Takahashi Naoto, Uehara Ritei, Nishida Hiroshi, Sakuma Izumi, Yamasaki Chika, Takahashi Kayo, Honma Yoko, Momoi Mariko Y, Uchiyama Takehiko
Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan.
J Infect. 2009 Sep;59(3):194-200. doi: 10.1016/j.jinf.2009.06.010. Epub 2009 Jun 25.
An epidemic of neonatal toxic shock syndrome (TSS)-like exanthematous disease (NTED) has emerged in Japan. NTED is caused by TSS toxin-1 produced predominantly by methicillin-resistant Staphylococcus aureus (MRSA). Using a large-scale investigation, the present study aimed to elucidate the overall clinical picture of NTED in Japan.
We performed nationwide surveys regarding NTED in Japanese neonatal intensive care units (NICUs) in 2000, 2002 and 2005, and summarized the clinical findings of 540 patients. We also performed a case-control study to identify the relationship between patients' clinical findings and NTED.
The frequency of NTED in Japanese NICUs in 2000 was 52.2% and declined to 28.3% in 2005. The number of NTED patients in 2000 was 240 and decreased to 139 in 2005. In 2005, the isolation of methicillin-sensitive S. aureus (MSSA) increased to 20.0% in term patients. Although no term infants suffered shock or death, preterm patients sometimes developed severe symptoms.
The number of NTED patients decreased over the 5-year period from 2000 to 2005, even though more than 100 patients contracted NTED in Japanese NICUs in 2005. MSSA as well as MRSA can cause NTED, and NTED is more severe in preterm infants than in term infants.
日本出现了新生儿中毒性休克综合征（TSS）样疹病（NTED）的流行。NTED由主要由耐甲氧西林金黄色葡萄球菌（MRSA）产生的TSS毒素-1引起。本研究通过大规模调查，旨在阐明日本NTED的整体临床情况。
我们于2000年、2002年和2005年在日本新生儿重症监护病房（NICU）进行了关于NTED的全国性调查，并总结了540例患者的临床发现。我们还进行了一项病例对照研究，以确定患者临床发现与NTED之间的关系。
2000年日本NICU中NTED的发生率为52.2%，到2005年降至28.3%。2000年NTED患者数量为240例，2005年降至139例。2005年，足月患者中耐甲氧西林金黄色葡萄球菌（MSSA）的分离率增至20.0%。虽然没有足月婴儿发生休克或死亡，但早产患者有时会出现严重症状。
从2000年到2005年的5年期间，NTED患者数量有所减少，尽管2005年日本NICU中有超过100例患者感染NTED。MSSA和MRSA均可导致NTED，且NTED在早产儿中比足月婴儿中更严重。
