ホウモン カイゴ ト ホウモン ニュウヨク カイゴ ニオケル カンセンショウ ト カンセン ヨボウ ノ ゼンコク チョウサ

在宅医療の進展に鑑み、344訪問介護事業所と1208訪問入浴介護事業における感染予防の状況に関する質問紙による全国調査を、2006年1月と6月に行った。結果は以下のようであった。1)訪問介護事業所の70.3%と訪問入浴介護事業所の92.9%が要介護5の利用者のケアを受け持っていた。2)訪問入浴介護事業所の60.5%が感染症と診断された利用者を受け持っていた。また、訪問入浴介護事業所のうち76.1%が褥創のある利用者がいると回答しており、70.3%では膀胱留置カテーテルを装着している利用者がいた。これらからは、訪問入浴事業所では訪問看護ステーションと同様に、感染症のリスクの高い易感染者を多くケアしていることが示されていた。3)訪問介護事業所の70.3%と訪問入浴介護事業所の89.7%は感染対策マニュアルを保有していたが、約30%の事業所では職員に対する感染対策研修を実施していない結果であった。日本では、在宅訪問事業に関わる事業所の規模が小さく、現場で感染予防教育を組織的に行うには困難が伴う。理論と実践の両面からの感染予防教育が介護基礎教育課程で強化されるべきである。The present situation of infection control strategies in 344 home‑visit care facilities and 1208 home‑visit bathing care facilities were evaluated using questionnaires in January and June, 2006. The results were as follows: 1) 70.3% of home‑visit care facilities and 92.9% of home‑visit bathing facilities had users who were classified as care level 5. 2) 60.5% of the home‑visit bathing care facilities had users who had been diagnosed with infections, 76.1% of them had users who were suffering from decubitus, and 70.3% of them had users using bladder catheters, indicating that these facilities gave care to the users who were immune‑compromised hosts having risks for infections as well as the users in home‑visit nursing care stations. 3) 70.3% of home‑visit care facilities and 89.7% of home‑visit bathing care facilities had their manuals for infection control, but about 30% of them did not make time to educate their staff regarding infection control. In Japan, most home‑visit facilities consist of so small number of staff members, where systematic education of infection control seems to be difficult to perform through active services. Theoretical and practical education of infection control should be carried out as part of the curriculum of basic education for students of care personnel

Association of the prtF1 Gene (Encoding Fibronectin-Binding Protein F1) and the sic Gene (Encoding the Streptococcal Inhibitor of Complement) with emm Types of Group A Streptococci Isolated from Japanese Children with Pharyngitis

A total of 66 clinical isolates of group A streptococci (GAS) were obtained from 66 Japanese children with pharyngitis. The prtF1 gene (encoding fibronectin-binding protein F1) and the sic gene (encoding the streptococcal inhibitor of complement) were present in 51 (77.3%) and 48 (72.7%) of the 66 isolates, respectively. These results indicated that a high prevalence of two virulence genes, prtF1 and sic, is characteristic of GAS in Japan