u308b\u3068\u8003\u3048\u3089\u308c\u308b\u3002\u3088\u3063\u3066\u672c\u7814\u7a76\u3067\u306f\u3001\u6210\u4eba\u306b\u304a\u3051\u308b
\n\u3000\u3000\u6025\u6027\u767a\u75c7\u306e\u54b3\u306b\u3064\u3044\u3066\u3001\u7d30\u83cc\u6027LRTI\u306e\u7d4c\u904e\u306b\u3064\u3044\u3066\u8abf\u3079\u305f\u3002 <\/p>\n

\u65b9\u6cd5\uff1a
\n\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u3068\u7814\u7a76\u5bfe\u8c61\u8005<\/strong>
\n\u3000\u2022 \u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u306e\u73fe\u5834\u304b\u3089\u53d6\u5f97\u3055\u308c\u305f\u767a\u73fe\u304b\u308928\u65e5\u4ee5\u4e0b\u306e\u6025\u6027\u767a\u75c7\u306e\u54b3\u3092\u4f34\u3046\u6210\u4eba2,061\u4eba\u306e\u30c7\u30fc\u30bf\uff08\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u591a\u65bd\u8a2d\u7814\u7a76GRACE-10 study
\n\u3000\u3000\u306e\u4e8c\u6b21\u5229\u7528\uff09\u3092\u7528\u3044\u305f\u3002\u3053\u306e\u7814\u7a76\u3067\u306f\u88ab\u9a13\u8005\u3089\u306f\u30a2\u30e2\u30ad\u30b7\u30b7\u30ea\u30f3\u7fa4\u3068\u30d7\u30e9\u30bb\u30dc\u7fa4\u306b\u30e9\u30f3\u30c0\u30e0\u306b\u5272\u308a\u4ed8\u3051\u3089\u308c\u3066\u3044\u305f\u304c\u3001\u4eca\u56de\u306e\u89e3\u6790\u306b\u306f\u75be\u75c5\u306e\u81ea\u7136
\n\u3000\u3000\u7d4c\u904e\u3092\u53cd\u6620\u3057\u3066\u3044\u308b\u30d7\u30e9\u30bb\u30dc\u7fa4\uff081,021\u540d\uff09\u306e\u307f\u3092\u7528\u3044\u305f\u3002\u8074\u8a3a\u306b\u3088\u308a\u660e\u3089\u304b\u306b\u80ba\u708e\u304c\u7591\u308f\u308c\u308b\u60a3\u8005\uff08\u5c40\u6240\u7684\u306a\u30e9\u97f3\u30fb\u6c17\u7ba1\u652f\u97f3\uff09\u3001\u5168\u8eab\u6240\u898b\u304c\u5f37\u3044
\n\u3000\u3000\u60a3\u8005\uff08\u9ad8\u71b1\u3001\u5614\u5410\u3001\u91cd\u5ea6\u306e\u4e0b\u75e2\uff09\u3001\u598a\u5a20\u3057\u3066\u3044\u308b\u60a3\u8005\u3001\u30da\u30cb\u30b7\u30ea\u30f3\u306b\u30a2\u30ec\u30eb\u30ae\u30fc\u304c\u3042\u308b\u60a3\u8005\u3001\u524d\u6708\u306b\u6297\u83cc\u85ac\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u308b\u60a3\u8005\u3001\u514d\u75ab\u4e0d\u5168\u306e
\n\u3000\u3000\u60a3\u8005\u306f\u9664\u5916\u3057\u305f\u3002
\n\u8a55\u4fa1\u9805\u76ee<\/strong>
\n\u3000\u2022 \u75c7\u72b6\uff094\u6bb5\u968e\u306eLikert scale\u306b\u3088\u3063\u3066\u4ee5\u4e0b\u306e\u75c7\u72b6\u3092\u8a18\u9332\u3057\u305f\uff1a\u54b3\u3001\u75f0\u3001\u606f\u5207\u308c\u3001\u5598\u9cf4\u3001\u9f3b\u6c41\u3001\u767a\u71b1\u3001\u5171\u901a\u3001\u7b4b\u8089\u75db\u3001\u982d\u75db\u3001\u7761\u7720\u969c\u5bb3\u3001\u5177\u5408\u306e\u60aa\u3055\u3001
\n\u3000\u3000\u65e5\u5e38\u751f\u6d3b\u3084\u4ed5\u4e8b\u306e\u969c\u5bb3\u3001\u610f\u8b58\u969c\u5bb3\u3001\u4e0b\u75e2\u3002
\n\u3000\u2022 \u691c\u4f53\uff09\u521d\u8a3a\u65e5\u306b\u75f0\u3068\u9f3b\u54bd\u982d\u306e\u57f9\u990a\u3092\u53d6\u5f97\u3057\u305f\u3002\u7d30\u83cc\u691c\u67fb\u3068\u30a6\u30a4\u30eb\u30b9\u5b66\u7684\u691c\u67fb\u3092\u5b9f\u65bd\u3057\u305f\u3002
\n\u3000\u2022 \u80f8\u90e8X\u7dda\uff09\u521d\u8a3a\u304b\u30897\u65e5\u4ee5\u5185\u3001\u3067\u304d\u308c\u30703\u65e5\u4ee5\u5185\u306b\u53d6\u5f97\u3057\u305f\u3002
\n\u7d30\u83cc\u611f\u67d3\u306e\u5b9a\u7fa9<\/strong>
\n\u3000\u2022 S. Pneumoniae, H. influenza, M. Pneumoniae, B. pertussiss, L. Pneumoniae \u304c\u6c17\u9053\u691c\u4f53\u304b\u3089\u691c\u51fa\u3055\u308c\u305f\u5834\u5408\u3001\u3042\u308b\u3044\u306f\u8840\u6e05\u5b66\u7684\u306b
\n\u3000\u3000\u8a3c\u660e\u3055\u308c\u305f\u5834\u5408\u306b\u3001\u7d30\u83cc\u611f\u67d3\u3042\u308a\u3068\u5b9a\u7fa9\u3057\u305f\u3002
\n\u6297\u83cc\u85ac\u306e\u4f7f\u7528<\/strong>
\n\u3000\u2022 \u533b\u5e2b\u306e\u5224\u65ad\u3067\u3001\u5fc5\u8981\u306a\u5834\u5408\u306f\u9069\u5207\u306a\u6297\u83cc\u85ac\u6295\u4e0e\u304c\u884c\u308f\u308c\u305f\u3002
\n\u30a2\u30a6\u30c8\u30ab\u30e0\u6307\u6a19<\/strong>
\n\u3000\u2022 \u521d\u8a3a\u304b\u3089\u300c\u75c7\u72b6\u304c\u3088\u304f\u306a\u3044\u300d\u3068\u8a55\u4fa1\u3055\u308c\u305f\u671f\u9593\u3001\u8a3a\u7642\u304b\u30892\u65e5\u76ee\u304b\u30894\u65e5\u76ee\u306e\u91cd\u75c7\u5ea6\u3001\u75be\u75c5\u5897\u60aa\u306b\u3088\u308b\u518d\u8a3a\u3001\u521d\u8a3a\u304b\u30894\u9031\u4ee5\u5185\u306b\u5165\u9662\u304c\u5fc5\u8981\u3068\u306a\u3063\u305f
\n\u3000\u3000\u969b\u306e\u65b0\u3057\u3044\u75c7\u72b6\u304a\u3088\u3073\u6240\u898b\u3001\u5bdb\u89e3\u307e\u3067\u306e\u671f\u9593\u3001\u65e5\u5e38\u7684\u306a\u6d3b\u52d5\u3084\u4ed5\u4e8b\u306b\u652f\u969c\u304c\u3042\u3063\u305f\u671f\u9593\u3002<\/p>\n

\u7d71\u8a08\u89e3\u6790\uff1a<\/strong>
\n\u3000\u2022 \u91cd\u75c7\u5ea6\uff08\u7dda\u5f62\u56de\u5e30\uff09\u3001\u671f\u9593\uff08Cox\u56de\u5e30\uff09\u3001\u518d\u8a3a\uff08\u30ed\u30b8\u30b9\u30c6\u30a3\u30c3\u30af\u56de\u5e30\uff09\u3092\u89e3\u6790\u3002\u591a\u5909\u91cf\u89e3\u6790\u306e\u969b\u306f\u8abf\u6574\u56e0\u5b50\u3092\u4ee5\u4e0b\u306e\u3088\u3046\u306b\u5b9a\u3081\u305f\uff1a\u5e74\u9f62\u3001\u55ab\u7159\u3001
\n\u3000\u3000\u4f75\u5b58\u75be\u75c5\uff08\u80ba\u30fb\u5fc3\u30fb\u7cd6\u5c3f\u75c5\uff09\u3001\u53d7\u8a3a\u307e\u3067\u306e\u54b3\u306e\u671f\u9593\u3002<\/p>\n

\u7d50\u679c\uff1a<\/strong>
\n\u3000\u2022 \u5bfe\u8c61\u8005\u306f834\u540d\u3067\u3001\u7d30\u83cc\u6027LRTI\u306f162\u540d\uff0819%\uff09\u306b\u8a8d\u3081\u3089\u308c\u305f\u3002
\n\u3000\u2022 \u8d77\u708e\u83cc\u306fS. Pneumoniae, H. influenza\uff08\u3044\u305a\u308c\u308234.7%\uff09\u304c\u591a\u304b\u3063\u305f\u3002
\n\u3000\u2022 \u7d30\u83cc\u6027LRTI\u306e\u60a3\u8005\u306b\u306f\u55ab\u7159\u8005\u304c\u591a\u304f\uff0833% vs 24%\uff09\u3001\u54b3\u306e\u671f\u9593\u304c\u9577\u304f\uff089\u65e5 vs 8\u65e5\uff09\u3001\u521d\u8a3a\u6642\u306e\u60a3\u8005\u306e\u8a34\u3048\u308b\u91cd\u75c7\u5ea6\u304c\u9ad8\u304f\uff0834 vs 30\uff09\u3001
\n\u3000\u3000\u30ec\u30f3\u30c8\u30b2\u30f3\u4e0a\u306e\u6240\u898b\u304c\u591a\u304b\u3063\u305f\uff086% vs 3%\uff09\u3002
\n\u3000\u2022 62\u540d(7%)\u306e\u60a3\u8005\u306b\u3001\u521d\u8a3a\u304b\u308910\u65e5\u4ee5\u5185\u306b5\u65e5\u4ee5\u4e0a\u306e\u6297\u83cc\u85ac\u4f7f\u7528\u304c\u8a8d\u3081\u3089\u308c\u305f\u3002\u3053\u308c\u3089\u306e\u60a3\u8005\u306f\u533b\u5e2b\u306e\u8a55\u4fa1\u3059\u308b\u91cd\u75c7\u5ea6\u304c\u9ad8\u304b\u3063\u305f\u304c\uff0836 vs 31\uff09\u3001
\n\u3000\u3000\u5e74\u9f62\u3084\u4f75\u5b58\u75be\u60a3\u306f\u975e\u4f7f\u7528\u7fa4\u3068\u5dee\u306f\u306a\u304b\u3063\u305f\u3002
\n\u3000\u2022 \u7d30\u83cc\u6027LRTI\u60a3\u8005\u306f2\u65e5\u76ee\u304b\u30894\u65e5\u76ee\u306b\u304b\u3051\u3066\u60a3\u8005\u306e\u8a34\u3048\u308b\u91cd\u75c7\u5ea6\u304c\u6709\u610f\u306b\u9ad8\u304f\u3001\u75c7\u72b6\u306e\u5897\u60aa\u306e\u305f\u3081\u518d\u8a3a\u3059\u308b\u5272\u5408\u3082\u6709\u610f\u306b\u9ad8\u304b\u3063\u305f\u3002
\n\u3000\u2022 X\u7dda\u4e0a\u80ba\u708e\u50cf\u304c\u8a8d\u3081\u3089\u308c\u308b\u60a3\u8005\u3092\u9664\u5916\u3057\u3066\u3082\u3001\u7d50\u679c\u306f\u5909\u308f\u3089\u306a\u304b\u3063\u305f\u3002
\n\u3000\u2022 \u7d30\u83cc\u6027LRTI\u7fa4\u3068\u975e\u7d30\u83cc\u6027LRTI\u7fa4\u306b\u305d\u308c\u305e\u308c1\u540d\u305a\u3064\u306e\u5165\u9662\u304c\u3042\u3063\u305f\u3002\u6b7b\u4ea1\u4f8b\u306f\u306a\u304b\u3063\u305f\u3002
\n\u3000\u2022 \u7d30\u83cc\u6027LRTI\u7fa4\u3068\u975e\u7d30\u83cc\u6027LRTI\u7fa4\u3067\u306f\u3001\u300c\u75c7\u72b6\u304c\u3088\u304f\u306a\u3044\u300d\u72b6\u614b\u306b\u3064\u3044\u3066\u7d4c\u904e\u306b\u6709\u610f\u306a\u5dee\u306f\u8a8d\u3081\u306a\u304b\u3063\u305f\u3002
\n\u3000\u2022 \u6297\u83cc\u85ac\u4f7f\u7528\u8005\u3092\u9664\u5916\u3057\u305f\u89e3\u6790\u3067\u306f\u3001\u75c7\u72b6\u5897\u60aa\u306e\u305f\u3081\u306e\u518d\u8a3a\u304c\u7d30\u83cc\u6027LRTI\u7fa4\u3067\u591a\u304b\u3063\u305f\uff0823% vs 16%, OR=1.67, 95%CI 1.06-2.63, P=.029\uff09\u3002
\n\u3000\u2022 S. Pneumonia \u611f\u67d3\u8005\u3092\u9664\u5916\u3057\u305f\u89e3\u6790\u3068\u3001H. influenza \u611f\u67d3\u8005\u3092\u9664\u5916\u3057\u305f\u89e3\u6790\u306b\u3064\u3044\u3066\u3001\u305d\u308c\u305e\u308c\u306b\u304a\u3044\u3066\u7279\u306b\u7d50\u679c\u306f\u5909\u308f\u3089\u306a\u304b\u3063\u305f\u3002<\/p>\n

\u8003\u5bdf\uff1a
\n\u7d50\u8ad6<\/strong>
\n\u3000\u2022 \u6025\u6027\u306e\u7d30\u83cc\u6027LTRI\u306f\u305d\u3046\u3067\u306a\u3044\u3082\u306e\u3088\u308a\u3082\u75c7\u72b6\u7d4c\u904e\u304c\u3084\u3084\u60aa\u3044\u3053\u3068\u304c\u660e\u3089\u304b\u306b\u306a\u3063\u305f\u304c\u3001\u3053\u306e\u76f8\u9055\u306e\u610f\u7fa9\u306f\u4e4f\u3057\u3044\u3002
\n\u9650\u754c<\/strong>
\n\u3000\u2022 \u3053\u306e\u7814\u7a76\u3067\u306f\u3001\u975e\u5e38\u306b\u91cd\u7be4\u3067\u5373\u6642\u7d39\u4ecb\u3055\u308c\u305f\u60a3\u8005\u306f\u542b\u307e\u308c\u3066\u3044\u306a\u3044\u306e\u3067\u3001\u7814\u7a76\u7d50\u679c\u306f\u91cd\u75c7\u60a3\u8005\u3078\u4e00\u822c\u5316\u3059\u308b\u3053\u3068\u306f\u3067\u304d\u306a\u3044\u3002
\n\u3000\u2022 \u7d30\u83cc\u304ccolonization\u3057\u3066\u3044\u305f\u4e8b\u4f8b\u3082\u7d30\u83cc\u6027LRTI\u306b\u5206\u985e\u3055\u308c\u305f\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002\u305f\u3060\u3057\u3001S. Pneumoniae, H. influenza\u306f\u5065\u5e38\u8005\u3067\u6700\u592710%\u307b\u3069
\n\u3000\u3000colonazation\u304c\u8a8d\u3081\u3089\u308c\u308b\u7a0b\u5ea6\u3067\u3042\u308b\u3002COPD\u60a3\u8005\u306b, H. influenza \u306ecolonazation\u304c\u591a\u3044\u304c\u3001\u3053\u306e\u7814\u7a76\u3067\u306f5%\u3057\u304b\u8a72\u5f53\u3057\u306a\u3044\u3002
\n\u5b9f\u81e8\u5e8a\u3078\u306e\u610f\u7fa9<\/strong>
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\u2015\u6587\u732e\u540d\u2015 Jolien Teepe, Berna DL Broekbuizen, Katberine Lens et al. Disease Course of Lower Respiratory Tract Infe … \u7d9a\u304d\u3092\u8aad\u3080 \u80ba\u708e\u306e\u7d4c\u904e\u306b\u3064\u3044\u3066\u306e\u8a18\u8ff0\u7814\u7a76<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-1220","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1220","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1220"}],"version-history":[{"count":2,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1220\/revisions"}],"predecessor-version":[{"id":1222,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1220\/revisions\/1222"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1220"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1220"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1220"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}