{"id":13123,"date":"2026-03-18T19:41:21","date_gmt":"2026-03-18T19:41:21","guid":{"rendered":"https:\/\/csiag.eu\/?p=13123"},"modified":"2026-04-10T10:47:51","modified_gmt":"2026-04-10T10:47:51","slug":"%e6%85%a2%e6%80%a7%e6%b0%97%e7%ae%a1%e6%94%af%e7%82%8e-%e3%82%b7%e3%83%b3%e3%83%93%e3%82%aa%e3%83%95%e3%83%ad%e3%83%bc","status":"publish","type":"post","link":"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/","title":{"rendered":"\u6162\u6027\u6c17\u7ba1\u652f\u708e - \u30b7\u30f3\u30d3\u30aa\u30d5\u30ed\u30fc\u30eb"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">\u76ee\u6b21<\/p>\n<span class=\"ez-toc-title-toggle\"><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Jekyll_Hyde\" >\u30b8\u30ad\u30eb\u3068\u30cf\u30a4\u30c9<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Was_steckt_dahinter\" >\u305d\u306e\u80cc\u666f\u306b\u306f\u4f55\u304c\u3042\u308b\u306e\u304b\uff1f<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Genomische_Besonderheiten_von_DSM_16440\" >Genomische Besonderheiten von DSM 16440<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Was_die_Sequenzierung_zeigt\" >Was die Sequenzierung zeigt<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Eine_bemerkenswerte_Unstimmigkeit\" >Eine bemerkenswerte Unstimmigkeit<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Pro_contra_E_faecalis\" >E.\u30d5\u30a7\u30ab\u30ea\u30b9\u306b\u8cdb\u5426\u4e21\u8ad6<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Pro_%E2%80%A6\" >\u30d7\u30ed ...<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#%E2%80%A6_contra\" >... \u30b3\u30f3\u30c8\u30e9<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Der_Mechanismus_im_Detail\" >\u30e1\u30ab\u30cb\u30ba\u30e0\u306e\u8a73\u7d30<\/a><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Die_Selektion_durch_Antibiotika\" >\u6297\u751f\u7269\u8cea\u306b\u3088\u308b\u9078\u629e<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#VRE_Vancomycin-Resistant_Enterococci\" >VRE\uff08\u30d0\u30f3\u30b3\u30de\u30a4\u30b7\u30f3\u8010\u6027\u8178\u7403\u83cc\uff09<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#%E2%80%A6_und_warum_wird_Symbioflor%C2%AE_dann_verkauft\" >\u2026 \u305d\u3057\u3066\u3001\u306a\u305c\u30b7\u30f3\u30d3\u30aa\u30d5\u30ed\u30a2\u00ae\u304c\u8ca9\u58f2\u3055\u308c\u3066\u3044\u308b\u306e\u3067\u3059\u304b\uff1f<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Risikofaktoren\" >\u30ea\u30b9\u30af\u8981\u56e0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Welche_Warnzeichen_gibt_es\" >\u8b66\u544a\u306e\u30b5\u30a4\u30f3\u3068\u306f\uff1f<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Harnwegsinfektionen_UTI\" >\u5c3f\u8def\u611f\u67d3\u75c7.<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Intraabdominelle_Infektionen_PeritonitisAbszesse\" >\u8179\u8154\u5185\u611f\u67d3\u75c7\uff08\u8179\u819c\u708e\/\u8179\u819c\u81bf\u760d\uff09<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Endokarditis\" >\u5fc3\u5185\u819c\u708e<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Sepsis_%E2%80%93_Notfall-Szenarien\" >\u6557\u8840\u75c7 \u2013 \u7dca\u6025\u4e8b\u614b\u30b7\u30ca\u30ea\u30aa\uff01<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Gibt_es_keine_Alternativen\" >\u4ee3\u66ff\u6848\u306f\u306a\u3044\u306e\u304b\uff1f<\/a><\/li><\/ul><\/nav><\/div>\n<span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">\u8aad\u66f8\u6642\u9593<\/span> <span class=\"rt-time\"> 8<\/span> <span class=\"rt-label rt-postfix\">\u8b70\u4e8b\u9332<\/span><\/span>\n<p class=\"wp-block-paragraph\">\u6162\u6027\u6c17\u7ba1\u652f\u708e\u306e\u6cbb\u7642\u306a\u3069\u306b\u4f7f\u7528\u3055\u308c\u308b\u30b7\u30f3\u30d3\u30aa\u30d5\u30ed\u306b\u306f\u30013\u3064\u306e\u30bf\u30a4\u30d7\u304c\u3042\u308b\u3002\u539f\u5247\u7684\u306b\u306f\u300170\u5e74\u4ee5\u4e0a\u524d\u304b\u3089\u5e02\u8ca9\u3055\u308c\u3066\u304a\u308a\u3001\u4ee5\u4e0b\u306e\u3082\u306e\u3092\u542b\u3093\u3067\u3044\u308b-\u300c\u514d\u75ab\u300d\u5909\u7a2e\u3067\u306f <em>\u30a8\u30f3\u30c6\u30ed\u30b3\u30c3\u30ab\u30b9\u30fb\u30d5\u30a7\u30ab\u30ea\u30b9 DSM 16440<\/em>- \u305d\u3057\u3066 <em>\u5927\u8178\u83ccDSM 17252<\/em>-\u30d0\u30af\u30c6\u30ea\u30a2\u3068\u4e9c\u925b\u3060\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u30a4\u30cd\u79d1\u306e\u82b1\u7c89\u75c7\u3084\u6162\u6027\u6c17\u7ba1\u652f\u708e\u3092\u60a3\u3063\u3066\u3044\u308b\u4eba\u306f\u3001\u51ac\u306e\u9593\u300c\u52d5\u304f\u300d\u3068\u3059\u3050\u306b\u3001\u6cbb\u7642\u4e0d\u53ef\u80fd\u306a\u6c38\u4e45\u7684\u306a\u80f8\u306e\u3059\u304f\u3088\u3046\u306a\u54b3\u306b\u60a9\u307e\u3055\u308c\u308b\u3002\u5e73\u548c\u3067\u9759\u304b\u306a\u306e\u306f\u3001\u5bd2\u3044\u5c4b\u5916\u3060\u3051\u306a\u306e\u3060\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u6709\u540d\u306a\u80ba\u306e\u5c02\u9580\u533b\uff08pulmonologists\uff09\u3067\u3042\u308b\u306f\u305a\u306e\u533b\u5e2b\u3067\u3055\u3048\u3001\u6cbb\u7642\u306e\u63d0\u6848\u3069\u3053\u308d\u304b\u3001\u76ee\u6a19\u6307\u5411\u306e\u8a3a\u65ad\u3055\u3048\u3057\u3066\u304f\u308c\u306a\u3044\u306e\u3067\u3042\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u30b7\u30f3\u30d0\u30a4\u30aa\u30d5\u30ed\u30fc\u30eb\u304c\u3053\u306e\u523a\u6fc0\u6027\u306e\u54b3\u306b\u52b9\u304f\u306e\u306f\u3001\u305d\u306e\u305f\u3081\u3067\u306f\u306a\u3044\u3002 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u305d\u306e\u4e3b\u306a\u7406\u7531\u306f\u3001\u6297\u751f\u7269\u8cea\u3068\u540c\u69d8\u3001\u8178\u5185\u306e\u514d\u75ab\u7cfb\uff08GALT\uff1a\u8178\u7ba1\u95a2\u9023\u30ea\u30f3\u30d1\u7d44\u7e54\uff09\u306b\u5bfe\u3057\u3066\u30dd\u30b8\u30c6\u30a3\u30d6\u3067\u5f37\u5316\u7684\u306a\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u304b\u3089\u3067\u3042\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3057\u304b\u3057 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u8178\u7ba1\u514d\u75ab\u30b7\u30b9\u30c6\u30e0\u306e\u72b6\u614b\u306b\u3088\u3063\u3066\u3001\u300c\u826f\u3044\u300d\u3068\u3082\u300c\u60aa\u3044\u300d\u3068\u3082\u306a\u308b\u6027\u8cea\u3092\u6301\u3063\u3066\u3044\u308b\u3002\u514d\u75ab\u7cfb\u3068\u64ec\u614b\u3092\u6f14\u3058\u308b\u65e9\u5909\u308f\u308a\u82b8\u4eba\u3067\u3042\u308b\u3002.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Jekyll_Hyde\"><\/span>\u30b8\u30ad\u30eb\u3068\u30cf\u30a4\u30c9<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u30b8\u30ad\u30eb\u535a\u58eb<\/strong>, \u4fe1\u983c\u3067\u304d\u308b\u533b\u5e2b <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u8178\u5185.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u30d3\u30bf\u30df\u30f3\u3092\u751f\u6210\u3057\u3001pH\u5024\u3092\u8abf\u6574\u3057\u3001\u5384\u4ecb\u306a\u30d0\u30af\u30c6\u30ea\u30a2\u3092\u8ffd\u3044\u6255\u3046\u3002\u660e\u3089\u304b\u306b\u512a\u7b49\u751f\u3067\u3042\u308b\u3002.<br>\u3057\u304b\u3057\u3001\u7acb\u6d3e\u306a\u5148\u751f\u306e\u30ab\u30d5\u30a7\u304c\u30b3\u30fc\u30d2\u30fc\u30ab\u30c3\u30d7\u3092\u96a0\u3059\u3088\u3046\u306b\u3001\u60aa\u6027\u56e0\u5b50\u3092\u96a0\u3057\u3066\u3044\u308b\u3002\u9069\u5207\u306a\u6297\u539f\u3092\u904b\u3073\u3001\u514d\u75ab\u30b7\u30b9\u30c6\u30e0\u3092\u9a19\u3057\u3066\u7121\u8996\u3055\u305b\u308b\u306e\u3060\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u6297\u751f\u7269\u8cea\u306e\u6295\u4e0e\u3001\u602a\u6211\u3001\u514d\u75ab\u4e0d\u5168\u3001\u305d\u3057\u3066\u7a81\u7136\u3001\u5584\u826f\u306a\u8178\u306e\u53cb\u304c\u610f\u5730\u60aa\u306a\u30cf\u30a4\u30c9\u6c0f\u306b\u5909\u8eab\u3059\u308b\u306e\u3060\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u305d\u3057\u3066\u30cf\u30a4\u30c9\u6c0f\u306b\u306f\u8a08\u753b\u304c\u3042\u308b\u3002\u90aa\u60aa\u306a\u8a08\u753b\u3060\u3002\u5f7c\u306f\u5b89\u5168\u306a\u8178\u3092\u51fa\u3066\u3001\u4f55\u306e\u8a98\u3044\u3082\u306a\u304f\u8840\u6d41\u306e\u4e2d\u306b\u8ff7\u3044\u8fbc\u3080\u3002.<br>\u305d\u3053\u3067\u6297\u751f\u7269\u8cea\u304c\u9f3b\u8840\u3092\u51fa\u3057\u3001\u6b6f\u3092\u98df\u3044\u3057\u3070\u308b\u3088\u3046\u306a\u300c\u30d0\u30a4\u30aa\u30d5\u30a3\u30eb\u30e0\u300d\u8981\u585e\u3092\u7bc9\u304f\u3002\u68ee\u306e\u5996\u602a\u306e\u3088\u3046\u306b\u30de\u30af\u30ed\u30d5\u30a1\u30fc\u30b8\u306b\u6f5c\u307f\u3001VIP\u30d1\u30fc\u30c6\u30a3\u30fc\u306e\u30c1\u30b1\u30c3\u30c8\u306e\u3088\u3046\u306a\u30bf\u30f3\u30d1\u30af\u8cea\u3067\u514d\u75ab\u30b7\u30b9\u30c6\u30e0\u3092\u6b3a\u304f\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u5fc3\u5185\u819c\u708e\uff1f\u5091\u4f5c\u3067\u3059\u3002\u5c3f\u8def\u611f\u67d3\u75c7\uff1f\u65e5\u5e38\u8336\u98ef\u4e8b\u3002\u8179\u819c\u708e\uff1f\u8da3\u5473\u3060\u3002\u75c5\u9662\u3067\u306f\u4eca\u3084\u30cf\u30a4\u30c9\u6c0f\u304c\u4e3b\u5f79\u3067\u3042\u308b\u3002\u30cf\u30a4\u30c9\u6c0f\u306f\u9662\u5185\u611f\u67d3\u5168\u4f53\u306e11%\u3092\u5f15\u304d\u8d77\u3053\u3059\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u30b8\u30ad\u30eb\u3068\u30cf\u30a4\u30c9\u306e\u5883\u754c\u306f\u7121\u5f62\u3067\u3042\u308b\u3002\u30cf\u30a4\u30c9\u6c0f\u306f\u5e38\u306b\u30b8\u30ad\u30eb\u535a\u58eb\u306e\u4f53\u5185\u306b\u3044\u308b\u3002\u5e83\u57df\u6297\u751f\u7269\u8cea\u3001\u5b8c\u6cbb\u3057\u3066\u3044\u306a\u3044\u514d\u75ab\u30b7\u30b9\u30c6\u30e0\u3001\u305d\u3057\u3066\u30b8\u30ad\u30eb\u535a\u58eb\u304c\u9593\u9055\u3063\u305f\u4e07\u80fd\u85ac\u3092\u98f2\u307f\u3001\u5909\u8c8c\u3059\u308b\u3002\u3053\u306e\u7d30\u83cc\u306e\u53ef\u5851\u6027\u306f\u4ed6\u306b\u985e\u3092\u898b\u306a\u3044\u3002\u30b9\u30ea\u306e\u3088\u3046\u306a\u30b9\u30d4\u30fc\u30c9\u3067\u3042\u3089\u3086\u308b\u6297\u751f\u7269\u8cea\u8010\u6027\u907a\u4f1d\u5b50\u3092\u4e57\u3063\u53d6\u3063\u3066\u3057\u307e\u3046\u306e\u3060\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u6cbb\u7642\u6cd5\u3082\u306a\u3051\u308c\u3070\u3001\u5909\u8eab\u3092\u5143\u306b\u623b\u3059\u8840\u6e05\u3082\u306a\u3044\u3002\u30b8\u30ad\u30eb\u535a\u58eb\u304c\u5065\u5eb7\u306a\u8178\u306e\u307e\u307e\u3067\u3001\u30cf\u30a4\u30c9\u6c0f\u306b\u5909\u7570\u3057\u306a\u3044\u3053\u3068\u3092\u7948\u308b\u3057\u304b\u306a\u3044\uff0e<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Was_steckt_dahinter\"><\/span>\u305d\u306e\u80cc\u666f\u306b\u306f\u4f55\u304c\u3042\u308b\u306e\u304b\uff1f<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u3069\u306e\u3088\u3046\u306b <em>\u30a2\u30b0\u30cb\u30a7\u30b7\u30e5\u30ab\u30fb\u30c0\u30ab<\/em> \u305d\u3057\u3066 <em>\u30c8\u30de\u30b7\u30e5\u30fb\u30e4\u30eb\u30bc\u30f3\u30dc\u30d5\u30b9\u30ad<\/em>&nbsp;\u306b\u63b2\u8f09\u3055\u308c\u305f\u3002 <em>\u5206\u5b50\u79d1\u5b66\u56fd\u969b\u30b8\u30e3\u30fc\u30ca\u30eb<\/em> \u201e<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10888668\/\" target=\"_blank\" rel=\"noreferrer noopener\">\u6575\u304b\u3089\u5473\u65b9\u3078&nbsp;<em>\u8178\u7403\u83cc<\/em>&nbsp;\u30d2\u30c8\u514d\u75ab\u7cfb\u3078\u306e\u591a\u69d8\u306a\u5f71\u97ff<\/a>\u201c\u300c\u3067\u3042\u308b\u3002 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u8af8\u5203\u306e\u5263\u3060\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">EFSA (<em>\u6b27\u5dde\u98df\u54c1\u5b89\u5168\u6a5f\u95a2<\/em>)\u306f\u3001FDA\u306eGRAS(Generally Recognised as Safe)\u30ea\u30b9\u30c8\u3068\u540c\u69d8\u3001\u5b89\u5168\u6027\u304c\u79d1\u5b66\u7684\u306b\u8a55\u4fa1\u3055\u308c\u627f\u8a8d\u3055\u308c\u305f\u98df\u54c1\u6dfb\u52a0\u7269\u3001\u98df\u54c1\u63a5\u89e6\u6750\u6599\u3001\u5fae\u751f\u7269\u3001\u305d\u306e\u4ed6\u306e\u7269\u8cea\u3092\u30ea\u30b9\u30c8\u30a2\u30c3\u30d7\u3057\u305f\u3082\u306e\u3067\u3042\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u30b7\u30f3\u30d3\u30aa\u30d5\u30ed<sup>\u00ae<\/sup> wurde nicht genehmigt, obwohl es den \u201esichereren&#8220; Stamm DSM 16440 enth\u00e4lt. Der Hauptgrund liegt nicht allein in der Jekyll-&amp;-Hyde-Problematik der Spezies, sondern auch darin, dass <strong>keine publizierte Genomsequenz explizit f\u00fcr DSM 16440<\/strong> vorliegt (s. Abschnitt \u201eGenomische Besonderheiten&#8220;). F\u00fcr eine EFSA-QPS-Listung (Qualified Presumption of Safety) reicht die stellvertretende Sequenzierung verwandter Klone formal nicht aus.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u554f\u984c\u306f\u3001\u671b\u307e\u3057\u3044\u52b9\u679c\u304c\u5f97\u3089\u308c\u308b\u6295\u4e0e\u91cf\u3082\u3001\u3069\u306e\u6642\u70b9\u3067\u5f97\u3089\u308c\u308b\u304b\u3082\u308f\u304b\u3063\u3066\u3044\u306a\u3044\u3053\u3068\u3067\u3042\u308b\u3002 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u201e\u306f \u201c\u3084\u308a\u3059\u304e \"\u3067\u3042\u308a\u3001\u79fb\u7c4d\u304c\u8feb\u3063\u3066\u3044\u308b\u3001, <em>\u8178\u7403\u83cc<\/em> \u8178\u58c1\u3092\u901a\u904e\u3057\u3066\u8840\u6d41\u3084\u8179\u819c\u8154\u306a\u3069\u306e\u533a\u753b\u306b\u5165\u308a\u3001\u305d\u3053\u3067\u75c5\u539f\u6027\u3092\u767a\u73fe\u3059\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3060\u304b\u3089\u3001\u826f\u304f\u898b\u3048\u308b\u304b\u60aa\u304f\u898b\u3048\u308b\u304b\u306f\u6587\u8108\u6b21\u7b2c\u3060\uff1a<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u5065\u5eb7\u306a\u8178\u3067<\/strong> \u82f1\u96c4<strong>, \u6297\u751f\u7269\u8cea\u306e\u904e\u5270\u6442\u53d6\u5f8c<\/strong> \u65e5\u548c\u898b\u4e3b\u7fa9\u8005\u3060\u3001,<strong> \u50b7\u53e3\u3084\u5fc3\u81d3\u306b<\/strong> \u6bba\u4eba\u8005\u3068 <strong>\u75c5\u9662\u74b0\u5883\u306b\u304a\u3044\u3066<\/strong> \u9023\u7d9a\u6bba\u4eba\u72af\u3060\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u4e0a\u8a18\u306e\u8a18\u4e8b\u306b\u306f\u3001\u7279\u306b\u3001\u6b21\u306e\u3088\u3046\u306a\u30b1\u30fc\u30b9\u304c\u66f8\u304b\u308c\u3066\u3044\u308b\u3002 <strong>\u30c7\u30a3\u30b9\u30d0\u30a4\u30aa\u30b7\u30b9<\/strong> (\u30de\u30a4\u30af\u30ed\u30d0\u30a4\u30aa\u30fc\u30e0\u306e\u30d0\u30e9\u30f3\u30b9\u304c\u5d29\u308c\u308b\u3068\uff09\uff1a<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u91cd\u8981\u306a\u8981\u7d20 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u5065\u5eb7\u306a\u72b6\u614b\u306b\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3059\u308b\u3053\u3068\u306f <em>\u30c7\u30aa\u30ad\u30b7\u30b3\u30fc\u30eb\u9178\u5869<\/em> (DCA\uff09\u3067\u3042\u308b\u3002DCA\u306f <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u3067\u3042\u308a\u3001\u305d\u306e\u8907\u88fd\u3068\u8ee2\u5199\u6d3b\u6027\u3092\u5236\u5fa1\u3057\u3066\u3044\u308b\u3002.<br>\u3068\u3044\u3046\u3053\u3068\u3060\uff1a <strong>\u540c\u3058\u91cf\u3067\u3082 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em>, \u30c7\u30aa\u30ad\u30b7\u30b3\u30fc\u30eb\u9178\u898f\u5236\u304c\u306a\u304f\u306a\u3063\u305f\u3068\u304d<\/strong> (\u6297\u751f\u7269\u8cea\u6295\u4e0e\u5f8c\u306a\u3069\uff09<strong>, \u305d\u306e\u52b9\u679c\u306f\u30de\u30a4\u30ca\u30b9\u306b\u8ee2\u3058\u308b\u3002.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u306b\u3064\u3044\u3066 <strong>\u7d76\u5bfe\u6570<\/strong> \u3088\u308a\u3082\u91cd\u8981\u5ea6\u306f\u4f4e\u3044\u3002 <strong>\u30b7\u30b9\u30c6\u30e0\u306e\u30d0\u30e9\u30f3\u30b9<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Genomische_Besonderheiten_von_DSM_16440\"><\/span>Genomische Besonderheiten von DSM 16440<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\"><strong>Wichtige Erg\u00e4nzung auf Basis publizierter Sequenzierungsdaten<\/strong><\/p>\n<\/blockquote>\n\n\n\n<p class=\"wp-block-paragraph\">Symbioflor\u00ae enth\u00e4lt <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> DSM 16440, einen von urspr\u00fcnglich zehn Isolaten, die in den 1950er Jahren aus dem Stuhl eines gesunden Menschen gewonnen wurden. Diese zehn Isolate tragen DSM-Nummern 16430 bis 16439.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pulsfeldgelelektrophorese-Analysen ergaben, dass <strong>DSM 16440 zu einer Gruppe von acht genomisch identischen Klonen<\/strong> geh\u00f6rt (DSM 16430, 16432, 16433, 16435\u201316439). Sequenzierungen wurden an den Klonen DSM 16430, 16431 und 16434 durchgef\u00fchrt und in \u00f6ffentlichen Datenbanken hinterlegt (European Nucleotide Archive: FLUS00000000 f\u00fcr DSM 16430, FLUT00000000 f\u00fcr DSM 16434; EMBL: HF558530 f\u00fcr das vollst\u00e4ndige Genom von DSM 16431).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Eine unter dem Akzessionsnamen DSM 16440 direkt publizierte Genomsequenz existiert nicht.<\/strong> SymbioPharm referenziert auf ihrer Website Sequenzierungspublikationen zu verwandten Klonen als Nachweis. Dies stellt eine regulatorisch akzeptierte, aber nicht vollst\u00e4ndig transparente L\u00f6sung dar. Der Hersteller wurde um die vollst\u00e4ndige Genomsequenz von DSM 16440 gebeten; eine Antwort steht aus.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Was_die_Sequenzierung_zeigt\"><\/span>Was die Sequenzierung zeigt<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Die genomische Analyse der Symbioflor-1-Klone ist in einem wesentlichen Punkt <strong>\u7652\u3057<\/strong>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Der Stamm hat die wichtigsten Virulenzgene <strong>verloren<\/strong>. Konkret fehlen:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Cytolysin<\/strong><br>Zellgift, das rote Blutk\u00f6rperchen und Immunzellen zerst\u00f6rt<\/li>\n\n\n\n<li><strong>Gelatinase \/ Coccolysin<\/strong>-<br>Gewebeabbauendes Enzym<\/li>\n\n\n\n<li><strong>Enterokokkales Oberfl\u00e4chenprotein (esp\/efaA)<\/strong> <br>Adh\u00e4sions- und Immunevasionsfaktor<\/li>\n\n\n\n<li><strong>Hyaluronidase<\/strong><br>Gewebs-invasives Enzym<\/li>\n\n\n\n<li><strong>Peptidantibiotikum AS-48<\/strong><\/li>\n\n\n\n<li><strong>vanB-Operon<\/strong><br>Vancomycin-Resistenz<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Noch vorhanden sind hingegen: Aggregationssubstanz, Kollagenadh\u00e4sionsprotein, Kapselbildungsgene, Resistenz gegen Sauerstoffradikale, Eigenschaften, die f\u00fcr die Schleimhautkolonisierung und damit f\u00fcr die probiotische Wirkung relevant sind.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Eine_bemerkenswerte_Unstimmigkeit\"><\/span>Eine bemerkenswerte Unstimmigkeit<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Allerdings zeigt sich bei genauem Hinsehen eine Inkonsistenz: <strong>DSM 16430<\/strong>, der als Repr\u00e4sentant der acht identischen Klone (zu denen DSM 16440 geh\u00f6rt) sequenziert wurde, besitzt ein <strong>kleineres Genom<\/strong> als die anderen Isolate. Ihm fehlt ein ~100 kb-Bereich, der unter anderem die <strong>Aggregationssubstanz<\/strong> kodiert, sowie ein ~36 kb-<strong>Prophagen<\/strong>-kodierender Bereich.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Das bedeutet: Wenn DSM 16430 als Sequenzierungsnachweis f\u00fcr DSM 16440 gilt, ist unklar, ob DSM 16440 die Aggregationssubstanz tats\u00e4chlich besitzt oder nicht, obwohl andere Publikationen sie f\u00fcr den Symbioflor-Stamm als vorhanden beschreiben (basierend auf dem vollst\u00e4ndiger sequenzierten DSM 16431). Dieser Widerspruch ist in der Literatur nicht aufgel\u00f6st.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Pro_contra_E_faecalis\"><\/span>E.\u30d5\u30a7\u30ab\u30ea\u30b9\u306b\u8cdb\u5426\u4e21\u8ad6<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Pro_%E2%80%A6\"><\/span>\u30d7\u30ed ...<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong><em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u30d3\u30bf\u30df\u30f3\u3092\u751f\u6210\u3057\u3001\u6804\u990a\u7d20\u3092\u4ee3\u8b1d\u3057\u3001\u8178\u5185pH\u5024\u3092\u7dad\u6301\u3059\u308b\u3002<\/strong>. .\u305d\u308c\u304c\u4e0d\u53ef\u6b20\u3060\u3002.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u514d\u75ab\u7cfb\u306f\u30c8\u30ec\u30fc\u30cb\u30f3\u30b0\u3068\u3057\u3066\u5fc5\u8981<\/strong><br>MALT\uff08\u7c98\u6db2\u95a2\u9023\u30ea\u30f3\u30d1\u7d44\u7e54\uff09\u306f\u3001\u5e38\u5728\u83cc\u3068\u306e\u63a5\u89e6\u3092\u901a\u3058\u3066\u306e\u307f\u3001\u305d\u306e\u6a5f\u80fd\u7684\u30fb\u69cb\u9020\u7684\u80fd\u529b\u3092\u30d5\u30eb\u306b\u767a\u63ee\u3059\u308b\u3002E.\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc\u306f\u4e3b\u8981\u306a \u201e\u30c8\u30ec\u30fc\u30ca\u30fc \u201c\u3067\u3042\u308b\u3002.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u4fb5\u7565\u304b\u3089\u5b88\u308b<\/strong><br>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc\u3084\u305d\u306e\u4ed6\u306e\u5e38\u5728\u5fae\u751f\u7269\u306f\u3001\u7a7a\u9593\u3084\u6804\u990a\u5206\u3092\u596a\u3044\u5408\u3044\u3001\u30d0\u30af\u30c6\u30ea\u30aa\u30b7\u30f3\u3092\u7523\u751f\u3059\u308b\u3053\u3068\u306b\u3088\u3063\u3066\u75c5\u539f\u6027\u7d30\u83cc\u3092\u9632\u3044\u3067\u3044\u308b\u3002.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u708e\u75c7\u3092\u6cbb\u3059<\/strong><br>\u30b7\u30f3\u30d3\u30aa\u30d5\u30ed\u30fc\u30eb\u306e\u4f8b\u3067\u306f\u3001\u6162\u6027\u6c17\u7ba1\u652f\u708e\u306e\u518d\u767a\u7387\u304c\u30b5\u30d7\u30ea\u30e1\u30f3\u30c8\u6442\u53d6\u4e2d\u306b43%\u6e1b\u5c11\u3057\u30018\u30f5\u6708\u5f8c\u306b\u306f68%\u6e1b\u5c11\u3057\u305f\u3002.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%80%A6_contra\"><\/span>... \u30b3\u30f3\u30c8\u30e9<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u96a0\u308c\u305f\u6bba\u4eba\u8005<\/strong><br>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc\u306f\u5fc3\u5185\u819c\u708e\u3001\u6ccc\u5c3f\u751f\u6b96\u5668\u611f\u67d3\u75c7\u3001\u8179\u8154\u5185\u611f\u67d3\u75c7\u3001\u6557\u8840\u75c7\u306e\u539f\u56e0\u3068\u306a\u308b\u3002\u5e02\u4e2d\u611f\u67d3\u6027\u5fc3\u5185\u819c\u708e\u306e\u7d0410-20%\u306fE. faecalis\u304c\u539f\u56e0\u3067\u3059\u3002.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u75c5\u9662\u5185\u306e\u3044\u305f\u308b\u3068\u3053\u308d\u306b\u3042\u308b<\/strong><br>E.\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc\u306f\u9662\u5185\u611f\u67d3\uff08HAI\uff1aHospital-Acquired Infection\uff09\u306e\u5c11\u306a\u304f\u3068\u308211%\u306e\u539f\u56e0\u3068\u306a\u3063\u3066\u304a\u308a\u3001\u7f79\u60a3\u7387\u3068\u6b7b\u4ea1\u7387\u304c\u5897\u52a0\u3057\u3066\u3044\u308b\u3002.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u6cbb\u7642\u304c\u4e0d\u91e3\u308a\u5408\u3044\u306b\u96e3\u3057\u3044<\/strong><br><em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u306f\u3001\u6297\u751f\u7269\u8cea\u3084\u514d\u75ab\u7d30\u80de\u3092\u5b9f\u8cea\u7684\u306b\u901a\u3055\u306a\u3044\u591a\u7cd6\u985e\u3001\u30bf\u30f3\u30d1\u30af\u8cea\u3001\u8102\u8cea\u306e\u69cb\u9020\u4f53\u3067\u3042\u308b\u30d0\u30a4\u30aa\u30d5\u30a3\u30eb\u30e0\u3092\u5f62\u6210\u3059\u308b\u80fd\u529b\u3092\u6301\u3063\u3066\u3044\u308b\u3002.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u3069\u3093\u306a\u30b9\u30d1\u30a4\u3088\u308a\u3082\u514d\u75ab\u30b7\u30b9\u30c6\u30e0\u304b\u3089\u96a0\u308c\u3066\u3044\u308b<\/strong><br>\u8a18\u4e8b\u306b\u3088\u308c\u3070\u3001\u751f\u304d\u6b8b\u308b\u305f\u3081\u306b\u6d3b\u6027\u9178\u7d20\u3092\u767a\u751f\u3055\u305b\u3001\u30de\u30af\u30ed\u30d5\u30a1\u30fc\u30b8\u306b\u6f5c\u4f0f\u3057\u3001Tax\uff08\u8178\u7403\u83cc\u51dd\u96c6\u7269\u8cea\uff09\u3092\u4f7f\u3063\u3066T\u7d30\u80de\u3092\u6d3b\u6027\u5316\u3055\u305b\u3001\u518d\u3073T\u7d30\u80de\u3092\u6b3a\u304f\u3002.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u3057\u304b\u3057\u3001\u305d\u3046\u3067\u306f\u306a\u3044\u3002 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u305d\u308c\u81ea\u4f53\u304c\u554f\u984c\u306a\u306e\u3060\u304c\u3001\u591a\u304f\u306e\u5834\u5408\uff08\u624b\u8853\u524d\u306a\u3069\uff09\u3001\u514d\u75ab\u7cfb\u3092\u5f31\u3081\u308b\u5e83\u57df\u6297\u751f\u7269\u8cea\u304c\u4f7f\u308f\u308c\u308b\u3002.<br>\u75c5\u539f\u6027\u306f\u3001\u75c5\u539f\u6027\u3068\u6297\u751f\u7269\u8cea\u8010\u6027\u306b\u95a2\u9023\u3057\u305f\u907a\u4f1d\u5b50\u8981\u7d20\u306e\u6c34\u5e73\u79fb\u52d5\u306b\u3088\u3063\u3066\u7372\u5f97\u3055\u308c\u308b\u3002\u3053\u308c\u306f\u3001\u76d7\u8cca\u304c\u81ea\u5206\u3067\u306f\u6b66\u5668\u3092\u4f5c\u3089\u305a\u3001\u4ed6\u4eba\u304b\u3089\u6b66\u5668\u5eab\u3092\u4e38\u3054\u3068\u62dd\u501f\u3059\u308b\u306e\u306b\u4f3c\u3066\u3044\u308b\u3002.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Der_Mechanismus_im_Detail\"><\/span>\u30e1\u30ab\u30cb\u30ba\u30e0\u306e\u8a73\u7d30<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>1. \u30d7\u30e9\u30b9\u30df\u30c9 - \u8f38\u9001\u624b\u6bb5<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u8178\u7403\u83cc\u306e\u30d7\u30e9\u30b9\u30df\u30c9\u5a92\u4ecb\u907a\u4f1d\u5b50\u306f\u3001\u30d0\u30f3\u30b3\u30de\u30a4\u30b7\u30f3\u8010\u6027\u8178\u7403\u83cc\uff08VRE\uff09\u306e\u767a\u751f\u306b\u5bc4\u4e0e\u3057\u3066\u3044\u308b\u3068\u8003\u3048\u3089\u308c\u3066\u304a\u308a\u3001\u7279\u306b\u8a3a\u7642\u6240\u3084\u5916\u79d1\u306a\u3069\u306e\u533b\u7642\u74b0\u5883\u3067\u306f\u91cd\u8981\u3067\u3042\u308b\u3002\uff09.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u30d7\u30e9\u30b9\u30df\u30c9\u306f<\/strong> \u5c0f\u3055\u306a\u5186\u5f62\u306eDNA\u65ad\u7247\u3067\u3001\u30d0\u30af\u30c6\u30ea\u30a2\u306e\u9593\u3092\u884c\u304d\u6765\u3057\u305f\u308a\u3001USB\u30e1\u30e2\u30ea\u306e\u3088\u3046\u306b\u300c\u6297\u751f\u7269\u8cea\u8010\u6027\u300d\u3092\u4fdd\u5b58\u3057\u305f\u308a\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u308b\u3002. <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> USB\u30e1\u30e2\u30ea\u30fc\u3092\u53d6\u308a\u51fa\u3057\u3001\u305d\u3053\u306b\u907a\u4f1d\u5b50\u3092\u30b3\u30d4\u30fc\u3059\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>2. \u6c34\u5e73\u7684\u907a\u4f1d\u5b50\u79fb\u52d5 - \u7a4d\u6975\u7684\u6355\u98df<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3053\u308c\u306f\u53d7\u52d5\u7684\u306a\u3082\u306e\u3060\u3051\u3067\u306f\u306a\u304f\u3001\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc\u306f\u80fd\u52d5\u7684\u3067\u3042\u308b\u3053\u3068\u3082\u3042\u308b\uff1a<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u4ed6\u306e\u30d0\u30af\u30c6\u30ea\u30a2\u304b\u3089\u30d7\u30e9\u30b9\u30df\u30c9\u3092\u53d6\u308a\u8fbc\u3080<strong>\u30c8\u30e9\u30f3\u30b9\u30d5\u30a9\u30fc\u30e1\u30fc\u30b7\u30e7\u30f3<\/strong>)<\/li>\n\n\n\n<li>\u6b7b\u3093\u3060\u30d0\u30af\u30c6\u30ea\u30a2\u304b\u3089DNA\u65ad\u7247\u3092\u5438\u53ce\u3059\u308b<\/li>\n\n\n\n<li>\u4ed6\u306e\u30d0\u30af\u30c6\u30ea\u30a2\u3068\u76f4\u63a5\u63a5\u89e6\u3057\u3001\u907a\u4f1d\u5b50\u3092\u4ea4\u63db\u3059\u308b(<strong>\u6d3b\u7528<\/strong>)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">...\u8178\u5185\u3067\u907a\u4f1d\u5b50\u3092\u76d7\u3080\u3088\u3046\u306a\u3082\u306e\u3060\u3002.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Die_Selektion_durch_Antibiotika\"><\/span>\u6297\u751f\u7269\u8cea\u306b\u3088\u308b\u9078\u629e<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u3053\u308c\u306f <strong>\u81ea\u7136\u6dd8\u6c70<\/strong> \u3092\u9023\u767a\u3057\u305f\uff1a<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u6297\u751f\u7269\u8cea\u306a\u3057\u306e\u30b7\u30ca\u30ea\u30aa<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u8178\u5185\u306b\u306f100\u7a2e\u985e\u306e\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc\u304c\u5b58\u5728\u3059\u308b<\/li>\n\n\n\n<li>99\u4eba\u304c\u654f\u611f\u30011\u4eba\u304c\u30e9\u30f3\u30c0\u30e0\u306a\u8010\u6027<\/li>\n\n\n\n<li>\u8010\u6027\u682a\u306b\u306f\u4f55\u306e\u30e1\u30ea\u30c3\u30c8\u3082\u306a\u3044\uff08\u73fe\u5834\u306b\u6297\u751f\u7269\u8cea\u304c\u306a\u3044\uff09<\/li>\n\n\n\n<li>100\u4eba\u5168\u54e1\u304c\u540c\u3058\u3088\u3046\u306b\u751f\u304d\u6b8b\u308b<\/li>\n\n\n\n<li>\u8010\u6027\u682a\u306f1%\u306e\u307e\u307e<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u6297\u751f\u7269\u8cea\u3042\u308a\u306e\u30b7\u30ca\u30ea\u30aa\uff1a<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc\u306b\u306f100\u7a2e\u985e\u306e\u83cc\u682a\u304c\u3042\u308b\u3002<\/li>\n\n\n\n<li>99\u4eba\u304c\u654f\u611f\u30011\u4eba\u304c\u62b5\u6297\u6027<\/li>\n\n\n\n<li>\u6297\u751f\u7269\u8cea\u304c\u6295\u4e0e\u3055\u308c\u300199\u982d\u306f\u76f4\u3061\u306b\u6b7b\u4ea1\u3057\u305f\u3002<\/li>\n\n\n\n<li>\u8010\u6027\u682a\u304c\u515a\u5168\u4f53\u3092\u652f\u914d\u3059\u308b\uff0e<\/li>\n\n\n\n<li>\u6297\u751f\u7269\u8cea\u6295\u4e0e\u5f8c\u3001\u96c6\u56e3\u306e95%\u304c\u8010\u6027\u3092\u793a\u3059<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">...\u305d\u3057\u3066\u3001\u6570\u65e5\u5f8c\u306e\u7d71\u8a08\u5e74<strong>\u9078\u629e\u7206\u767a<\/strong>!<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"VRE_Vancomycin-Resistant_Enterococci\"><\/span>VRE\uff08\u30d0\u30f3\u30b3\u30de\u30a4\u30b7\u30f3\u8010\u6027\u8178\u7403\u83cc\uff09<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">\u4e0a\u8a18\u306e\u8a18\u4e8b\u306e\u4e00\u4f8b\u3068\u3057\u3066\uff1a<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u30d0\u30f3\u30b3\u30de\u30a4\u30b7\u30f3\u8010\u6027\u8178\u7403\u83cc\uff08VRE\uff09\u306f\u3001\u305d\u306e\u4e00\u90e8\u304c\u30d7\u30e9\u30b9\u30df\u30c9\u3092\u4ecb\u3057\u305f\u907a\u4f1d\u5b50\u306b\u3088\u3063\u3066\u5f15\u304d\u8d77\u3053\u3055\u308c\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u306a\u305c\u3053\u308c\u304c\u4e8b\u5b9f\u4e0a\u306e\u30db\u30e9\u30fc\u30b7\u30ca\u30ea\u30aa\u306a\u306e\u304b\uff1f<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u306a\u305c\u306a\u3089 <em>\u30d0\u30f3\u30b3\u30de\u30a4\u30b7\u30f3<\/em> \u305d\u306e <strong>\u6700\u7d42\u624b\u6bb5\u306e\u6297\u751f\u7269\u8cea<\/strong> \u3092\u8868\u3059\u3002\u75c5\u539f\u4f53\u304c\u4ed6\u306e\u3059\u3079\u3066\u306e\u6297\u751f\u7269\u8cea\u306b\u5bfe\u3057\u3066\u8010\u6027\u3067\u3042\u308b\u5834\u5408\u3001\u6b8b\u3055\u308c\u305f\u81e8\u5e8a\u7684\u9078\u629e\u80a2\u306f\u4ee5\u4e0b\u306e\u901a\u308a\u3067\u3042\u308b\u3002 <em>\u30d0\u30f3\u30b3\u30de\u30a4\u30b7\u30f3<\/em>. .\u3057\u304b\u3057\u3001\u3082\u3057\u75c5\u539f\u4f53\u81ea\u4f53\u304c\u8010\u6027\u3092\u6301\u3063\u3066\u3044\u308b\u3068\u3057\u305f\u3089\u3001\u3053\u308c\u306f\u5f93\u6765\u306e\u533b\u5b66\u3067\u306f\u89e3\u6c7a\u3067\u304d\u306a\u3044\u554f\u984c\u3067\u3042\u308b\uff0e<br>\u30a8\u30c3\u30bb\u30f3\u30b7\u30e3\u30eb\u30aa\u30a4\u30eb\u306f\u6bba\u83cc\u30fb\u6bba\u30a6\u30a4\u30eb\u30b9\u4f5c\u7528\u304c\u3042\u308a\u3001\u75c5\u539f\u4f53\u304c\u3055\u3089\u3055\u308c\u308b\u6570\u767e\u7a2e\u985e\u306e\u300c\u6297\u751f\u7269\u8cea\u300d\u306e\u4ee3\u8868\u3067\u3042\u308b\u305f\u3081\u3001\u3044\u304b\u306a\u308b\u75c5\u539f\u4f53\u3082\u8010\u6027\u3092\u6301\u305f\u306a\u3044\u3002\u3064\u307e\u308a <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u30bb\u30fc\u30eb\u3092\u30ad\u30e3\u30f3\u30bb\u30eb\u3059\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>F\u00fcr DSM 16440 gilt:<\/strong> Das vanB-Operon, der h\u00e4ufigste Resistenzweg gegen Vancomycin bei Enterokokken, fehlt dem Stamm genomisch vollst\u00e4ndig. Das ist ein wesentlicher Sicherheitsvorteil gegen\u00fcber klinischen Isolaten.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%80%A6_und_warum_wird_Symbioflor%C2%AE_dann_verkauft\"><\/span>...\u305d\u3057\u3066\u3001\u306a\u305c\u30b7\u30f3\u30d3\u30aa\u30d5\u30ed\u30fc\u306a\u306e\u304b\uff1f<sup>\u00ae<\/sup> \u305d\u306e\u5f8c\u3001\u58f2\u5374\u3055\u308c\u305f\u306e\u3067\u3059\u304b\uff1f<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u305d\u308c\u306f \u201e\u8a66\u884c\u932f\u8aa4 \u201c\u3068\u3044\u3046\u306b\u306f\u5341\u5206\u6709\u52b9\u3060\u304c\u3001\u73fe\u4ee3\u7684\u3068\u3044\u3046\u306b\u306f\u900f\u660e\u6027\u306b\u6b20\u3051\u308b\u3002.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3042\u308b\u3044\u306f\u3001\u201e\u5b89\u5168\u306a \u201c\u7cfb\u7d71\u3067\u3042\u308a\u3001\u52b9\u304f\u304b\u3089\u3067\u3042\u308b\u3002\u3044\u3064\u307e\u3067\u52b9\u304f\u304b\u306f\u307e\u3060\u308f\u304b\u3089\u306a\u3044\u3002\u4f8b\u3048\u3070\u3001EF-2001\u682a\uff08\u30d7\u30ed\u30d0\u30a4\u30aa\u30c6\u30a3\u30af\u30b9\u682a\uff09\u306b\u306f\u6297\u751f\u7269\u8cea\u8010\u6027\u907a\u4f1d\u5b50\u304c\u6bd4\u8f03\u7684\u5c11\u306a\u3044\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Die Sequenzierungsdaten f\u00fcr den Symbioflor 1 Stamm DSM 16440 sind nicht verf\u00fcgbar gemacht, weshalb eine \u00dcberpr\u00fcfung der exakten Zusammensetzung nicht gegeben ist, obwohl der Hersteller auf seiner Webseite verk\u00fcndet &#8222;<strong>\u85ac\u5264\u3068\u3057\u3066\u306eEnterococcus faecalis DSM 16440\u306f\u3001\u6570\u5341\u5e74\u306b\u308f\u305f\u308a\u975e\u5e38\u306b\u3088\u304f\u7814\u7a76\u3055\u308c\u3066\u304a\u308a\u3001\u305d\u306e\u907a\u4f1d\u5b50\u306f\u5b8c\u5168\u306b\u89e3\u8aad\u3055\u308c\u3066\u3044\u308b\u3002.<\/strong>&#8220; Verwandte Klone sind hingegen sequenziert und hinterlegt.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u306e\u5168\u30b2\u30ce\u30e0\u914d\u5217\u3092\u30e1\u30fc\u30ab\u30fc\u306b\u554f\u3044\u5408\u308f\u305b\u305f\u3002 <strong>\u30a8\u30f3\u30c6\u30ed\u30b3\u30c3\u30ab\u30b9\u30fb\u30d5\u30a7\u30ab\u30ea\u30b9 DSM 16440<\/strong> \u3092\u8981\u8acb\u3057\u305f\u3002\u305d\u308c\u306b\u5fdc\u3058\u3066\u66f4\u65b0\u3057\u307e\u3059\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3068\u3044\u3046\u3053\u3068\u3060\uff1a <strong>\u5b89\u5168\u306a\u300d\u30d7\u30ed\u30d0\u30a4\u30aa\u30c6\u30a3\u30af\u30b9\u682a\u3067\u3042\u3063\u3066\u3082\u3001\u8178\u5185\u306e\u91ce\u751f\u306eE. faecalis\u306b\u5929\u7136\u306e\u8010\u6027\u907a\u4f1d\u5b50\u3092\u79fb\u3059\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002<\/strong> <strong>\u7533\u4f1d\u3048\u308b<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3053\u306e\u8a18\u4e8b\u304c\u3001E. faecalis\u304c\u4e16\u754c\u4e2d\u3067\u6700\u3082\u5e83\u304f\u8513\u5ef6\u3057\u3066\u3044\u308b\u591a\u5264\u8010\u6027\u75c5\u9662\u75c5\u539f\u83cc\u306e\u3072\u3068\u3064\u3067\u3042\u308b\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u308b\u3068\u8ff0\u3079\u3066\u3044\u308b\u306e\u306f\u3001\u307e\u3055\u306b\u3053\u306e\u305f\u3081\u3067\u3042\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3053\u308c\u306f\u3001\u3059\u3067\u306b\u305d\u306e\u90e8\u65cf\u304c\u5b58\u5728\u3059\u308b\u3053\u3068\u3092\u610f\u5473\u3059\u308b\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u30a2\u30f3\u30d4\u30b7\u30ea\u30f3<\/li>\n\n\n\n<li>\u30a8\u30ea\u30b9\u30ed\u30de\u30a4\u30b7\u30f3<\/li>\n\n\n\n<li>\u30d5\u30eb\u30aa\u30ed\u30ad\u30ce\u30ed\u30f3\u7cfb\u6297\u83cc\u85ac<\/li>\n\n\n\n<li>\u30b2\u30f3\u30bf\u30de\u30a4\u30b7\u30f3<\/li>\n\n\n\n<li>\u30d0\u30f3\u30b3\u30de\u30a4\u30b7\u30f3<\/li>\n\n\n\n<li>\u304a\u305d\u3089\u304f\u8907\u6570\u306e\u7d44\u307f\u5408\u308f\u305b<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u306f\u62b5\u6297\u529b\u304c\u3042\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u304c\u3042\u308b\u3002 <strong>\u30ca\u30c1\u30e5\u30e9\u30eb<\/strong> \u3078\u306e\u62b5\u6297\uff1a<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u30c8\u30ea\u30e1\u30c8\u30d7\u30ea\u30e0<\/li>\n\n\n\n<li>\u30ea\u30f3\u30b3\u30b5\u30df\u30c9\u7cfb\uff08\u30af\u30ea\u30f3\u30c0\u30de\u30a4\u30b7\u30f3\u306a\u3069\uff09<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u305d\u308c\u306f <strong>\u5185\u5728\u7684<\/strong>, \u7372\u5f97\u3057\u3066\u3044\u306a\u3044\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">(2010\u5e74\u306e\u7814\u7a76\u72b6\u6cc1\u306b\u3064\u3044\u3066\u306f\u3001\u4ee5\u4e0b\u3092\u53c2\u7167\u306e\u3053\u3068\u3002 <a href=\"https:\/\/www.clinicalmicrobiologyandinfection.org\/article\/S1198-743X(14)61686-4\/fulltext\" target=\"_blank\" rel=\"noreferrer noopener\">\u3053\u308c<\/a> \u5168\u6587\u3042\u308a\uff09\u3002<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Risikofaktoren\"><\/span>\u30ea\u30b9\u30af\u8981\u56e0<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u6297\u751f\u7269\u8cea\u306e\uff08\u904e\u5270\uff09\u6d88\u8cbb<\/strong> \u8178\u5185\u7d30\u83cc\u7570\u5e38\u75c7\u306e\u539f\u56e0<\/li>\n\n\n\n<li><strong>\u8178\u7ba1\u30d0\u30ea\u30a2\u306e\u969c\u5bb3<\/strong>, \u4f8b\uff1a\u8178\u306e\u624b\u8853\u3001\u708e\u75c7\u6027\u8178\u75be\u60a3\uff08IBD\u3001\u30af\u30ed\u30fc\u30f3\u75c5\uff09\u3001\u96c6\u4e2d\u6cbb\u7642\uff08\u80c3\u7ba1\u3001\u30ab\u30c6\u30fc\u30c6\u30eb\u306a\u3069\uff09\u306b\u3088\u308b\u3082\u306e<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u8178\u304c \u201e\u8ca0\u50b7 \u201c\u3057 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u304c\u8178\u5185\u306b\u5b58\u5728\u3059\u308b\u3068\u3001\u8ee2\u5ea7\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u307e\u308b\u3002.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Welche_Warnzeichen_gibt_es\"><\/span>\u8b66\u544a\u306e\u30b5\u30a4\u30f3\u3068\u306f\uff1f<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Mr.\u30cf\u30a4\u30c9\u304c\u767b\u5834\u3059\u308b\u3068\u304d\u3001\u305d\u308c\u306f\u4e3b\u306b\u6b21\u306e\u3088\u3046\u306a\u5f62\u3067\u8d77\u3053\u308b\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Harnwegsinfektionen_UTI\"><\/span><strong>\u5c3f\u8def\u611f\u67d3\u75c7\uff08UTI\uff09<\/strong>.<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">\u5c3f\u8def\u7d50\u77f3 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u6025\u6027\u306b\u767a\u75c7\u3059\u308b\u3053\u3068\u304c\u591a\u304f\u3001\u7279\u7570\u7684\u306a\u75c7\u72b6\u304c\u6025\u901f\u306b\u73fe\u308c\u308b\u305f\u3081\u8a3a\u65ad\u306f\u5bb9\u6613\u3067\u3042\u308b\uff1a<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u6392\u5c3f\u6642\u306e\u707c\u71b1\u611f<\/li>\n\n\n\n<li>\u983b\u5c3f\uff08\u30dd\u30e9\u30ad\u5c3f\uff09<\/li>\n\n\n\n<li>\u5c3f\u306e\u6fc1\u308a\u3084\u8840\u5c3f<\/li>\n\n\n\n<li>\u4e0b\u8179\u90e8\u3084\u9aa8\u76e4\u5468\u8fba\u306e\u75db\u307f<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u6ce8\u610f<\/strong>\u3068 <strong>\u514d\u75ab\u4e0d\u5168\u60a3\u8005<\/strong> (\u79fb\u690d\u5f8c\u306a\u3069\uff09\u3001\u75c7\u72b6\u306f\u3082\u3063\u3068\u5fae\u5999\u3067\u3042\u308b\u304b\u3001\u3042\u308b\u3044\u306f\u307e\u3063\u305f\u304f\u73fe\u308c\u306a\u3044\u3002 <em>\u514d\u75ab\u53cd\u5fdc\u306e\u4f4e\u4e0b<\/em> \u3080\u3057\u308d\u975e\u7279\u7570\u7684\u306a\uff08\u3042\u308b\u3044\u306f\u5b58\u5728\u3057\u306a\u3044\uff09\u75c7\u72b6\u3092\u4f34\u3046\u3002.<br>\u3053\u3053 <strong>\u7279\u5225\u306a\u6ce8\u610f\u304c\u5fc5\u8981\u3060\uff01<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Intraabdominelle_Infektionen_PeritonitisAbszesse\"><\/span>\u8179\u8154\u5185\u611f\u67d3\u75c7\uff08\u8179\u819c\u708e\/\u8179\u819c\u81bf\u760d\uff09<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">\u75c5\u539f\u4f53\u304c\u8179\u8154\u5185\u306b\u4fb5\u5165\u3057\u305f\u3068\u304d\u3067\u3042\u308b\u3002\u96c6\u4e2d\u6cbb\u7642\u5ba4\uff08ICU\uff09\u306b\u304a\u3051\u308b\u611f\u67d3\u75c7\u306e\u7d0425%\u306f\u3001\u4ee5\u4e0b\u306e\u75c5\u539f\u4f53\u306b\u3088\u3063\u3066\u5f15\u304d\u8d77\u3053\u3055\u308c\u3066\u3044\u308b\u3002 <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u5f15\u304d\u8d77\u3053\u3055\u308c\u305f\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u5b9f\u7528\u7684\u306a\u75c7\u72b6\uff1a<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u6fc0\u3057\u3044\u8179\u75db<\/strong><\/li>\n\n\n\n<li><strong>Fieber &#8211; oft hoch &gt;38,5\u00b0C<\/strong><\/li>\n\n\n\n<li><strong>\u5410\u304d\u6c17\uff0f\u5614\u5410<\/strong><\/li>\n\n\n\n<li><strong>\u8179\u819c\u708e\u306e\u5fb4\u5019<\/strong> (\u5178\u578b\u7684\u306a\u4f8b\uff1a\u30ac\u30fc\u30c9\u30ea\u30f3\u30b0-\u8179\u90e8\u3092\u5727\u8feb\u3059\u308b\u3068\u7b4b\u8089\u304c\u3059\u3050\u306b\u7dca\u5f35\u3059\u308b\u3001\u53cd\u8df3\u6027\u5727\u75db-\u5727\u8feb\u3092\u6025\u306b\u89e3\u9664\u3059\u308b\u3068\u6fc0\u75db\u304c\u8d70\u308b)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u554f\u984c\u3060\uff1a<\/strong> \u3053\u306e\u3088\u3046\u306a\u75c7\u72b6\u306f\u3001\u4e00\u6982\u306b <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em>, \u304c\u3001\u3053\u306e\u305f\u3073<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u8179\u90e8\u624b\u8853<\/li>\n\n\n\n<li>\u809d\u79fb\u690d<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u305d\u3057\u3066\u3001\u6b21\u306e\u3088\u3046\u306b\u767a\u5c55\u3059\u308b\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u30d5\u30a3\u30fc\u30d0\u30fc<\/li>\n\n\n\n<li>\u8179\u75db<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u3068\u3057\u3066\u77e5\u3089\u308c\u3066\u3044\u308b\u3002 <strong>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc\u306e\u8d64\u65d7<\/strong> \u89e3\u91c8\u3059\u308b<strong>!<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Endokarditis\"><\/span>\u5fc3\u5185\u819c\u708e<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">\u5fc3\u7b4b\u304c\u4fb5\u3055\u308c\u305f\u5834\u5408\u305d\u308c\u306f <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u306f\u73fe\u5728\u3001\u75c5\u9662\u5916\u3067\u767a\u75c7\u3057\u305f\u5fc3\u5185\u819c\u708e\u306e10-20%\u3092\u5360\u3081\u3066\u3044\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u5b9f\u8df5\u7684\u306a\u75c7\u72b6\uff08\u30af\u30e9\u30b7\u30c3\u30af\uff09\uff1a<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u6301\u7d9a\u3059\u308b\u767a\u71b1<\/strong> (\u65e5\uff0f\u9031\uff09<\/li>\n\n\n\n<li><strong>\u3081\u307e\u3044\u3001\u8131\u529b\u611f\u3001\u75b2\u52b4\u611f<\/strong><\/li>\n\n\n\n<li>\u65b0\u898f\u307e\u305f\u306f\u60aa\u5316 <strong>\u75c5\u7406\u7684<\/strong> <strong>\u5fc3\u96d1\u97f3<\/strong><\/li>\n\n\n\n<li><strong>\u30da\u30c6\u30c1\u30a2\u30a8<\/strong> (\u76ae\u819a\u306b\u5c0f\u3055\u306a\u8d64\u3044\u70b9-\u51fa\u8840\uff09\u3002<\/li>\n\n\n\n<li><strong>\u30aa\u30b9\u30e9\u30fc\u7d50\u7bc0<\/strong> (\u6307\u5148\u3084\u3064\u307e\u5148\u306b\u75db\u307f\u3092\u4f34\u3046\u7d50\u7bc0\u304c\u3067\u304d\u308b\uff09<\/li>\n\n\n\n<li><strong>\u30b8\u30a7\u30a4\u30f3\u30a6\u30a7\u30a4\u75c5\u5909<\/strong> (\u624b\u306e\u3072\u3089\uff0f\u8db3\u306e\u88cf\u306e\u7de9\u89e3\u6027\u306e\u8d64\u3044\u6591\u70b9\uff09<\/li>\n\n\n\n<li><strong>\u30b9\u30d7\u30ea\u30f3\u30bf\u30fc\u51fa\u8840<\/strong> (\u722a\u306e\u4e0b\u306e\u5c0f\u3055\u306a\u51fa\u8840\uff09<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">\u5fc3\u5185\u819c\u708e <em>\u30d5\u30a7\u30ab\u30ea\u30b9\u83cc<\/em> \u7f36 <strong>\u30b5\u30a4\u30ec\u30f3\u30c8<\/strong> \u3059\u306a\u308f\u3061\u3001\u4e0a\u8a18\u306e\u75c7\u72b6\u306f\u4f55\u3082\u8d77\u3053\u3089\u306a\u3044\u3002.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Sepsis_%E2%80%93_Notfall-Szenarien\"><\/span>\u6557\u8840\u75c7 <strong>\u7dca\u6025\u6642\u306e\u30b7\u30ca\u30ea\u30aa<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">\u5168\u8eab\u6027\u306e\u75c5\u539f\u4f53\u304c\u8513\u5ef6\u3057\u3066\u3044\u308b\u5834\u5408\u3001\u3064\u307e\u308a\u751f\u7269\u5168\u4f53\u304c\u5f71\u97ff\u3092\u53d7\u3051\u3066\u3044\u308b\u5834\u5408\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u5b9f\u7528\u7684\u306a\u75c7\u72b6(<\/strong>SIRS\u57fa\u6e96 <em>\u5168\u8eab\u6027\u708e\u75c7\u53cd\u5fdc\u75c7\u5019\u7fa4<\/em><strong>):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fieber &gt;38\u00b0C oder Hypothermie &lt;36\u00b0C<\/strong><\/li>\n\n\n\n<li><strong>Herzfrequenz &gt;90\/min<\/strong><\/li>\n\n\n\n<li><strong>Atemfrequenz &gt;20\/min oder pCO2 &lt;32 mmHg<\/strong><\/li>\n\n\n\n<li><strong>\u767d\u8840\u7403<\/strong> (\u767d\u8840\u7403\uff09<strong> &gt;12.000 <\/strong>\u307e\u305f\u306f<strong> &lt;4.000<\/strong><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u6557\u8840\u75c7\u6027\u30b7\u30e7\u30c3\u30af\u306e\u5834\u5408<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u8840\u5727\u306e\u4f4e\u4e0b\uff08\u6c34\u5206\u3067\u306f\u6539\u5584\u3067\u304d\u306a\u3044\uff09<\/strong><\/li>\n\n\n\n<li><strong>\u81d3\u5668\u4e0d\u5168\uff08\u814e\u81d3\u3001\u809d\u81d3\u3001\u80ba\uff09<\/strong><\/li>\n\n\n\n<li><strong>\u610f\u8b58\u306e\u5909\u5316<\/strong><\/li>\n\n\n\n<li><strong>\u983b\u8108\u3001\u767a\u6c57<\/strong><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Gibt_es_keine_Alternativen\"><\/span>\u4ee3\u66ff\u6848\u306f\u306a\u3044\u306e\u304b\uff1f<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u30b8\u30a7\u30a4\u30f3 - \u5468\u8fba\u306b\u7814\u7a76\u30c1\u30fc\u30e0\u306f\u3042\u308b\u304c <em>Mar\u00eda C. Urdaci\uff08\u30d5\u30e9\u30f3\u30b9\u30fb\u30dc\u30eb\u30c9\u30fc\u5927\u5b66\u5fae\u751f\u7269\u5b66\u30fb\u30d0\u30a4\u30aa\u5fdc\u7528\u7814\u7a76\u5ba4(LBMA)<\/em>, \u3092\u6271\u3046\u3002 <em>E. \u30c7\u30e5\u30e9\u30f3\u30b9 EP1<\/em> \u3092\u6271\u3046\uff1a<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">E. durans EP1\u682a\u306f\u3001EFSA\u304c\u8a2d\u5b9a\u3057\u305f\u8981\u4ef6\u3092\u6e80\u305f\u3057\u3066\u3044\u308b\u3002E. durans EP1\u306f\u6297\u708e\u75c7\u4f5c\u7528\u3092\u793a\u3057\u30017\u65e5\u5f8c\u306b\u8178\u9593\u819c\u30ea\u30f3\u30d1\u7bc0\u306eIgA\u7d30\u80de\u3092\u5897\u52a0\u3055\u305b\u3001Faecalibacterium prausnitzii\u3092\u5897\u52a0\u3055\u305b\u308b\u3053\u3068\u3067\u30de\u30a4\u30af\u30ed\u30d0\u30a4\u30aa\u30fc\u30e0\u3092\u8abf\u6574\u3057\u305f\u3002\u3055\u3089\u306b\u3001EP1\u309221\u65e5\u9593\u6295\u4e0e\u3057\u305f\u30de\u30a6\u30b9\u3067\u306f\u3001\u3053\u306e\u6bd4\u8f03\u8a66\u9a13\u306e\u3088\u3046\u306a\u526f\u4f5c\u7528\u306f\u89b3\u5bdf\u3055\u308c\u306a\u304b\u3063\u305f\u3002 <em><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17466591\/\" target=\"_blank\" rel=\"noreferrer noopener\">\u30d7\u30ed\u30d0\u30a4\u30aa\u30c6\u30a3\u30af\u30b9\u8178\u7403\u83cc\uff08Enterococcus faecalis\uff09\u30b7\u30f3\u30d3\u30aa\u30d5\u30ed1\u682a\u306b\u304a\u3051\u308b\u6f5c\u5728\u7684\u8178\u7403\u83cc\u75c5\u539f\u6027\u56e0\u5b50\u306e\u5b58\u5728\u306b\u95a2\u3059\u308b\u6bd4\u8f03\u30b2\u30ce\u30e0\u89e3\u6790<\/a><\/em> \u3092\u5360\u3081\u305f\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">E.\u30c7\u30e5\u30e9\u30f3\u306eOSY-EGY\u306f\u3001\u30c8\u30ed\u30a4\u306e\u6728\u99ac\u306e\u3088\u3046\u306a \u201e\u60aa\u3044 \u201c\u30b3\u30fc\u30c9\u3092\u542b\u3080\u30d7\u30e9\u30b9\u30df\u30c9\u3092\u6301\u305f\u305a\uff08\u4e0a\u8a18\u306eUSB\u30e1\u30e2\u30ea\u3092\u53c2\u7167\uff09\u3001\u307e\u305f\u305d\u308c\u3092\u4fdd\u6709\u3059\u308b\u3053\u3068\u3082\u3067\u304d\u306a\u3044\u3002\u305d\u306e\u30b2\u30ce\u30e0\u306b\u306f\u3001\u30d5\u30a1\u30fc\u30b8\u306b\u3088\u308b\u6539\u5909\u3084\u907a\u4f1d\u5b50\u306e\u6c34\u5e73\u79fb\u52d5\u306b\u5bfe\u3059\u308b\u914d\u5217\u30d9\u30fc\u30b9\u306e\u514d\u75ab\u3092\u4e0e\u3048\u308bCRISPR\u30a2\u30ec\u30a4\u304c\u3001\u78ba\u8a8d\u3055\u308c\u3066\u3044\u308b\u3082\u306e1\u3064\u3068\u6f5c\u5728\u7684\u306a\u3082\u306e3\u3064\u542b\u307e\u308c\u3066\u3044\u308b\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u8a3c\u660e\u3055\u308c\u305f\u3001\u7279\u306b\u5b89\u5168\u6027\u306b\u95a2\u3059\u308b\u3059\u3079\u3066\u306e\u5229\u70b9\u304c\u3042\u308b\u306b\u3082\u304b\u304b\u308f\u3089\u305a\u3001\u5e02\u8ca9\u54c1\u306f\u306a\u3044\u3002.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>","protected":false},"excerpt":{"rendered":"<p><span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">\u8aad\u66f8\u6642\u9593<\/span> <span class=\"rt-time\"> 8<\/span> <span class=\"rt-label rt-postfix\">\u8b70\u4e8b\u9332<\/span><\/span>Symbioflor, u.a. gegen chronische Bronchitis eingesetzt, wird in drei Varianten angeboten. Es ist vom Grundsatz her seit \u00fcber 70 Jahren auf dem Markt und beinhaltet &#8211; in der &#8222;immun&#8220;-Variante &#8211; Enterococcus faecalis DSM 16440&#8211; und E.coli DSM 17252-Bakterien und Zink. Wer an einer Gr\u00e4serpollen-Allergie und chronischer Bronchitis leidet, wird in den Wintermonaten von einem permanenten, nicht zu therapierenden Reizhusten geplagt, sobald er sich &#8222;r\u00fchrt&#8220;. Nur drau\u00dfen, in der K\u00e4lte, herrscht alsbald Ruhe. Arztbesuche, selbst bei vorgeblich renommierten Lungenfach\u00e4rzten (Pneumologen), ergeben keinen Therapievorschlag, nicht einmal eine zielf\u00fchrende Befundung, denn diagnostisch sind alle Parameter ohne Befund, normal &#8211; alles in bester Ordnung, &#8211; abgesehen vom immer noch unver\u00e4ndert gegenw\u00e4rtigen und wahrlich plagenden&hellip;&nbsp;<a href=\"https:\/\/csiag.eu\/ja\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/\" rel=\"bookmark\">\u7d9a\u304d\u3092\u8aad\u3080 \"<span class=\"screen-reader-text\">\u6162\u6027\u6c17\u7ba1\u652f\u708e - \u30b7\u30f3\u30d3\u30aa\u30d5\u30ed\u30fc\u30eb<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-13123","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"modified_by":"Achim Goerner","_links":{"self":[{"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/posts\/13123","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/comments?post=13123"}],"version-history":[{"count":3,"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/posts\/13123\/revisions"}],"predecessor-version":[{"id":13408,"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/posts\/13123\/revisions\/13408"}],"wp:attachment":[{"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/media?parent=13123"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/categories?post=13123"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csiag.eu\/ja\/wp-json\/wp\/v2\/tags?post=13123"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}