1
|
Yano H, Hayashi W, Kawakami S, Aoki S, Anzai E, Zuo H, Kitamura N, Hirabayashi A, Kajihara T, Kayama S, Sugawara Y, Yahara K, Sugai M. Nationwide genome surveillance of carbapenem-resistant Pseudomonas aeruginosa in Japan. Antimicrob Agents Chemother 2024; 68:e0166923. [PMID: 38564665 PMCID: PMC11064530 DOI: 10.1128/aac.01669-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Japan is a country with an approximate 10% prevalence rate of carbapenem-resistant Pseudomonas aeruginosa (CRPA). Currently, a comprehensive overview of the genotype and phenotype patterns of CRPA in Japan is lacking. Herein, we conducted genome sequencing and quantitative antimicrobial susceptibility testing for 382 meropenem-resistant CRPA isolates that were collected from 78 hospitals across Japan from 2019 to 2020. CRPA exhibited susceptibility rates of 52.9%, 26.4%, and 88.0% against piperacillin-tazobactam, ciprofloxacin, and amikacin, respectively, whereas 27.7% of CRPA isolates was classified as difficult-to-treat resistance P. aeruginosa. Of the 148 sequence types detected, ST274 (9.7%) was predominant, followed by ST235 (7.6%). The proportion of urine isolates in ST235 was higher than that in other STs (P = 0.0056, χ2 test). Only 4.1% of CRPA isolates carried the carbapenemase genes: blaGES (2) and blaIMP (13). One ST235 isolate carried the novel blaIMP variant blaIMP-98 in the chromosome. Regarding chromosomal mutations, 87.1% of CRPA isolates possessed inactivating or other resistance mutations in oprD, and 28.8% showed mutations in the regulatory genes (mexR, nalC, and nalD) for the MexAB-OprM efflux pump. Additionally, 4.7% of CRPA isolates carried a resistance mutation in the PBP3-encoding gene ftsI. The findings from this study and other surveillance studies collectively demonstrate that CRPA exhibits marked genetic diversity and that its multidrug resistance in Japan is less prevailed than in other regions. This study contributes a valuable data set that addresses a gap in genotype/phenotype information regarding CRPA in the Asia-Pacific region, where the epidemiological background markedly differs between regions.
Collapse
Affiliation(s)
- Hirokazu Yano
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Wataru Hayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Sayoko Kawakami
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Sadao Aoki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Eiko Anzai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Hui Zuo
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Norikazu Kitamura
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Shizuo Kayama
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Yo Sugawara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| |
Collapse
|
2
|
Hirabayashi A, Yahara K, Oka K, Kajihara T, Ohkura T, Hosaka Y, Shibayama K, Sugai M, Yagi T. Comparison of disease and economic burden between MRSA infection and MRSA colonization in a university hospital: a retrospective data integration study. Antimicrob Resist Infect Control 2024; 13:27. [PMID: 38424606 PMCID: PMC10905874 DOI: 10.1186/s13756-024-01383-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/10/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Although there is a growing concern and policy regarding infections or colonization caused by resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), the prognosis of MRSA infections compared to that of methicillin-susceptible Staphylococcus aureus (MSSA) infections remains controversial. Moreover, there have not been any studies comparing both the burden of disease and its impact on the healthcare economy between MRSA infection and colonization while adjusting for confounding factors. These comparisons are crucial for developing effective infection control measures and healthcare policies. We aimed to compare the disease and economic burden between MRSA and MSSA infections and between MRSA infection and colonization. METHODS We retrospectively investigated data of 496 in-patients with MRSA or MSSA infections and of 1178 in-patients with MRSA infections or MRSA colonization from a university hospital in Japan from 2016 to 2021. We compared in-hospital mortality, length of stay, and hospital charges between in-patients with MRSA and MSSA infections and those with MRSA infections and MRSA colonization using multiple regressions. We combined surveillance data, including all microbiological test results, data on patients with infections, treatment histories, and clinical outcomes, to create the datasets. RESULTS There was no statistically significant difference in in-hospital mortality rates between matched MRSA vs. MSSA infections and MRSA infection vs. colonization. On the contrary, the adjusted effects of the MRSA infection compared to those of MSSA infection on length of stay and hospital charges were 1.21-fold (95% confidence interval [CI] 1.03-1.42, P = 0.019) and 1.70-fold (95% CI 1.39-2.07, P < 0.00001), respectively. The adjusted effects of the MRSA infection compared to those of MRSA colonization on length of stay and hospital charges were 1.41-fold (95% CI 1.25-1.58, P < 0.00001) and 1.53-fold (95% CI 1.33-1.75, P < 0.00001), respectively. Regarding confounding factors, hemodialysis or hemofiltration was consistently identified and adjusted for in the multiple regression analyses comparing MRSA and MSSA infections, as well as MRSA infection and MRSA colonization. CONCLUSIONS MRSA infection was associated with longer length of stay and higher hospital charges than both MSSA infection and MRSA colonization. Furthermore, hemodialysis or hemofiltration was identified as a common underlying factor contributing to increased length of stay and hospital charges.
Collapse
Affiliation(s)
- Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Keisuke Oka
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Teruko Ohkura
- Department of Medical Technique, Nagoya University Hospital, Aichi, Japan
| | - Yumiko Hosaka
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi , Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan.
| |
Collapse
|
3
|
Hosaka Y, Muraki Y, Kajihara T, Kawakami S, Hirabayashi A, Shimojima M, Ohge H, Sugai M, Yahara K. Antimicrobial use and combination of resistance phenotypes in bacteraemic Escherichia coli in primary care: a study based on Japanese national data in 2018. J Antimicrob Chemother 2024; 79:312-319. [PMID: 38084874 PMCID: PMC10832589 DOI: 10.1093/jac/dkad379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/26/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Antimicrobial use (AMU) in primary care is a contributing factor to the emergence of antimicrobial-resistant bacteria. We assessed the potential effects of AMU on the prevalence of a combination of resistance phenotypes in bacteraemic Escherichia coli in outpatient care settings between primary care facilities ('clinics') and hospitals. METHODS Population-weighted total AMU calculated from the national database was expressed as DDDs per 1000 inhabitants per day (DID). National data for all routine microbiological test results were exported from the databases of a major commercial clinical laboratory, including 16 484 clinics, and the Japan Nosocomial Infections Surveillance, including 1947 hospitals. AMU and the prevalence of combinations of resistance phenotypes in bacteraemic E. coli isolates were compared between clinics and hospitals. RESULTS The five most common bacteria isolated from patients with bacteraemia were the same in clinics, outpatient settings and inpatient settings in hospitals, with E. coli as the most frequent. Oral third-generation cephalosporins and fluoroquinolones were the top two AMU outpatient drugs, except for macrolides, and resulted in at least three times higher AMU in clinics than in hospitals. The percentage of E. coli isolates resistant to both drugs in clinics (18.7%) was 5.6% higher than that in hospitals (13.1%) (P < 10-8). CONCLUSIONS Significant AMU, specifically of oral third-generation cephalosporins and fluoroquinolones, in clinics is associated with a higher prevalence of E. coli isolates resistant to both drugs. This study provides a basis for national interventions to reduce inappropriate AMU in primary care settings.
Collapse
Affiliation(s)
- Yumiko Hosaka
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuichi Muraki
- Department of Clinical Pharmacoepidemiology, Kyoto Pharmaceutical University, Kyoto, Japan
| | - Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Sayoko Kawakami
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
4
|
Kitamura N, Kajihara T, Volpiano CG, Naung M, Méric G, Hirabayashi A, Yano H, Yamamoto M, Yoshida F, Kobayashi T, Yamanashi S, Kawamura T, Matsunaga N, Okochi J, Sugai M, Yahara K. Exploring the effects of antimicrobial treatment on the gut and oral microbiomes and resistomes from elderly long-term care facility residents via shotgun DNA sequencing. Microb Genom 2024; 10:001180. [PMID: 38376378 PMCID: PMC10926694 DOI: 10.1099/mgen.0.001180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024] Open
Abstract
Monitoring antibiotic-resistant bacteria (ARB) and understanding the effects of antimicrobial drugs on the human microbiome and resistome are crucial for public health. However, no study has investigated the association between antimicrobial treatment and the microbiome-resistome relationship in long-term care facilities, where residents act as reservoirs of ARB but are not included in the national surveillance for ARB. We conducted shotgun metagenome sequencing of oral and stool samples from long-term care facility residents and explored the effects of antimicrobial treatment on the human microbiome and resistome using two types of comparisons: cross-sectional comparisons based on antimicrobial treatment history in the past 6 months and within-subject comparisons between stool samples before, during and 2-4 weeks after treatment using a single antimicrobial drug. Cross-sectional analysis revealed two characteristics in the group with a history of antimicrobial treatment: the archaeon Methanobrevibacter was the only taxon that significantly increased in abundance, and the total abundance of antimicrobial resistance genes (ARGs) was also significantly higher. Within-subject comparisons showed that taxonomic diversity did not decrease during treatment, suggesting that the effect of the prescription of a single antimicrobial drug in usual clinical treatment on the gut microbiota is likely to be smaller than previously thought, even among very elderly people. Additional analysis of the detection limit of ARGs revealed that they could not be detected when contig coverage was <2.0. This study is the first to report the effects of usual antimicrobial treatments on the microbiome and resistome of long-term care facility residents.
Collapse
Affiliation(s)
- Norikazu Kitamura
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Camila Gazolla Volpiano
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Cardiometabolic Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Myo Naung
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Cardiometabolic Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Guillaume Méric
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Cardiometabolic Health, University of Melbourne, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Cardiovascular Research, Translation and Implementation, La Trobe University, Melbourne, Victoria, Australia
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hirokazu Yano
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masaya Yamamoto
- Saiseikai Matsuyama Nigitatsuen Geriatric Health Service Facility, Ehime, Japan
| | | | | | - Sari Yamanashi
- Uraraen Geriatric Health Service Facility, Fukushima, Japan
| | | | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jiro Okochi
- Tatsumanosato Geriatric Health Service Facility, Osaka, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
5
|
Kayama S, Yahara K, Sugawara Y, Kawakami S, Kondo K, Zuo H, Kutsuno S, Kitamura N, Hirabayashi A, Kajihara T, Kurosu H, Yu L, Suzuki M, Hisatsune J, Sugai M. Author Correction: National genomic surveillance integrating standardized quantitative susceptibility testing clarifies antimicrobial resistance in Enterobacterales. Nat Commun 2024; 15:782. [PMID: 38278812 PMCID: PMC10817951 DOI: 10.1038/s41467-024-45349-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024] Open
Affiliation(s)
- Shizuo Kayama
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Yo Sugawara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Sayoko Kawakami
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kohei Kondo
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hui Zuo
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shoko Kutsuno
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Norikazu Kitamura
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hitomi Kurosu
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Liansheng Yu
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Junzo Hisatsune
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| |
Collapse
|
6
|
Kayama S, Yahara K, Sugawara Y, Kawakami S, Kondo K, Zuo H, Kutsuno S, Kitamura N, Hirabayashi A, Kajihara T, Kurosu H, Yu L, Suzuki M, Hisatsune J, Sugai M. National genomic surveillance integrating standardized quantitative susceptibility testing clarifies antimicrobial resistance in Enterobacterales. Nat Commun 2023; 14:8046. [PMID: 38052776 PMCID: PMC10698200 DOI: 10.1038/s41467-023-43516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023] Open
Abstract
Antimicrobial resistance is a global health concern; Enterobacterales resistant to third-generation cephalosporins (3GCs) and carbapenems are of the highest priority. Here, we conducted genome sequencing and standardized quantitative antimicrobial susceptibility testing of 4,195 isolates of Escherichia coli and Klebsiella pneumoniae resistant to 3GCs and Enterobacterales with reduced meropenem susceptibility collected across Japan. Our analyses provided a complete classification of 3GC resistance mechanisms. Analyses with complete reference plasmids revealed that among the blaCTX-M extended-spectrum β-lactamase genes, blaCTX-M-8 was typically encoded in highly similar plasmids. The two major AmpC β-lactamase genes were blaCMY-2 and blaDHA-1. Long-read sequencing of representative plasmids revealed that approximately 60% and 40% of blaCMY-2 and blaDHA-1 were encoded by such plasmids, respectively. Our analyses identified strains positive for carbapenemase genes but phenotypically susceptible to carbapenems and undetectable by standard antimicrobial susceptibility testing. Systematic long-read sequencing enabled reconstruction of 183 complete plasmid sequences encoding three major carbapenemase genes and elucidation of their geographical distribution stratified by replicon types and species carrying the plasmids and potential plasmid transfer events. Overall, we provide a blueprint for a national genomic surveillance study that integrates standardized quantitative antimicrobial susceptibility testing and characterizes resistance determinants.
Collapse
Affiliation(s)
- Shizuo Kayama
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Yo Sugawara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Sayoko Kawakami
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kohei Kondo
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hui Zuo
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shoko Kutsuno
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Norikazu Kitamura
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hitomi Kurosu
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Liansheng Yu
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Junzo Hisatsune
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| |
Collapse
|
7
|
Kajihara T, Yahara K, Kitamura N, Hirabayashi A, Hosaka Y, Sugai M. Distribution, Trends, and Antimicrobial Susceptibility of Bacteroides, Clostridium, Fusobacterium, and Prevotella Species Causing Bacteremia in Japan During 2011-2020: A Retrospective Observational Study Based on National Surveillance Data. Open Forum Infect Dis 2023; 10:ofad334. [PMID: 37469615 PMCID: PMC10352651 DOI: 10.1093/ofid/ofad334] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/29/2023] [Indexed: 07/21/2023] Open
Abstract
Background The increasing prevalence of anaerobic bacteremia is a major concern worldwide and requires longitudinal monitoring. Methods We present one of the largest and longest longitudinal studies on the prevalence and antimicrobial resistance of Bacteroides, Clostridium, Fusobacterium, and Prevotella spp. isolated from blood culture samples using national comprehensive surveillance data in Japan during 2011-2020 as part of the Japan Nosocomial Infections Surveillance. Results Data for 41 949 Bacteroides spp., 40 603 Clostridium spp., 7013 Fusobacterium spp., and 5428 Prevotella spp. isolates were obtained. The incidences of bacteremia caused by Bacteroides fragilis, Clostridium perfringens, and Fusobacterium nucleatum significantly increased during the period (P < .0001). Among the 20 species analyzed, 18 showed no significant changes in susceptibility over time, including B. fragilis, C perfringens, and F. nucleatum. However, resistance to clindamycin increased in B. thetaiotaomicron (P = .0312), and resistance to ampicillin increased in B. ovatus (P = .0008). Conclusions Our comprehensive national surveillance data analysis demonstrated a continuous increase in the incidence of anaerobic bacteremia, particularly in B. fragilis, C. perfringens, and F. nucleatum. This may be linked to the increasing number of colorectal cancer cases or advancing methods for species identification and susceptibility testing, requiring cautious interpretation. The discovery of an upsurge in anaerobic bacteremia and potential alterations in susceptibility highlights the necessity for more extensive studies in this field.
Collapse
Affiliation(s)
- Toshiki Kajihara
- Correspondence: Toshiki Kajihara, MD, Phd, Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho Higashimurayama, Tokyo 189-0002, Japan ()
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Norikazu Kitamura
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yumiko Hosaka
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | | |
Collapse
|
8
|
Kajihara T, Yahara K, Hirabayashi A, Hosaka Y, Kitamura N, Sugai M, Shibayama K. Association between the proportion of laparoscopic approaches for digestive surgeries and the incidence of consequent surgical site infections, 2009-2019: A retrospective observational study based on national surveillance data in Japan. PLoS One 2023; 18:e0281838. [PMID: 36800364 PMCID: PMC9937488 DOI: 10.1371/journal.pone.0281838] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Surgical site infections (SSIs) are among the most common healthcare-associated infections. Laparoscopy is increasingly being used in various surgical procedures. However, no study has examined the association between the proportion of laparoscopic procedures and the incidence of SSIs in digestive surgery using nationwide surveillance data. METHODS We retrospectively investigated national SSI surveillance data from the Japan Nosocomial Infections Surveillance between 2009 and 2019. The annual trend of the SSI rate and the proportion of laparoscopic procedures were assessed, focusing on five major digestive surgeries. This was based on data from 109,544 (appendix surgery), 206,459 (gallbladder surgery), 60,225 (small bowel surgery), 363,677 (colon surgery), and 134,695 (rectal surgery) procedures. The effect of a 10% increase in the proportion of laparoscopic procedures on the reduction of the SSI rate was estimated using mixed-effect logistic regression. FINDINGS The average SSI rate of the five digestive surgeries decreased from 11.8% in 2009 to 8.1% in 2019. The proportion of laparoscopic procedures in each of the five digestive surgeries increased continuously (p<0.001). The SSI rate for laparoscopic procedures was always lower than that for open procedures. The results were consistent between all and core hospitals participating in the surveillance. The odds ratios of the 10% increase in the proportion of laparoscopic procedures for five digestive surgeries were always <0.950 (p<0.001). CONCLUSION An increase in the proportion of laparoscopic procedures was associated with a reduction in the SSI rate in digestive surgeries.
Collapse
Affiliation(s)
- Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail:
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yumiko Hosaka
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Norikazu Kitamura
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology/Drug Resistance and Pathogenesis, Nagoya University, Graduate School of Medicine, Showa-ku, Nagoya, Japan
| |
Collapse
|
9
|
Suzuki M, Hashimoto Y, Hirabayashi A, Yahara K, Yoshida M, Fukano H, Hoshino Y, Shibayama K, Tomita H. Genomic Epidemiological Analysis of Antimicrobial-Resistant Bacteria with Nanopore Sequencing. Methods Mol Biol 2023; 2632:227-246. [PMID: 36781732 DOI: 10.1007/978-1-0716-2996-3_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Antimicrobial-resistant (AMR) bacterial infections caused by clinically important bacteria, including ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) and mycobacteria (Mycobacterium tuberculosis and nontuberculous mycobacteria), have become a global public health threat. Their epidemic and pandemic clones often accumulate useful accessory genes in their genomes, such as AMR genes (ARGs) and virulence factor genes (VFGs). This process is facilitated by horizontal gene transfer among microbial communities via mobile genetic elements (MGEs), such as plasmids and phages. Nanopore long-read sequencing allows easy and inexpensive analysis of complex bacterial genome structures, although some aspects of sequencing data calculation and genome analysis methods are not systematically understood. Here we describe the latest and most recommended experimental and bioinformatics methods available for the construction of complete bacterial genomes from nanopore sequencing data and the detection and classification of genotypes of bacterial chromosomes, ARGs, VFGs, plasmids, and other MGEs based on their genomic sequences for genomic epidemiological analysis of AMR bacteria.
Collapse
Affiliation(s)
- Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Yusuke Hashimoto
- Department of Bacteriology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Mitsunori Yoshida
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hanako Fukano
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshihiko Hoshino
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Haruyoshi Tomita
- Department of Bacteriology, Gunma University Graduate School of Medicine, Maebashi, Japan.,Laboratory of Bacterial Drug Resistance, Gunma University Graduate School of Medicine, Maebashi, Japan
| |
Collapse
|
10
|
Kajihara T, Yahara K, Nagi M, Kitamura N, Hirabayashi A, Hosaka Y, Abe M, Miyazaki Y, Sugai M. Distribution, trends, and antifungal susceptibility of Candida species causing candidemia in Japan, 2010-2019: A retrospective observational study based on national surveillance data. Med Mycol 2022; 60:6696379. [PMID: 36095139 PMCID: PMC9521341 DOI: 10.1093/mmy/myac071] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/08/2022] [Accepted: 09/09/2022] [Indexed: 11/14/2022] Open
Abstract
The increasing incidence of candidemia and the emergence of drug-resistant Candida species are major concerns worldwide. Therefore, long-term surveillance studies are required. Here, we provide one of the largest longitudinal overviews of the trends in the prevalence of Candida species using national data of 57 001 candidemia isolates obtained from more than 2000 hospitals for the 2010-2019 period in the Japan Nosocomial Infections Surveillance database. The proportion of Candida species, except Candida krusei and Candida guilliermondii, was almost the same during the study period. The proportion of C. guilliermondii surpassed that of C. krusei in 2014. The incidence of candidemia due to C. albicans (p < 0.0001), C. parapsilosis (p = 0.0002), and C. tropicalis (p < 0.0001) have decreased significantly over this period. Azole susceptibility of Candida tropicalis was low, with 17.8% of isolates resistant to fluconazole and 13.5% resistant to voriconazole. The micafungin susceptibility of C. glabrata was low, with 8.0% of isolates showing resistance. The resistance rate of C. krusei toward amphotericin B fluctuated considerably (between 3.2% and 35.7%) over this period. The incidence rate of candidemia caused by C. parapsilosis and C. guilliermondii in hospitals responsible for bone marrow transplantation was significantly higher than that in other hospitals. Overall, our study suggests that in Japan, the species distribution of Candida was almost the same in this period and similar to that reported in North America and Europe. A relatively high resistance to azoles and micafungin was observed in C. glabrata, C. tropicalis, and C. krusei isolates, which require continued surveillance.
Collapse
Affiliation(s)
- Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho Higashimurayama, Tokyo 189-0002, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho Higashimurayama, Tokyo 189-0002, Japan
| | - Minoru Nagi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho Higashimurayama, Tokyo 189-0002, Japan.,Department of Fungal Infection, National Institute of Infectious Diseases, 1-23-1 Toyama Shinjuku-ku, Tokyo 162-8640, Japan
| | - Norikazu Kitamura
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho Higashimurayama, Tokyo 189-0002, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho Higashimurayama, Tokyo 189-0002, Japan
| | - Yumiko Hosaka
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho Higashimurayama, Tokyo 189-0002, Japan
| | - Masahiro Abe
- Department of Fungal Infection, National Institute of Infectious Diseases, 1-23-1 Toyama Shinjuku-ku, Tokyo 162-8640, Japan
| | - Yoshitsugu Miyazaki
- Department of Fungal Infection, National Institute of Infectious Diseases, 1-23-1 Toyama Shinjuku-ku, Tokyo 162-8640, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho Higashimurayama, Tokyo 189-0002, Japan
| |
Collapse
|
11
|
Hara Y, Iguchi M, Tetsuka N, Morioka H, Hirabayashi A, Suzuki M, Tomita Y, Oka K, Yagi T. <Editors' Choice> Multicenter survey for carbapenemase-producing Enterobacterales in central Japan. Nagoya J Med Sci 2022; 84:630-639. [PMID: 36237878 PMCID: PMC9529634 DOI: 10.18999/nagjms.84.3.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/02/2021] [Indexed: 11/20/2022]
Abstract
Carbapenemase-producing Enterobacterales (CPE) raise concerns about the treatment options for infectious diseases and infection control. We conducted a multicenter study to clarify the molecular epidemiology of CPE in the Aichi Prefecture during the first 3-month period from 2015 to 2019. Carbapenemase production was screened using a modified carbapenem inactivation method, and the genotypes of the carbapenemase genes were determined by polymerase chain reaction sequencing. Genetic relatedness was analyzed using multilocus sequence typing (MLST). Twenty-four hospitals participated in this study. Of the 56,494 Enterobacterales strains detected during the study period, 341 (0.6%) that met the susceptibility criteria were analyzed. Sixty-five of the 341 strains were determined to be CPE, with an incidence rate of 0.12% (65/56,494). The bacterial species responsible for CPE were Klebsiella pneumoniae (n = 24), Enterobacter cloacae complex (n = 23), Klebsiella oxytoca (n = 10), and Escherichia coli (n = 8). Most of the carbapenemase genotypes were IMP-1 (58/65), and only three were IMP-6 types. Three E. coli strains that produced NDM-5 were detected. MLST analysis showed that Sequence type (ST) 78 was predominant in E. cloacae complex CPE (14/23, 60.9%). Meanwhile, various STs were detected in carbapenemase-producing (CP) K. pneumoniae, of which ST37 and ST517 were the most common. The incidence rate of CPE in this region was comparable to national data. This 3-month surveillance revealed the spread of ST78 of CP E. cloacae complex and ST517 and ST592 of CP K. pneumoniae across hospitals, indicating the need to strengthen regional infection control programs.
Collapse
Affiliation(s)
- Yuki Hara
- Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Department of Clinical Laboratory, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Mitsutaka Iguchi
- Department of Infectious diseases, Nagoya University Hospital, Nagoya, Japan
| | - Nobuyuki Tetsuka
- Department of Infection control, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroshi Morioka
- Department of Infectious diseases, Nagoya University Hospital, Nagoya, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuka Tomita
- Department of Infection control, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Keisuke Oka
- Department of Infectious diseases, Nagoya University Hospital, Nagoya, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Department of Infectious diseases, Nagoya University Hospital, Nagoya, Japan
| |
Collapse
|
12
|
Dao TD, Kasuga I, Hirabayashi A, Nguyen DT, Tran HT, Vu H, Pham LTN, Vu TMH, Hasebe F, Nguyen HT, Thi TL, Tran HH, Shibayama K, Takemura T, Suzuki M. Emergence of mobile tigecycline resistance gene tet(X4)-harboring Shewanella xiamenensis in a water environment. J Glob Antimicrob Resist 2022; 28:140-142. [PMID: 35021125 DOI: 10.1016/j.jgar.2021.12.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/10/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Tigecycline resistance mediated by the mobile tigecycline-inactivating enzyme gene, tet(X), in gram-negative bacteria is an emerging concern for global public health. However, limited information on the distribution of tet(X) is available in the natural environment. In this study, we investigated the presence of tet(X) in environmental gram-negative bacteria. METHODS A carbapenem- and tigecycline-resistant Shewanella xiamenensis isolate, NUITM-VS1, was obtained from an urban drainage in Hanoi, Vietnam, in March 2021. Whole-genome analysis was performed by long-read and short-read sequencing, resulting in a complete genome sequence. Antibiotic resistance genes (ARGs) in the genome were detected based on the custom ARG database, including all known tigecycline-resistant genes. RESULTS The S. xiamenensis isolate, NUITM-VS1, harbored the tet(X4) gene and the carbapenemase gene, blaOXA-48, on the chromosome. The tet(X4) was flanked by IS91 family transposase genes, suggesting that the acquisition of tet(X4) was mediated by this mobile gene element (MGE), whereas no MGE was found around blaOXA-48, which is consistent with the previous findings that blaOXA-48-like β-lactamase genes are species-specific intrinsic ARGs in Shewanella species. CONCLUSION To the best of our knowledge, this is the first report of tet(X4)-harboring Shewanella species. Our results provide genetic evidence of the complexity of the dynamics of clinically important ARGs among bacteria in a water environment.
Collapse
Affiliation(s)
- Trung Duc Dao
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Ikuro Kasuga
- Vietnam-Japan University, Vietnam National University, Hanoi, Vietnam; Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Dong Tu Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Hien Thi Tran
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Hieu Vu
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Linh Tuyet Ngoc Pham
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Thi My Hanh Vu
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Futoshi Hasebe
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Ha Thanh Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Trang Le Thi
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Hoang Huy Tran
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Keigo Shibayama
- Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Taichiro Takemura
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| |
Collapse
|
13
|
Ha VTT, Tran LD, Mai NTT, Hirabayashi A, Nguyen ST, Tran HH, Shibayama K, Suzuki M. Potential spread of mcr-9-carrying IncHI2 plasmids in Enterobacter hormaechei in Vietnam. J Glob Antimicrob Resist 2021; 27:332-334. [PMID: 34800709 DOI: 10.1016/j.jgar.2021.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/31/2021] [Accepted: 09/15/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Mobile colistin resistance (mcr) genes are widely distributed around the world. To date, ten major variants of mcr genes are known (mcr-1 to mcr-10). However, only a few instances of Enterobacterales isolates harbouring mcr genes other than mcr-1 have been reported in Vietnam. The aim of this study was to investigate mcr-harbouring antimicrobial-resistant Enterobacterales isolates in Vietnam. METHODS Two mcr-9-harbouring Enterobacter hormaechei clinical isolates (NIHE14-1904 and MH17-539M) were obtained from medical institutions in Hanoi, Vietnam, in 2014 and 2017, respectively. Their genomes and plasmid sequences were analysed by short-read and long-read sequencing. Subsequently, comparative sequence analysis of their mcr-9-carrying plasmids was performed. RESULTS Strains NIHE14-1904 and MH17-539M belonged to sequence types ST916 and ST66, respectively, according to the Enterobacter cloacae multilocus sequence typing (MLST) scheme. NIHE14-1904 and MH17-539M harboured the mcr-9 gene on similar IncHI2 plasmids, namely pNIHE14-1904-mcr9 (373.1 kb) and pMH17-539M-mcr9 (289.3 kb), respectively. These plasmids were also highly identical to widespread IncHI2 plasmids that are often associated with mcr genes. CONCLUSION For the first time, mcr-9-harbouring Enterobacterales isolates were detected in Vietnam, which carried mcr-9 on IncHI2 plasmids. The prevalence of such plasmids needs to be monitored in the future owing to their high dissemination.
Collapse
Affiliation(s)
- Van Thi Thu Ha
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - Linh Dieu Tran
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Son Thai Nguyen
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - Hoang Huy Tran
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Keigo Shibayama
- Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| |
Collapse
|
14
|
Hirabayashi A, Yahara K, Mitsuhashi S, Nakagawa S, Imanishi T, Ha VTT, Nguyen AV, Nguyen ST, Shibayama K, Suzuki M. Plasmid analysis of NDM metallo-β-lactamase-producing Enterobacterales isolated in Vietnam. PLoS One 2021; 16:e0231119. [PMID: 34319973 PMCID: PMC8318238 DOI: 10.1371/journal.pone.0231119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/21/2021] [Indexed: 11/19/2022] Open
Abstract
Carbapenem-resistant Enterobacterales (CRE) represent a serious threat to public health due to the lack of treatment and high mortality. The rate of antimicrobial resistance of Enterobacterales isolates to major antimicrobials, including carbapenems, is much higher in Vietnam than in Western countries, but the reasons remain unknown due to the lack of genomic epidemiology research. A previous study suggested that carbapenem resistance genes, such as the carbapenemase gene blaNDM, spread via plasmids among Enterobacterales in Vietnam. In this study, we characterized blaNDM-carrying plasmids in Enterobacterales isolated in Vietnam, and identified several possible cases of horizontal transfer of plasmids both within and among species of bacteria. Twenty-five carbapenem-nonsusceptible isolates from a medical institution in Hanoi were sequenced on Illumina short-read sequencers, and 13 blaNDM-positive isolates, including isolates of Klebsiella pneumoniae, Escherichia coli, Citrobacter freundii, Morganella morganii, and Proteus mirabilis, were further sequenced on an Oxford Nanopore Technologies long-read sequencer to obtain complete plasmid sequences. Almost identical 73 kb IncFII(pSE11)::IncN hybrid plasmids carrying blaNDM-1 were found in a P. mirabilis isolate and an M. morganii isolate. A 112 kb IncFII(pRSB107)::IncN hybrid plasmid carrying blaNDM-1 in an E. coli isolate had partially identical sequences with a 39 kb IncR plasmid carrying blaNDM-1 and an 88 kb IncFII(pHN7A8)::IncN hybrid plasmid in a C. freundii isolate. 148-149 kb IncFIA(Hl1)::IncA/C2 plasmids and 75-76 kb IncFII(Yp) plasmids, both carrying blaNDM-1 were shared among three sequence type 11 (ST11) isolates and three ST395 isolates of K. pneumoniae, respectively. Most of the plasmids co-carried genes conferring resistance to clinically relevant antimicrobials, including third-generation cephalosporins, aminoglycosides, and fluoroquinolones, in addition to blaNDM-1. These results provide insight into the genetic basis of CRE in Vietnam, and could help control nosocomial infections.
Collapse
Affiliation(s)
- Aki Hirabayashi
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Yahara
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Satomi Mitsuhashi
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
| | - So Nakagawa
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Tadashi Imanishi
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Van Thi Thu Ha
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - An Van Nguyen
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - Son Thai Nguyen
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail: (KS); (MS)
| | - Masato Suzuki
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail: (KS); (MS)
| |
Collapse
|
15
|
Hirabayashi A, Yanagisawa H, Takahashi H, Yahara K, Boeing P, Wolfenden B, Nov V, Lorn V, Veng M, Ann V, Darapheak C, Shibayama K, Suzuki M. On-Site Genomic Epidemiological Analysis of Antimicrobial-Resistant Bacteria in Cambodia With Portable Laboratory Equipment. Front Microbiol 2021; 12:675463. [PMID: 34054783 PMCID: PMC8158813 DOI: 10.3389/fmicb.2021.675463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/22/2021] [Indexed: 11/29/2022] Open
Abstract
The rapid emergence of carbapenemase-producing gram-negative bacteria (CPGNB) is a global threat due to the high mortality of infection and limited treatment options. Although there have been many reports of CPGNB isolated from Southeast Asian countries, to date there has been no genetic analysis of CPGNB isolated from Cambodia. Sequence-based molecular epidemiological analysis enables a better understanding of the genotypic characteristics and epidemiological significance of antimicrobial-resistant (AMR) bacteria in each country, and allows countries to enact measures related to AMR issues. In this study, we performed on-site genomic epidemiological analysis of CPGNB isolated in Cambodia using a portable laboratory equipment called Bento Lab, which combines a PCR thermal cycler, microcentrifuge, gel electrophoresis apparatus, and LED transilluminator, along with the MinION nanopore sequencer. PCR targeting of major carbapenemase genes using Bento Lab revealed that two Escherichia coli isolates and one Acinetobacter baumannii isolate harbored carbapenemase genes: blaNDM, blaOXA–48, and blaOXA–23, respectively. The results of phenotypic diagnostic tests for CPGNB, such as the carbapenem inactivation method and double-disk diffusion test using a specific inhibitor of metallo-β-lactamases, were consistent with their AMR genotypes. Whole-genome sequencing analysis using MinION revealed that blaNDM–5 gene was carried on a 93.9-kb plasmid with IncFIA/IncFIB/IncFII/IncQ1 replicons, and blaOXA–181 gene was carried on a 51.5-kb plasmid with the IncX3 replicon in E. coli isolates. blaOXA–23 was encoded in two locations on the chromosome of A. baumannii. Plasmids carrying blaNDM–5 or blaOXA–181 in E. coli were highly structurally identical to plasmids prevalent in Enterobacterales in China and other countries, suggesting that they disseminated from a common evolutionary origin. Our findings demonstrate the potential impact of portable laboratory equipment on AMR bacteria research in hospitals and research centers with limited research facilities, and provide the first glimpse into the genomic epidemiology of CPGNB in Cambodia.
Collapse
Affiliation(s)
- Aki Hirabayashi
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Hiromizu Takahashi
- Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Koji Yahara
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | | | | | - Vandarith Nov
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Vichet Lorn
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Mom Veng
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Vuth Ann
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Chau Darapheak
- National Institute of Public Health, Phnom Penh, Cambodia
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masato Suzuki
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
16
|
Yahara K, Ma KC, Mortimer TD, Shimuta K, Nakayama SI, Hirabayashi A, Suzuki M, Jinnai M, Ohya H, Kuroki T, Watanabe Y, Yasuda M, Deguchi T, Eldholm V, Harrison OB, Maiden MCJ, Grad YH, Ohnishi M. Emergence and evolution of antimicrobial resistance genes and mutations in Neisseria gonorrhoeae. Genome Med 2021; 13:51. [PMID: 33785063 PMCID: PMC8008663 DOI: 10.1186/s13073-021-00860-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/24/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Antimicrobial resistance in Neisseria gonorrhoeae is a global health concern. Strains from two internationally circulating sequence types, ST-7363 and ST-1901, have acquired resistance to third-generation cephalosporins, mainly due to mosaic penA alleles. These two STs were first detected in Japan; however, the timeline, mechanism, and process of emergence and spread of these mosaic penA alleles to other countries remain unknown. METHODS We studied the evolution of penA alleles by obtaining the complete genomes from three Japanese ST-1901 clinical isolates harboring mosaic penA allele 34 (penA-34) dating from 2005 and generating a phylogenetic representation of 1075 strains sampled from 35 countries. We also sequenced the genomes of 103 Japanese ST-7363 N. gonorrhoeae isolates from 1996 to 2005 and reconstructed a phylogeny including 88 previously sequenced genomes. RESULTS Based on an estimate of the time-of-emergence of ST-1901 (harboring mosaic penA-34) and ST-7363 (harboring mosaic penA-10), and > 300 additional genome sequences of Japanese strains representing multiple STs isolated in 1996-2015, we suggest that penA-34 in ST-1901 was generated from penA-10 via recombination with another Neisseria species, followed by recombination with a gonococcal strain harboring wildtype penA-1. Following the acquisition of penA-10 in ST-7363, a dominant sub-lineage rapidly acquired fluoroquinolone resistance mutations at GyrA 95 and ParC 87-88, by independent mutations rather than horizontal gene transfer. Data in the literature suggest that the emergence of these resistance determinants may reflect selection from the standard treatment regimens in Japan at that time. CONCLUSIONS Our findings highlight how antibiotic use and recombination across and within Neisseria species intersect in driving the emergence and spread of drug-resistant gonorrhea.
Collapse
Affiliation(s)
- Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Kevin C Ma
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Tatum D Mortimer
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Ken Shimuta
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shu-Ichi Nakayama
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Michio Jinnai
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, Chigasaki, Kanagawa, Japan
| | - Hitomi Ohya
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, Chigasaki, Kanagawa, Japan
| | - Toshiro Kuroki
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, Chigasaki, Kanagawa, Japan
- Present address: Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoinooka, Imabari, Ehime, 794-8555, Japan
| | - Yuko Watanabe
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, Chigasaki, Kanagawa, Japan
| | - Mitsuru Yasuda
- Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Takashi Deguchi
- Department of Urology, Kizawa Memorial Hospital, Gifu, Japan
| | - Vegard Eldholm
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | - Yonatan H Grad
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
| |
Collapse
|
17
|
Maehana S, Eda R, Hirabayashi A, Niida N, Nakamura M, Furukawa T, Ikeda S, Kojima F, Sakai K, Sei K, Kitasato H, Suzuki M. Natural factories that manufacture antimicrobial resistance genes: quadruple bla GES-carrying plasmids in Aeromonas and Pseudomonas species. Int J Antimicrob Agents 2021; 57:106327. [PMID: 33789128 DOI: 10.1016/j.ijantimicag.2021.106327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 03/15/2021] [Accepted: 03/20/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Shotaro Maehana
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan; Department of Microbiology, School of Allied Health Science, Kitasato University, Kanagawa, Japan; Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Ryotaro Eda
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Nagi Niida
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Masaki Nakamura
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan; Department of Microbiology, School of Allied Health Science, Kitasato University, Kanagawa, Japan; Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan; Infection Control Research Center, Omura Satoshi Memorial Institute, Kitasato University, Tokyo, Japan
| | - Takashi Furukawa
- Department of Environmental Hygiene, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Shinsuke Ikeda
- Department of Orthopaedic Surgery, Zama General Hospital, Kanagawa, Japan
| | - Fumiaki Kojima
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan; Department of Pharmacology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Kouji Sakai
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunari Sei
- Department of Environmental Hygiene, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Hidero Kitasato
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan; Department of Microbiology, School of Allied Health Science, Kitasato University, Kanagawa, Japan; Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| |
Collapse
|
18
|
Hirabayashi A, Ha VTT, Nguyen AV, Nguyen ST, Shibayama K, Suzuki M. Emergence of a plasmid-borne tigecycline resistance in Klebsiella pneumoniae in Vietnam. J Med Microbiol 2021; 70. [PMID: 33704044 DOI: 10.1099/jmm.0.001320] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Tigecycline is a last-resort antimicrobial used to treat multidrug-resistant Gram-negative bacterial infections. One of the common antimicrobial resistance mechanisms is the efflux pump system composed of membrane protein complexes to excrete xenobiotic substrates. Recently, a novel gene cluster, tmexCD1-toprJ1, encoding the resistance-nodulation-cell division (RND) efflux pump was identified on plasmids in Klebsiella pneumoniae isolates in China. TMexCD1-TOprJ1 was found to be capable of excreting multiple antimicrobials, including tigecycline, which contributed to the strain's resistance. In this study, we identified K. pneumoniae isolates harbouring the tmexCD1-toprJ1 genes outside of China for the first time. Two tigecycline-resistant K. pneumoniae isolates belonging to ST273 by multilocus sequence typing were collected from different patients in a medical institution in Hanoi, Vietnam, in 2015. Whole-genome sequence analysis revealed that these isolates harboured a 288.0 kb tmexCD1-toprJ1-carrying plasmid with IncFIB and IncHI1B replicons. The tmexCD1-toprJ1 gene cluster was surrounded by several mobile gene elements, including IS26, and the plasmids had high sequence identity with that of K. pneumoniae isolated in China. Our finding suggests that the horizontal spread of tigecycline resistance mediated by tmexCD1-toprJ1-carrying plasmids has occurred in Vietnam and other countries, and raises concern about the further global dissemination.
Collapse
Affiliation(s)
- Aki Hirabayashi
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Van Thi Thu Ha
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - An Van Nguyen
- Present address: Department of Viral Infection and International Health, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan.,Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - Son Thai Nguyen
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masato Suzuki
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
19
|
Fukano H, Terazono T, Hirabayashi A, Yoshida M, Suzuki M, Wada S, Ishii N, Hoshino Y. Human pathogenic Mycobacterium kansasii (former subtype I) with zoonotic potential isolated from a diseased indoor pet cat, Japan. Emerg Microbes Infect 2021; 10:220-222. [PMID: 33467980 PMCID: PMC7872583 DOI: 10.1080/22221751.2021.1878935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Nontuberculous mycobacterial (NTM) infections in humans have increased in prevalence in recent decades. Mycobacterium kansasii is one of the most prevalent human pathogenic NTM species worldwide. Herein, we report the first isolation of M. kansasii from an indoor domestic cat in Japan. Comparative genome sequence analysis of the feline isolate showed this pathogen is genetically identical to human pathogenic M. kansasii. This finding suggests that M. kansasii has a potential risk of zoonoses and requires the "One Health" approach to control NTM infection.
Collapse
Affiliation(s)
- Hanako Fukano
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Mitsunori Yoshida
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shinpei Wada
- Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Norihisa Ishii
- National Sanatorium Tamazenshoen, Higashimurayama, Japan
| | - Yoshihiko Hoshino
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
20
|
Yahara K, Suzuki M, Hirabayashi A, Suda W, Hattori M, Suzuki Y, Okazaki Y. Long-read metagenomics using PromethION uncovers oral bacteriophages and their interaction with host bacteria. Nat Commun 2021; 12:27. [PMID: 33397904 PMCID: PMC7782811 DOI: 10.1038/s41467-020-20199-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022] Open
Abstract
Bacteriophages (phages), or bacterial viruses, are very diverse and highly abundant worldwide, including as a part of the human microbiomes. Although a few metagenomic studies have focused on oral phages, they relied on short-read sequencing. Here, we conduct a long-read metagenomic study of human saliva using PromethION. Our analyses, which integrate both PromethION and HiSeq data of >30 Gb per sample with low human DNA contamination, identify hundreds of viral contigs; 0-43.8% and 12.5-56.3% of the confidently predicted phages and prophages, respectively, do not cluster with those reported previously. Our analyses demonstrate enhanced scaffolding, and the ability to place a prophage in its host genomic context and enable its taxonomic classification. Our analyses also identify a Streptococcus phage/prophage group and nine jumbo phages/prophages. 86% of the phage/prophage group and 67% of the jumbo phages/prophages contain remote homologs of antimicrobial resistance genes. Pan-genome analysis of the phages/prophages reveals remarkable diversity, identifying 0.3% and 86.4% of the genes as core and singletons, respectively. Furthermore, our study suggests that oral phages present in human saliva are under selective pressure to escape CRISPR immunity. Our study demonstrates the power of long-read metagenomics utilizing PromethION in uncovering bacteriophages and their interaction with host bacteria.
Collapse
Affiliation(s)
- Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Wataru Suda
- Laboratory for Microbiome Science, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Masahira Hattori
- Laboratory for Microbiome Science, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Yutaka Suzuki
- Laboratory of Systems Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Bunkyo City, Japan
| | - Yusuke Okazaki
- Bioproduction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| |
Collapse
|
21
|
Eda R, Maehana S, Hirabayashi A, Nakamura M, Furukawa T, Ikeda S, Sakai K, Kojima F, Sei K, Suzuki M, Kitasato H. Complete genome sequencing and comparative plasmid analysis of KPC-2-producing Klebsiella pneumoniae isolated from hospital sewage water in Japan. J Glob Antimicrob Resist 2020; 24:180-182. [PMID: 33373730 DOI: 10.1016/j.jgar.2020.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/24/2020] [Accepted: 12/06/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The Klebsiella pneumoniae carbapenemase (blaKPC) gene is one of the most widespread carbapenemase genes in the world. However, there are few reports on KPC-producing bacteria in Japan. The aim of this study was therefore to investigate KPC-producing K. pneumoniae in Japan. METHODS A KPC-2-producingK. pneumoniae strain (KAM260) was isolated from hospital sewage water in Japan in 2018. The complete genome was determined by whole-genome sequencing. Subsequent comparative sequence analysis of the blaKPC-2-carrying plasmid was performed. RESULTS Klebsiella pneumoniae KAM260, belonging to sequence type 3026 (ST3026), harboured the blaKPC-2 gene in 114.6-kbp plasmid pKAM260_2 with IncFIB(pQIL) and IncFII(K) replicons. pKAM260_2 was highly identical to pKpQIL-like plasmids, which carry blaKPC genes and have spread worldwide. pKAM260_2 had functional conjugation-associated genes and was transferable to Escherichia coli. CONCLUSION pKAM260_2, the self-transmissible plasmid carrying theblaKPC-2 gene, was detected from hospital sewage water in Japan and was characterised as a pKpQIL-like plasmid. This plasmid needs to be monitored in Japan in the future owing to its high diffusivity.
Collapse
Affiliation(s)
- Ryotaro Eda
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Shotaro Maehana
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan; Department of Microbiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masaki Nakamura
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan; Department of Microbiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan; Infection Control Research Center, Omura Satoshi Memorial Institute, Kitasato University, Tokyo, Japan; Regenerative Medicine and Cell Design Research Facility, Kanagawa, Japan
| | - Takashi Furukawa
- Department of Environmental Hygiene, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Shinsuke Ikeda
- Department of Orthopaedic Surgery, Zama General Hospital, Kanagawa, Japan
| | - Kouji Sakai
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo, Japan
| | - Fumiaki Kojima
- Regenerative Medicine and Cell Design Research Facility, Kanagawa, Japan; Department of Pharmacology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Kazunari Sei
- Department of Environmental Hygiene, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Hidero Kitasato
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan; Department of Microbiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan; Regenerative Medicine and Cell Design Research Facility, Kanagawa, Japan.
| |
Collapse
|
22
|
Hirabayashi A, Yahara K, Kajihara T, Sugai M, Shibayama K. Geographical distribution of Enterobacterales with a carbapenemase IMP-6 phenotype and its association with antimicrobial use: An analysis using comprehensive national surveillance data on antimicrobial resistance. PLoS One 2020; 15:e0243630. [PMID: 33332370 PMCID: PMC7745981 DOI: 10.1371/journal.pone.0243630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/24/2020] [Indexed: 11/19/2022] Open
Abstract
Enterobacterales resistant to carbapenems, a class of last-resort antimicrobials, are ranked as an “urgent” and “critical” public health hazard by CDC and WHO. IMP-type carbapenemase-containing Enterobacterales are endemic in Japan, and blaIMP-6 is one of the notable carbapenemase genes responsible for the resistance. The gene is plasmid-encoded and confers resistance to meropenem, but not to imipenem. Therefore, IMP-6-producing Enterobacterales isolates are occasionally overlooked in clinical laboratories and are referred to as ‘stealth-type’. Since previous reports in Japan were confined only to some geographical regions, their distribution across prefectures and the factors affecting the distribution remain unclear. Here, we revealed the dynamics of the geographical distribution of Enterobacterales with IMP-6 phenotype associated with antimicrobial use in Japan. We utilized comprehensive national surveillance data of all routine bacteriological test results from more than 1,400 hospitals in 2015 and 2016 to enumerate Escherichia coli and Klebsiella pneumoniae isolates with the antimicrobial susceptibility pattern (phenotype) characteristic of IMP-6 (imipenem susceptible, meropenem resistant), and to tabulate the frequency of isolates with the phenotype for each prefecture. Isolates were detected in approximately half of all prefectures, and combined analysis with the national data of antimicrobial usage revealed a statistically significant association between the frequency and usage of not carbapenems but third-generation cephalosporins (p = 0.006, logistic mixed-effect regression) and a weaker association between the frequency and usage of fluoroquinolones (p = 0.043). The usage of third-generation cephalosporins and fluoroquinolones may select the strains with the IMP-6 phenotype, and contribute to their occasional spread. We expect the findings will promote antimicrobial stewardship to reduce the spread of the notable carbapenemase gene.
Collapse
Affiliation(s)
- Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail: (AH); (KY)
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail: (AH); (KY)
| | - Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
23
|
Yahara H, Hiraki A, Maruoka Y, Hirabayashi A, Suzuki M, Yahara K. Shotgun metagenome sequencing identification of a set of genes encoded by Actinomyces associated with medication-related osteonecrosis of the jaw. PLoS One 2020; 15:e0241676. [PMID: 33253207 PMCID: PMC7703938 DOI: 10.1371/journal.pone.0241676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/19/2020] [Indexed: 12/22/2022] Open
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is intractable and severely affects a patient’s quality of life. Although many cases of MRONJ have been reported in the past decade, the disease pathophysiology is unclear and there are no evidence-based therapeutic strategies. MRONJ usually features bone inflammation and infection. Prior studies that explored the association between MRONJ and microbial infection used the culture-based approach, which is not applicable to hundreds of unculturable taxa in the human oral microbiome, or 16S ribosomal RNA gene sequencing, which does not provide quantitative information of the abundance of specific taxa, and information of the presence, abundance, and function of specific genes in the microbiome. Here, deep shotgun metagenome sequencing (>10 Gb per sample) of bulk DNA extracted from saliva of MRONJ patients and healthy controls was performed to overcome these limitations. Comparative quantitative analyses of taxonomic and functional composition of these deep metagenomes (initially of 5 patients and 5 healthy controls) revealed an average 10.1% increase of genus Actinomyces and a 33.2% decrease in genus Streptococcus normally predominant in the human oral microbiota. Pan-genome analysis identified genes present exclusively in the MRONJ samples. Further analysis of the reads mapping to the genes in the extended dataset comprising five additional MRONJ samples and publicly available dataset of nine healthy controls resulted in the identification of 31 genes significantly associated with MRONJ. All these genes were encoded by Actinomyces genomic regions. Of these, the top two abundant genes were almost exclusively encoded by Actinomyces among usual taxa in the human oral microbiota. The potential relationships of these key genes with the disease are discussed at molecular level based on the literature. Although the sample size was small, this study will aid future studies to verify the data and characterize these genes in vitro and in vivo to understand the disease mechanisms, develop molecular targeted drugs, and for early stage screening and prognosis prediction.
Collapse
Affiliation(s)
- Hiroko Yahara
- Genome Medical Science Project (Toyama), Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
- * E-mail: (HY); (KY)
| | - Akimitsu Hiraki
- Section of Oral Oncology, Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka, Japan
| | - Yutaka Maruoka
- Department of Oral and Maxillofacial Surgery, Center Hospital, National Center for Global Health and Medicine (NCGM), Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
- * E-mail: (HY); (KY)
| |
Collapse
|
24
|
Fukano H, Miyama H, Takatsuki S, Hirabayashi A, Suzuki M, Yoshida M, Uwamino Y, Hasegawa N, Hoshino Y. Complete Genome Sequence of Mycolicibacterium sp. Strain NIID-NTM18, Isolated from Cardiac Implantable Electronic Device Infection and Most Similar to Mycolicibacterium litorale. Microbiol Resour Announc 2020; 9:e00830-20. [PMID: 32883792 PMCID: PMC7471387 DOI: 10.1128/mra.00830-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/06/2020] [Indexed: 11/20/2022] Open
Abstract
Mycolicibacterium litorale is a rapidly growing mycobacterial organism with unknown pathogenic features. Here, we report the complete genome sequence of Mycolicibacterium sp. strain NIID-NTM18, which was isolated from a cardiac implantable electronic device infection and which is most similar to M. litorale This sequence will provide essential information for future studies of the pathogenicity of these mycobacteria.
Collapse
Affiliation(s)
- Hanako Fukano
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroshi Miyama
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Seiji Takatsuki
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistant Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masato Suzuki
- Antimicrobial Resistant Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Mitsunori Yoshida
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshifumi Uwamino
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Hasegawa
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - Yoshihiko Hoshino
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
25
|
Kajihara T, Yahara K, Hirabayashi A, Shibayama K, Sugai M. Japan Nosocomial Infections Surveillance (JANIS): Current Status, International Collaboration, and Future Directions for a Comprehensive Antimicrobial Resistance Surveillance System. Jpn J Infect Dis 2020; 74:87-96. [PMID: 32863357 DOI: 10.7883/yoken.jjid.2020.499] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Japan Nosocomial Infections Surveillance (JANIS) is one of the largest national antimicrobial resistance (AMR) surveillance systems in the world. The JANIS Clinical Laboratory division collects comprehensive specimen-based data from diagnostic microbiology laboratories of participating hospitals to monitor the isolation rate of 11 major bacteria and specific AMR bacteria, and creates antibiograms of approximately 20 bacterial species. Data on the JANIS web database system are also annually tabulated and shared with the WHO Global Antimicrobial Resistance Surveillance System. To create a network of international AMR surveillance systems among Asian countries, Japan is developing an international web database system named ASIan Antimicrobial Resistance Surveillance Network (ASIARS-Net) based on the JANIS system; ASIARS-Net is an open-source database and confidentially available at almost no cost. JANIS continues to evolve in multiple directions; some are discussed at the end of this review.
Collapse
Affiliation(s)
- Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan
| | - Keigo Shibayama
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan.,Department of Bacteriology II, National Institute of Infectious Diseases, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan
| |
Collapse
|
26
|
Kajihara T, Yahara K, Stelling J, Eremin SR, Tornimbene B, Thamlikitkul V, Hirabayashi A, Anzai E, Wakai S, Matsunaga N, Hayakawa K, Ohmagari N, Sugai M, Shibayama K. Comparison of de-duplication methods used by WHO Global Antimicrobial Resistance Surveillance System (GLASS) and Japan Nosocomial Infections Surveillance (JANIS) in the surveillance of antimicrobial resistance. PLoS One 2020; 15:e0228234. [PMID: 32589639 PMCID: PMC7319286 DOI: 10.1371/journal.pone.0228234] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/14/2020] [Indexed: 11/18/2022] Open
Abstract
A major issue in the surveillance of antimicrobial resistance (AMR) is "de-duplication" or removal of repeated isolates, for which there exist multiple methods. The World Health Organization (WHO) Global Antimicrobial Resistance Surveillance System (GLASS) requires de-duplication by selecting only the first isolate of a given bacterial species per patient per surveillance period per specimen type per age group, gender, and infection origin stratification. However, no study on the comparative application of this method has been reported. The objective of this study was to evaluate differences in data tabulation between the WHO GLASS and the Japan Nosocomial Infections Surveillance (JANIS) system, which counts both patients and isolates after removing repeated isolates of the same bacterial species isolated from a patient within 30 days, regardless of specimen type, but distinguishing isolates with change of antimicrobial resistance phenotype. All bacterial data, consisting of approximately 8 million samples from 1795 Japanese hospitals in 2017 were exported from the JANIS database, and were tabulated using either the de-duplication algorithm of GLASS, or JANIS. We compared the tabulated results of the total number of patients whose blood and urine cultures were taken and of the percentage of resistant isolates of Escherichia coli for each priority antibiotic. The number of patients per specimen type tabulated by the JANIS method was always smaller than that of GLASS. There was a small (< 3%) difference in the percentage of resistance of E. coli for any antibiotic between the two methods in both out- and inpatient settings and blood and urine isolates. The two tabulation methods did not show considerable differences in terms of the tabulated percentages of resistance for E. coli. We further discuss how the use of GLASS tabulations to create a public software and website that could help to facilitate the understanding of and treatment against AMR.
Collapse
Affiliation(s)
- Toshiki Kajihara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
- * E-mail: (TK); (KY)
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
- * E-mail: (TK); (KY)
| | - John Stelling
- Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | | | | | - Visanu Thamlikitkul
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Aki Hirabayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Eiko Anzai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Satoyo Wakai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Toyama, Tokyo, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Toyama, Tokyo, Japan
| | - Norio Ohmagari
- AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Toyama, Tokyo, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
| | - Keigo Shibayama
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Higashimurayama, Tokyo, Japan
- Department of Bacteriology II, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| |
Collapse
|
27
|
Tsuzuki S, Matsunaga N, Yahara K, Gu Y, Hayakawa K, Hirabayashi A, Kajihara T, Sugai M, Shibayama K, Ohmagari N. National trend of blood-stream infection attributable deaths caused by Staphylococcus aureus and Escherichia coli in Japan. J Infect Chemother 2020; 26:367-371. [DOI: 10.1016/j.jiac.2019.10.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/21/2019] [Accepted: 10/29/2019] [Indexed: 01/31/2023]
|
28
|
Tetsuka N, Hirabayashi A, Matsumoto A, Oka K, Hara Y, Morioka H, Iguchi M, Tomita Y, Suzuki M, Shibayama K, Yagi T. Molecular epidemiological analysis and risk factors for acquisition of carbapenemase-producing Enterobacter cloacae complex in a Japanese university hospital. Antimicrob Resist Infect Control 2019; 8:126. [PMID: 31367347 PMCID: PMC6657070 DOI: 10.1186/s13756-019-0578-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/15/2019] [Indexed: 12/25/2022] Open
Abstract
Background To clarify the molecular epidemiology of carbapenem-resistant Enterobacter cloacae complex (CREC) and the risk factors for acquisition of carbapenemase-producing E. cloacae complex (CPEC). Methods Using clinical CREC isolates detected in a Japanese university hospital over 4 years, carbapenemase production was screened with phenotypic methods. Carbapenemase genes were analysed by PCR and sequencing. Molecular epidemiological analyses were conducted with repetitive extragenic palindromic (REP)-PCR and multilocus sequence typing (MLST). CRECs were identified to the subspecies level by hsp60 sequencing. Whole-genome sequencing of plasmids was conducted. A case-control study was performed to identify risk factors for acquisition of CPEC among patients with CREC. Results Thirty-nine CRECs including 20 CPECs carrying bla IMP-1 were identified. Patients with CPEC had longer hospital stay before detection (26.5 days vs. 12 days, p = 0.008), a urinary catheter (odds ratio [OR], 5.36; 95% confidence interval [CI], 1.14-30.9; p = 0.023), or intubation (OR, 7.53; 95% CI, 1.47-53.8; p = 0.008) compared to patients without CPEC. Four genetically closely related CPEC clusters were observed, which showed that three of four CPEC clusters corresponded to E. asburiae (ST 53), E. hormaechei subsp. steigerwaltii (ST 113 and ST 1047) and E. cloacae subsp. cloacae (ST 513) by MLST and hsp60 sequencing. Seven representative plasmids shared structures with class I integron containing bla IMP-1 and IncHI2A replicon type. Conclusions A longer hospital stay, presence of a urinary catheter, and intubation are risk factors for CPEC acquisition. In addition to horizontal transmission of genetically indistinguishable CPECs, IncHI2A plasmid carrying bla IMP-1 appeared to be transferred among genetically different ECs.
Collapse
Affiliation(s)
- Nobuyuki Tetsuka
- 1Department of Infectious Diseases, Nagoya University Hospital, 65 Tsurumai, Nagoya, Aichi 466-0065 Japan.,2Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Aichi Japan
| | - Aki Hirabayashi
- 3Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Akane Matsumoto
- 1Department of Infectious Diseases, Nagoya University Hospital, 65 Tsurumai, Nagoya, Aichi 466-0065 Japan
| | - Keisuke Oka
- 1Department of Infectious Diseases, Nagoya University Hospital, 65 Tsurumai, Nagoya, Aichi 466-0065 Japan.,2Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Aichi Japan
| | - Yuki Hara
- 2Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Aichi Japan.,4Japanese Red Cross Nagoya Daini Hospital, Nagoya, Aichi Japan
| | - Hiroshi Morioka
- 1Department of Infectious Diseases, Nagoya University Hospital, 65 Tsurumai, Nagoya, Aichi 466-0065 Japan
| | - Mitsutaka Iguchi
- 1Department of Infectious Diseases, Nagoya University Hospital, 65 Tsurumai, Nagoya, Aichi 466-0065 Japan
| | - Yuka Tomita
- 1Department of Infectious Diseases, Nagoya University Hospital, 65 Tsurumai, Nagoya, Aichi 466-0065 Japan
| | - Masato Suzuki
- 3Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- 5Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tetsuya Yagi
- 1Department of Infectious Diseases, Nagoya University Hospital, 65 Tsurumai, Nagoya, Aichi 466-0065 Japan.,2Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Aichi Japan
| |
Collapse
|
29
|
Kato D, Morioka H, Tomita Y, Iguchi M, Hirabayashi A, Tetsuka N, Sadomoto T, Hyodo M, Mochizuki M, Osada Y, Yamamoto M, Kato Y, Inagaki T, Ichikawa K, Yagi T. Active surveillance in response to the identification of a single carbapenemase-producing Escherichia coli at a Japanese university hospital. J Infect Chemother 2018; 24:1013-1015. [PMID: 29941275 DOI: 10.1016/j.jiac.2018.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/13/2018] [Accepted: 05/28/2018] [Indexed: 11/25/2022]
Abstract
This report described the experience of active surveillance culture implemented in response to the identification of a single carbapenemase-producing Escherichia coli in a Japanese university hospital. It revealed a horizontal transmission event and an additional asymptomatic carrier of carbapenemase-producing Escherichia coli with unique drug susceptibility and resistance gene profiles. Early implementation of active surveillance culture as a part of multifaceted infection control measures appeared to be useful to control further transmission of carbapenemase-producing Escherichia coli even in the low endemic facility. Further investigations on the timing and usefulness of active surveillance culture in the control of carbapenemase-producing Enterobacteriaceae would be warranted.
Collapse
Affiliation(s)
- Daizo Kato
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - Hiroshi Morioka
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - Yuka Tomita
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - Mitsutaka Iguchi
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - Aki Hirabayashi
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - Noriyuki Tetsuka
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - Takuya Sadomoto
- Division of Nursing, Nagoya University Hospital, Aichi, Japan
| | - Miyuki Hyodo
- Division of Nursing, Nagoya University Hospital, Aichi, Japan
| | - Mariko Mochizuki
- Department of Clinical Laboratory, Nagoya University Hospital, Aichi, Japan
| | - Yukari Osada
- Department of Clinical Laboratory, Nagoya University Hospital, Aichi, Japan
| | - Masato Yamamoto
- Department of Hospital Pharmacy, Nagoya University Hospital, Aichi, Japan
| | - Yoshiaki Kato
- Department of Hospital Pharmacy, Nagoya University Hospital, Aichi, Japan
| | - Takayuki Inagaki
- Department of Hospital Pharmacy, Nagoya University Hospital, Aichi, Japan
| | - Kazuya Ichikawa
- Department of Hospital Pharmacy, Nagoya University Hospital, Aichi, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan.
| |
Collapse
|
30
|
Hirabayashi A, Kato D, Tomita Y, Iguchi M, Yamada K, Kouyama Y, Morioka H, Tetsuka N, Yagi T. Risk factors for and role of OprD protein in increasing minimal inhibitory concentrations of carbapenems in clinical isolates of Pseudomonas aeruginosa. J Med Microbiol 2017; 66:1562-1572. [PMID: 28984565 DOI: 10.1099/jmm.0.000601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study examined the risk factors for, and molecular mechanisms underlying, the increase in carbapenem minimum inhibitory concentrations (MICs) in clinical isolates of Pseudomonas aeruginosa. METHODOLOGY Consecutive clinical isolates of P. aeruginosa were collected. The MicroScan WalkAway system detected more than fourfold increases in the MICs of carbapenems in P. aeruginosa isolates serially recovered from some patients during their clinical course. The clinical risk factors associated with this increase were examined by multiple logistic regression analysis. Western blot analysis and nucleotide sequencing of the oprD gene of 19 clonally related and paired P. aeruginosa isolates from the same patients were undertaken to examine the mechanisms underlying the increase in MICs. RESULTS The results showed that prior use of carbapenems (OR, 2.799; 95 % CI, 1.088-7.200; P=0.033) and the use of ventilators or tracheostomies (OR, 2.648; 95 % CI, 1.051-6.671; P=0.039) were risk factors for increased carbapenem MICs. Analysis of the underlying mechanisms revealed that loss of functional OprD protein due to mutation of the oprD gene tended to occur in P. aeruginosa isolates with imipenem MICs of more than 8 µg ml-1; a reduction in OprD expression was observed in P. aeruginosa isolates with imipenem MICs of 4 or 8 µg ml-1. This difference in the resistance mechanism was not correlated with the MICs of meropenem. CONCLUSION This difference in the resistance mechanism of P. aeruginosa indicates a critical breakpoint at an imipenem MIC of 8 µg ml-1, in accordance with EUCAST criteria. Reducing carbapenem use will prevent P. aeruginosa clinical isolates from developing resistance to carbapenems.
Collapse
Affiliation(s)
- Aki Hirabayashi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan.,Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Daizo Kato
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yuka Tomita
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Mitsutaka Iguchi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Keiko Yamada
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yuichi Kouyama
- Department of Hospital Pharmacy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Hiroshi Morioka
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan.,Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Nobuyuki Tetsuka
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan.,Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.,Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| |
Collapse
|
31
|
Kubo A, Atsugi T, Yokouchi M, Hirabayashi A, Ohyama M, Amagai M. 245 Tight junction barriers in sebaceous glands are crucial for proper terminal differentiation of sebocytes. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
32
|
Morioka H, Iguchi M, Oodate M, Yoneda M, Ushijima F, Hirabayashi A, Tetsuka N, Tomita Y, Kato D, Yagi T. Pneumococcal biliary tract infections - How rare are they? J Infect Chemother 2016; 23:415-418. [PMID: 28024739 DOI: 10.1016/j.jiac.2016.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 10/30/2016] [Accepted: 11/21/2016] [Indexed: 12/16/2022]
Abstract
Pneumococcal biliary tract infections (PBTIs) were reported as rare due to the bacterium's bile solubility. The purpose of this study was to determine the occurrence and clinical characteristics of PBTIs. A retrospective case series review was conducted from January 2006 to August 2014 at a tertiary referral university hospital in Japan. Patients with a blood or bile culture positive for Streptococcus pneumoniae diagnosed with definite cholangitis or cholecystitis according to Tokyo Guideline 2013 were enrolled in this study. Data on clinical information, treatments, and outcomes were collected. During 104 months, 48 cases of positive blood cultures and 13 cases of positive bile cultures were recorded, and after excluding 43 and 5 of these, respectively, a total of 10 patients were diagnosed with PBTI. Most patients (9/10) had biliary tract problems and biliary devices in place. PBTIs were not rare; conversely, they were a relatively common cause of pneumococcal bacteremia in this center treating a high volume of biliary tract illnesses.
Collapse
Affiliation(s)
- Hiroshi Morioka
- Department of Infectious Diseases, Nagoya University Hospital, Japan; Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Japan
| | - Mitsutaka Iguchi
- Department of Infectious Diseases, Nagoya University Hospital, Japan
| | - Mitsuru Oodate
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan; Department of Bacteriology, Nagoya University Graduate School of Medicine, Japan
| | - Masaki Yoneda
- Department of Psychiatry, Nagoya University Hospital, Japan
| | - Futoshi Ushijima
- Department of Respiratory Medicine and Clinical Immunology, Toyota Kosei Hospital, Japan
| | - Aki Hirabayashi
- Department of Infectious Diseases, Nagoya University Hospital, Japan; Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Japan
| | - Nobuyuki Tetsuka
- Department of Infectious Diseases, Nagoya University Hospital, Japan; Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Japan
| | - Yuka Tomita
- Department of Infectious Diseases, Nagoya University Hospital, Japan
| | - Daizo Kato
- Department of Infectious Diseases, Nagoya University Hospital, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Japan; Department of Infectious Diseases, Nagoya University Graduate School of Medicine, Japan.
| |
Collapse
|
33
|
Morioka H, Hirabayashi A, Iguchi M, Tomita Y, Kato D, Sato N, Hyodo M, Kawamura N, Sadomoto T, Ichikawa K, Inagaki T, Kato Y, Kouyama Y, Ito Y, Yagi T. The first point prevalence survey of health care-associated infection and antimicrobial use in a Japanese university hospital: A pilot study. Am J Infect Control 2016; 44:e119-23. [PMID: 27372390 DOI: 10.1016/j.ajic.2016.03.045] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/13/2016] [Accepted: 03/14/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Point prevalence surveys (PPSs) in Japanese hospitals have not yet been reported. The purpose of this pilot PPS study was to evaluate the epidemiology of health care-associated infections (HAIs) and antimicrobial use in a Japanese tertiary university hospital. METHODS A 1-day, cross-sectional PPS was performed at a Japanese university hospital. Data on demographics, active HAIs, and antimicrobial use of all inpatients were collected using a data collection form. RESULTS Of 841 patients, 85 (10.1%) had 90 active HAIs, and 308 patients (36.6%) were administered 494 antimicrobials. Among the 90 HAIs and 58 pathogens, the most frequent infection and isolated pathogen were pneumonia (20.0%) and Enterobacteriaceae (27.6%), respectively. Of the 118 antimicrobials used for treatment of HAIs, carbapenems were the most frequently administered category of antimicrobials (22.9%). In regard to antimicrobials for surgical prophylaxis, 37 of 119 (31.1%) were administered to patients on postoperative day 3 or later, and 48 of 119 (40.3%) were administered orally. CONCLUSIONS The incidence of HAIs is higher than in other developed countries. The social and medical situation in Japan may affect patient demographics, active HAIs, and antimicrobial use. Multicenter PPSs are necessary to uncover the real epidemiology of HAIs and antimicrobial use in Japan.
Collapse
Affiliation(s)
- Hiroshi Morioka
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Aki Hirabayashi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Mitsutaka Iguchi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yuka Tomita
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Daizo Kato
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Naokazu Sato
- Department of Nephrology, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Miyuki Hyodo
- Department of Nursing, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Naoko Kawamura
- Department of Nursing, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Takuya Sadomoto
- Department of Nursing, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Kazuya Ichikawa
- Department of Hospital Pharmacy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Takayuki Inagaki
- Department of Hospital Pharmacy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yoshiaki Kato
- Department of Hospital Pharmacy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yuichi Kouyama
- Department of Hospital Pharmacy, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yoshinori Ito
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan.
| |
Collapse
|
34
|
Morioka H, Hirabayashi A, Iguchi M, Tomita Y, Kato D, Ito Y, Yagi T. The First Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in a Japanese University Hospital: A Pilot Study. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
35
|
Nakabayashi T, Gotoh Y, Kamada N, Fujioka M, Ishihara T, Hirabayashi A, Sato H. Characterization of in vitro biotransformation of the new oral anticoagulants, the factor VIIa inhibitors AS1927819-00 and AS1932804-00. Pharmazie 2013; 68:406-413. [PMID: 23875246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We recently developed a prodrug (AS1932804-00, CMP) of the novel FVIIa inhibitor AS1924269-00, which possesses a carbamate amidine backbone. In addition, we developed another type of prodrug (AS1927819-00, OXP) with an oxime amidine backbone. In this study, we investigated the efficiency of conversion of these novel FVIIa prodrugs to their active forms by evaluating the production of the active form in vitro by using microsomes, mitochondria, and cryopreserved hepatocytes, and compared it with the in vivo conversion mechanisms of the prodrugs (oxime amidine vs. carbamate amidine). We observed that OXP and CMP showed improved oral absorption, and the efficiency of conversion of CMP to the active form was higher than that of OXP. The in vivo rate of conversion of OXP to its active form was low in rats, and compared to liver microsomes and mitochondria, cryopreserved hepatocytes supplemented with serum and coenzymes were an appropriate metabolic test tool. On the other hand, the efficiency of conversion of CMP to its active from could be appropriately evaluated using small intestinal microsomes. The development of a prodrug can be optimized when information about the stability of carboxylic acid esters in the presence of serum esterases, membrane permeability of intermediate forms, and differential tissue specificity to metabolic activities for carbamate and oxime backbones of amidine can be obtained.
Collapse
Affiliation(s)
- T Nakabayashi
- Pharmacokinetics Research Laboratories, Kissei Pharmaceutical Co., Ltd., 19-48 Yoshino, 399-8710 Matsumoto-City, Nagano-Pref, Japan.
| | | | | | | | | | | | | |
Collapse
|
36
|
Nakabayashi T, Gotoh Y, Kamada N, Fujioka M, Ishihara T, Hirabayashi A, Sato H. Pharmacokinetics of the amidine prodrug of a novel oral anticoagulant factor VIIa inhibitor (AS1924269-00) in rats. Pharmazie 2013; 68:349-354. [PMID: 23802432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AS1924269-00 is a promising orally applicable anticoagulant that inhibits FVIIa but has very low oral absorption. Therefore, in this study, we aimed to develop a prodrug of AS1924269-00, which possesses a carbamate-added amidine functional group, with high membrane permeability. We investigated the pharmacokinetics of the carbamate-type prodrug of AS1924269-00 in rats. The Caco-2 cell monolayer was used as an in vitro model and in parallel an artificial membrane permeability assay (PAMPA) was performed to examine the transport mechanisms of the prodrug. The bioavailability of the active form was determined to be only 0.3% in rats, but the oral absorption of the prodrug was markedly improved, and its bioavailability was 36%. Our in vivo result was consistent with the finding that compared to AS1924269-00, the prodrug showed favorable permeability in Caco-2 cells and PAMPA. We introduced carbamate into the amidine functional group of the FVIIa inhibitor, which possesses the amidine backbone, and converted it to a prodrug using carboxylic acid ethyl ester. This novel prodrug had favorable absorption and membrane permeability in vivo and in vitro. Thus, we suggest a clinical application of the carbamate-added amidine prodrug of the FVIIa inhibitor.
Collapse
Affiliation(s)
- T Nakabayashi
- Pharmacokinetics Research Laboratories, Kissei Pharmaceutical Co., Ltd., Nagano, Japan.
| | | | | | | | | | | | | |
Collapse
|
37
|
Valdivia Vega RP, Perez Carlos J, LI X, LI X, Xu X, Zhang W, Ren H, Chen N, Yorioka N, Doi T, Hirashio S, Arita M, Hirabayashi A, Tilkiyan E, Chonova E, Ronchev Y, Kumchev E, Giamalis P, Spartalis M, Stangou M, Tsouchnikas I, Moysiades D, Dimopoulou D, Garyfalos A, Efstratiadis G, Memmos D, Schonermarck U, Eichhorn P, Sitter T, Wendler T, Vielhauer V, Lederer S, Fechner K, Fischereder M, Bantis C, Heering P, Kouri NM, Stangou M, Schwandt C, Kuhr N, Ivens K, Rump LC, Matta V, Melis P, Conti M, Cao R, Binda V, Altieri P, Asunis AM, Catani W, Floris M, Angioi A, Congia M, Cucca F, Minerba L, Peri M, Pani A, Beck LH, Fervenza FC, Fervenza FC, Bomback AS, Ayalon R, Irazabal MV, Eirin A, Cattran DC, Appel GB, Salant DJ, Santoro D, Postorino A, Costantino G, Bellinghieri G, Savica V, Weiner M, Goh SM, Mohammad A, Eriksson P, Westman K, Selga D, Salama A, Segelmark M, Chocova Z, Hruskova Z, Mareckova H, Svobodova B, Jancova E, Bednarova V, Rysava R, Tesar V, Hruskova Z, Jancova E, Hanzal V, Zamboch K, Grussmannova M, Svojanovsky J, Klaboch J, Kubisova M, Sevcik J, Olsanska R, Sobotkova M, Becvar R, Nemec P, Kodeda M, Jilek D, Chocova Z, Tesar V, Hussain M, Dhaygude A, Cartery C, Cartery C, Huart A, Plaisier E, Bongard V, Montastruc F, Ronco P, Pourrat J, Chauveau D, Prasad N, Gurjar D, Bhadauria D, Sharma RK, Gupta A, Kaul A, Jain M, Venning M, Brown N, Bruce I, Noor S, Dhaygude A, Bekker P, Potarca A, Dairaghi D, Miao S, Powers JP, Jaen JC, Schall TJ, Kalavrizioti D, Kalavrizioti D, Gerolymos M, Komninakis D, Rodi M, Mouzaki A, Kalliakmani P, Goumenos D, Choi BS, Choi BS, Park CW, Kim YS, Yang CW, Sun IO, Qin W, Xie L, Tan C, Qin W, Mian W, Fu P, Tan C, Kaminskyy V, Bantis C, Heering P, Kouri NM, Kuhr N, Schwandt C, Ivens K, Rump LC, Hao X, Hao X, Ren H, Wang W, Chen N, Cengiz C, Nur C, Nurdan Y, Selman G, Pinar T, Mehmet T, Lale S, Caliskan S, Shinzawa M, Yamamoto R, Nagasawa Y, Oseto S, Mori D, Niihata K, Fukunaga M, Yamauchi A, Tsubakihara Y, Rakugi H, Isaka Y, Chen JS, Lin YF, Lin WY, Shu KH, Chen HH, Wu CJ, Yang CS, Tseng TL, Zaza G, Bernich P, Lupo A, Panizo N, Rivera F, Lopez Gomez JM, Regn SROG, Ceresini G, Vaglio A, Urban ML, Corradi D, Usberti E, Palmisano A, Buzio C, Vaglio A, Zineb H, Ramdani B, Marques LPJ, Rioja LDS, Rocco R, Nery ACF, Novaes BC, Bridoux F, Sicard A, Labatut D, Touchard G, Sarkozy C, Vanhille P, Callard P, Essig M, Provot F, Nony A, Ronco P, Karras A, Agustin CP, M Belen HR, Carmen CP, Eliana O, Elisa P, Luis P, Alberto MC, Javier N, Isabel F, Cao R, Conti M, Atzeni A, Fois A, Piras D, Maxia S, Angioi A, Binda V, Melis P, Sau G, Pili G, Floris M, Asunis AM, Porcu M, Derudas D, Angelucci E, Ledda A, La Nasa G, Pani A, Ossareh S, Asgari M, Savaj S, Ataipour Y, Abdi E, Malakoutian T, Rajaa R, Berkchi FZ, Haffane L, Squalli Z, Rouass L, Al Hamany Z, Ezzaitouni F, Benamar L, Bayahya R, Ouzeddoun N, Gao-Yuan H, Yao X, Xin C, Zhen C, Yong-Chun G, Qing-Wen W, Hui-Ping C, Da-XI J, De-Hua G, Wei-Xin H, Zhi-Hong L, Rajaa R, Fatima Zahra B, Laila H, Zoubair S, Rouass L, Al Hamany Z, Ezzaitouni F, Benamar L, Bayahya R, Naima O, Smykal-Jankowiak K, Niemir Z, Polcyn-Adamczak M, Szramka-Pawlak B, Zaba R, Zhang C, Zhang C, Ren H, MA Y, Wang W, Zhang W, Shen P, Chen N, Ouyang Y, Ouyang Y, Pan X, Wang Z, Feng X, Shen P, Ren H, Ni L, Zhang W, Chen N. Primary and secondary glomerulonephritis II. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
38
|
Hirabayashi A, Miyaji K, Akagi T. Continuous epoprostenol therapy and septal defect closure in a patient with severe pulmonary hypertension. Catheter Cardiovasc Interv 2009; 73:688-91. [DOI: 10.1002/ccd.21877] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
39
|
Tanaka N, Tamai T, Mukaiyama H, Hirabayashi A, Muranaka H, Ishikawa T, Akahane S, Akahane M. Beta(3)-adrenoceptor agonists for the treatment of frequent urination and urinary incontinence: 2-[4-(2-[[(1S,2R)-2-hydroxy-2-(4-hydroxyphenyl)-1-methylethyl]amino]ethyl)phenoxy]-2-methylpropionic acid. Bioorg Med Chem 2001; 9:3265-71. [PMID: 11711302 DOI: 10.1016/s0968-0896(01)00240-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In a search for novel analogues of beta(3)-adrenoceptor (AR) agonists relaxing the bladder for treatment of urinary dysfunction, 2-[4-(2-[[(1S,2R)-2-hydroxy-2-(4-hydroxyphenyl)-1-methylethyl]amino]ethyl)phenoxy]-2-methylpropionic acids (1a-e), into which a fibrate-like structure had been incorporated, were synthesised. Compound 1a was found to be a selective beta(3)-AR agonist in functional assays using the ferret detrusor (beta(3)-AR), rat uterus (beta(2)-AR), and rat atrium (beta(1)-AR); beta(3): EC(50)=7.8 nM, beta(2): IC(50)=7,300 nM, beta(1): EC(20)=23,000 nM. The introduction of a chlorine atom or methyl substituent at the ortho-position on the phenyl ring of 1a further improved beta(3)-AR selectivity. In an in vivo study, 1a lowered intrabladder pressure (ED(50)=31 microg/kg) in rats, without increasing heart rate, in keeping with the in vitro results. Consequently, it is proposed that 1a and its analogues (1b-e), possess beta(3)-AR agonistic activity in the absence of undesirable beta(1)- or beta(2)-AR mediated actions, and may be useful for clinical treatment and pharmacological studies.
Collapse
Affiliation(s)
- N Tanaka
- Central Research Laboratory, Kissei Pharmaceutical Company Ltd., 4365-1, Hotaka, Nagano, 399-8304, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Huang M, Hirabayashi A, Okumura A, Hirabayashi Y. Matrix effect on the analysis of oligonucleotides by using a mass spectrometer with a sonic spray ionization source. ANAL SCI 2001; 17:1179-82. [PMID: 11990592 DOI: 10.2116/analsci.17.1179] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Matrix or impurities remaining in a DNA sample solution after various sample treatment procedures may influence a subsequent DNA analysis. In this work, several matrices were investigated concerning their effects on the analysis of oligonucleotide by using an ion-trap mass spectrometer equipped with a sonic spray ionization source. Inorganic salts of sodium chloride and magnesium chloride depressed the signal intensity by about 50% when the content of the salts was about 10 microM. dNTPs and Taq showed more severe depression on the oligonucleotide. However, Tris, or (hydroxymethyl)aminomethane, intensified the signal intensity, if its content was within an appropriate range. When the content of Tris was about 500 microM, the signal intensity was enhanced by factors of 3 and 5 for the 6-mer and the 20-mer oligonucleotides, respectively. With the existence of Tris, matrix effects from the inorganic salts, dNTPs and Taq were reduced.
Collapse
Affiliation(s)
- M Huang
- Life Science Group, Hitachi Ltd., Kawagoe, Saitama, Japan.
| | | | | | | |
Collapse
|
41
|
Affiliation(s)
- A Okumura
- Central Research Laboratory, Hitachi, Ltd., Higashi-koigakubo, Kokubunji, Tokyo 185-8601, Japan
| | | | | | | |
Collapse
|
42
|
Tanaka N, Tamai T, Mukaiyama H, Hirabayashi A, Muranaka H, Akahane S, Miyata H, Akahane M. Discovery of novel N-phenylglycine derivatives as potent and selective beta(3)-adrenoceptor agonists for the treatment of frequent urination and urinary incontinence. J Med Chem 2001; 44:1436-45. [PMID: 11311067 DOI: 10.1021/jm000455z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
With a novel assay using isolated ferret detrusor to estimate beta(3)-adrenoceptor agonistic activity, we found that a series of glycine derivatives of ritodrine, a beta(2)-adrenoceptor agonist, are potent beta(3)-adrenoceptor agonists, with excellent selectivity versus beta(1) and beta(2) subtypes. Substitution of halogens in the phenyl ring increased potency and selectivity for the beta(3)-adrenoceptor, and this was dependent upon the position of the halogens. The chlorine-substituted derivatives 3f-i exhibited potent beta(3)-adrenoceptor-mediated relaxation of ferret detrusor (EC(50) = 0.93, 11, 14, and 160 nM) and higher potency at beta(3)-adrenoceptors than at beta(1) or beta(2). The intravenous administration of 3h significantly reduced the urinary bladder pressure in anesthetized male rats (ED(50) = 48 microg/kg) without cardiovascular side effects. This article is the first report of structure-activity relationships (SAR) concerning beta(3)-adrenoceptor agonists as agents for the treatment of urinary frequency and incontinence.
Collapse
Affiliation(s)
- N Tanaka
- Central Research Laboratory, Kissei Pharmaceutical Company Ltd., 4365-1, Hotaka, Nagano 399-8304, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Abstract
In order to avoid overfitting, we propose error correcting memorization learning. This method is derived from minimization of error between outputs of a trained neural network and correct values for noisy training examples, although the correct values are unknown. We show that noise is adequately suppressed by error correcting memorization learning. The noise suppression mechanism is theoretically clarified. It is found that redundancy plays an essential role for noise suppression and depends on a set of training inputs. We give the condition for the training inputs to provide the redundancy. Moreover, by clarifying the relationships between the proposed method and the weighted least squares estimation with the Mahalanobis norm, we reveal effectiveness of the weighted least squares estimation on noise suppression.
Collapse
Affiliation(s)
- A Nakashima
- Corporate Research and Development Center, Toshiba Corporation, Kawasaki, Japan.
| | | | | |
Collapse
|
44
|
Suga K, Hirabayashi A, Motoyama K, Kume N, Matsunaga N, Tamura H, Kato H. Repeated 131I treatment of a residual ovarian teratoma containing malignant thyroid tissue. Br J Radiol 1999; 72:1110-3. [PMID: 10700830 DOI: 10.1259/bjr.72.863.10700830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 49-year-old woman with ovarian teratoma received 131I treatment three times for an unresectable mass containing malignant thyroid tissue after surgery. Repeated 131I treatment effectively reduced serum thyroglobulin (Tg) level and tumour uptake of 131I, despite absence of any change in size of the treated tumour. Treatment did not inhibit the increase of serum CA-125 and tumour 201Tl uptake, associated with progression of a radioresistant intratumoral hyper-perfused tissue component, detected by colour Doppler ultrasound. Serum CA-125 level and tumour 201Tl uptake were not significantly changed despite temporary increases in serum Tg level after each 131I treatment. These observations indicate the importance of diagnostic measures using combined functional imaging and tumour markers in managing this rare tumour.
Collapse
Affiliation(s)
- K Suga
- Department of Radiology, Yamaguchi University School of Medicine, Japan
| | | | | | | | | | | | | |
Collapse
|
45
|
Suga K, Hirabayashi A, Kishimoto K, Kume N, Matsumoto T, Matsunaga N. Tc-99m DTPA used as reference imaging to evaluate the distribution of other tumor-seeking tracers in tumors associated with neurofibromatosis. Clin Nucl Med 1999; 24:435-9. [PMID: 10361941 DOI: 10.1097/00003072-199906000-00012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Two patients with multiple benign and malignant tumors associated with neurofibromatosis underwent radionuclide imaging with Tc-99m DTPA, Tl-201, and Ga-67. In these patients, Tc-99m DTPA accumulated intensively in both the benign and malignant tumors and localized and defined the extent of every tumor. In contrast, Ga-67 and Tl-201 uptake was seen only in focal areas of tumor where there was malignant transformation or at sites that showed progressive tumor growth. Tc-99m DTPA imaging accurately demonstrated areas of neoplastic involvement and identified the areas that would be seen with the other two tracers in individual tumors. Tc-99m DTPA may not always be used for the differential diagnosis of malignant and benign tumors of neurofibromatosis, but it can provide a reference pattern for imaging to evaluate accurately the distribution of Tl-201 and Ga-67 by mapping out the anatomic extent of these tumors.
Collapse
Affiliation(s)
- K Suga
- Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan
| | | | | | | | | | | |
Collapse
|
46
|
Suga K, Kume N, Hirabayashi A, Kishimoto K, Hara A, Matsunaga N. Crossed cerebellar diaschisis demonstrated by brain SPECT with Tc-99m MAA in a child with an intracardiac right-to-left shunt. Clin Nucl Med 1999; 24:282-3. [PMID: 10466533 DOI: 10.1097/00003072-199904000-00019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- K Suga
- Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan
| | | | | | | | | | | |
Collapse
|
47
|
Fujimoto T, Hirabayashi A, Okuda S, Shimizu K, Takuma H. Emission and absorption studies of He I lambda 5874.5 Å (23P-31D) and lambda 6679.7 Å (21P-33D) intercombination transitions. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0022-3700/19/5/016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
48
|
Suga K, Kume N, Hirabayashi A, Kishimoto K, Hara A, Matsunaga N. Abnormal brain perfusion demonstrated by Tc-99m MAA total-body scan in two children with complex congenital heart disease. Ann Nucl Med 1998; 12:297-302. [PMID: 9839493 DOI: 10.1007/bf03164917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This paper describes abnormal brain perfusion unexpectedly demonstrated by Tc-99m MAA total-body imaging in two children with intracardiac right-to-left shunt (RLS) associated with complex congenital heart disease. One child was a 12-year-old girl with asplenia cardiac syndrome and multiple cerebral infarctions caused by thromboembolism in the internal carotid artery, and the other child was a 6-month-old boy who developed focal cerebral infarction following shunt operation. In both children, the total-body imaging depicted the brain due to RLS, where radioactivity decreased unilaterally in the cerebral hemisphere. In the first patient, radioactivity also decreased in the contralateral cerebellum, suggesting the crossed cerebellar diaschisis phenomenon. These abnormalities in brain perfusion were confirmed by Tc-99m HMPAO brain SPECT. Careful review of the distribution of the radiotracer in the depicted brain on Tc-99m MAA total-body imaging may provide important information regarding brain perfusion in some patients with a high risk of stroke complication associated with RLS.
Collapse
Affiliation(s)
- K Suga
- Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan
| | | | | | | | | | | |
Collapse
|
49
|
Suga K, Kume N, Hirabayashi A, Kishimoto K, Matsunaga N. Extrarenal collection of Tc-99m MAG3 mimicking a urinary leak in a patient who underwent partial nephrectomy. Clin Nucl Med 1998; 23:546-7. [PMID: 9712398 DOI: 10.1097/00003072-199808000-00019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- K Suga
- Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan
| | | | | | | | | |
Collapse
|
50
|
Hirabayashi A, Yorioka N, Oda H, Sekiguchi Y, Kuramoto A, Okushin S, Yamakido M. Involvement of bacterial antigens in immunoglobulin A nephropathy. Hiroshima J Med Sci 1996; 45:113-7. [PMID: 9119709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To investigate the involvement of bacterial antigens in Immunoglobulin A (IgA) nephropathy, we measured IgA, IgG and IgM antibodies to gram-negative Escherichia coli (E.coli) and Haemophilus influenzae (H.influenzae) by ELISA in 24 patients (11 males and 13 females) with IgA nephropathy and 22 normal controls (11 males and 11 females). The titers of IgA and IgM antibodies for E.coli and H.influenzae were significantly higher in the IgA nephropathy group than in the controls. In addition, IgA and IgM antibody titers for E.coli and H.influenzae showed a significant positive correlation with serum IgA and IgM levels. These findings suggest that subclinical infection by these bacteria stimulates IgA production and that this may be a factor in the development and progression of IgA nephropathy.
Collapse
Affiliation(s)
- A Hirabayashi
- Department of Internal Medicine, Hiroshima General Hospital, Hatsukaichi City, Japan
| | | | | | | | | | | | | |
Collapse
|