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Sakamoto N, Laolerd W, Akeda Y, Sugawara Y, Motooka D, Yamamoto N, Takeuchi D, Shanmugakani RK, Nishi I, Suzuki M, Shibayama K, Iida T, Santanirand P, Tomono K, Hamada S. Temporal shifts in the predominant carbapenemase gene types among carbapenemase-producing Klebsiella pneumoniae isolated in Bangkok, Thailand, during 2013-2016. J Med Microbiol 2023; 72. [PMID: 37294294 DOI: 10.1099/jmm.0.001711] [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: 06/10/2023] Open
Abstract
Introduction. Carbapenemase-producing Enterobacteriaceae (CPE) have emerged as a global threat to public health and clinical practice.Hypothesis/Gap Statement. In Thailand, reports describing CPEs carrying bla NDM and bla OXA-48-like genes have been increasing recently; however, data on detailed plasmid analysis and temporal shift of sequence type and carbapenemase type are limited.Aim. In this study, we analysed whole-genome sequencing (WGS) data of clinically isolated carbapenemase-producing Klebsiella pneumoniae (CPKP) to reveal the molecular epidemiology of CPKP in a tertiary-care hospital in Bangkok, Thailand.Methodology. Seventy-seven non-duplicated CPKP isolates collected during 2013-2016 were examined for their drug-resistance genes, sequence types and phylogenetic relationships.Results. All the tested isolates possessed carbapenemase gene(s), and the major type of carbapenemase gene in 2014-2015 was bla NDM-1, whereas isolates in 2016 harboured more bla OXA-232 than bla NDM-1. Other carbapenemase gene variants, such as bla NDM-4, bla NDM-5, bla OXA-48, bla OXA-181 and bla IMP-14 were detected in some CPKP isolates. Furthermore, this study revealed that CPKP co-harbouring two genes, bla NDM-1 and bla OXA-232 or bla OXA-181, emerged during this period. Notably, such isolates co-carrying the two carbapenemase genes emerged in three different sequence types, even in a single hospital, and then spread clonally. The WGS of CPKP revealed a temporal shift of the predominant carbapenemase genes from bla NDM-1 to bla OXA-232 along with a variation in other carbapenemase gene types within a span of 4 years.Conclusion. Our findings suggest that a substantial change in CPE types occurred in Thailand and potentially in Southeast Asian countries.
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Affiliation(s)
- Noriko Sakamoto
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Warawut Laolerd
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yukihiro Akeda
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
- Osaka University Hospital, Osaka University, Osaka, Japan
| | - Yo Sugawara
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Daisuke Motooka
- Department of Infection Metagenomics, Genome Information Center, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Norihisa Yamamoto
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
- Osaka University Hospital, Osaka University, Osaka, Japan
| | - Dan Takeuchi
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Rathina Kumar Shanmugakani
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Isao Nishi
- Osaka University Hospital, Osaka University, Osaka, Japan
| | - Masato Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuya Iida
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Department of Infection Metagenomics, Genome Information Center, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Center for Infectious Disease Education and Research, Osaka University, Osaka, Japan
| | - Pitak Santanirand
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kazunori Tomono
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
- Osaka University Hospital, Osaka University, Osaka, Japan
| | - Shigeyuki Hamada
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
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Watanabe H, Koike A, Kato H, Kawamatsu N, Ichinohe T, Machino T, Nishi I, Kawamoto H, Sankai Y, Ieda M. Effects of cardiac rehabilitation with motion assistance from a wearable cyborg hybrid assistive limb on patients with chronic heart failure: a randomized controlled trial with a one-year follow-up. J Phys Ther Sci 2023; 35:114-120. [PMID: 36744202 PMCID: PMC9889210 DOI: 10.1589/jpts.35.114] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/09/2022] [Indexed: 02/04/2023] Open
Abstract
[Purpose] We have recently reported that using a wearable cyborg hybrid assistive limb improved the isometric knee extensor muscle strength of patients with chronic heart failure. Here, we investigated the long-term effects of a lumbar-type hybrid assistive limb for patients with chronic heart failure. [Participants and Methods] A total of 28 hospitalized patients with chronic heart failure (mean age, 73.1 ± 13.8 years) were randomly assigned to two groups: the hybrid assistive limb group or the control group, in which they performed a sit-to-stand exercise with or without the hybrid assistive limb, respectively. The cardiac rehabilitation therapy included this intervention, which was performed as many times as possible for 5-30 minutes per day for 6-10 days. Clinical assessments like lower-limb muscle strength, walking ability, etc., were measured before and after the intervention. Cardiac events were followed up for up to a year after discharge. [Results] No adverse events occurred during the study period in either group. In terms of long-term effects, the incidence of cardiac events was 23% and 45% in the hybrid assistive limb and the control groups, respectively. [Conclusion] Hybrid assistive limb-assisted exercise therapy may be a safe and feasible cardiac rehabilitation tool in patients with chronic heart failure. The lumbar-type wearable cyborg hybrid assistive limb may have a positive effect on heart failure prognosis by adding long-term exercise therapy.
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Affiliation(s)
- Hiroki Watanabe
- Department of Neurosurgery, Faculty of Medicine, University
of Tsukuba, Japan
| | - Akira Koike
- Department of Cardiology, Faculty of Medicine, University
of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan,Corresponding author. Akira Koike (E-mail: )
| | - Hidenori Kato
- Department of Rehabilitation, University of Tsukuba
Hospital, Japan
| | - Naoto Kawamatsu
- Department of Cardiology, Faculty of Medicine, University
of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Takako Ichinohe
- Department of Cardiology, Faculty of Medicine, University
of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Takeshi Machino
- Department of Cardiology, Faculty of Medicine, University
of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Isao Nishi
- Department of Cardiology, Kamisu Clinical Education and
Training Center, University of Tsukuba Hospital, Japan
| | | | | | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University
of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
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3
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Kuchibiro T, Komatsu M, Yamasaki K, Nakamura T, Niki M, Nishio H, Kida K, Ohama M, Nakamura A, Nishi I. Evaluation of the VITEK2 AST-XN17 card for the detection of carbapenemase-producing Enterobacterales in isolates primarily producing metallo β-lactamase. Eur J Clin Microbiol Infect Dis 2022; 41:723-732. [PMID: 35211803 PMCID: PMC9033686 DOI: 10.1007/s10096-022-04424-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
Carbapenemase-producing Enterobacterales (CPE) are not always resistant to carbapenem antimicrobial susceptibility testing (AST) and can be difficult to detect. With the newly created VITEK2 AST-XN17 card, the types of antibiotics measured in AST can be increased. In this study, we evaluated the detectability of CPE using the results of AST with multiple antimicrobial agents with additional measurements of the AST-XN17 card. In addition, we evaluated the CPE detectability of comments on CPE using the VITEK2 Advance Expert System (AES). In total, 169 Enterobacterales samples, including 76 non-CPE and 93 CPE, collected from multiple medical institutions in the Kinki region of Japan, were used in this investigation. AST with VITEK2 was performed by adding the AST-XN17 card in addition to the AST-N268 or AST-N404 card. Measurement results were identified using cutoff values, primarily Clinical and Laboratory Standards Institute breakpoints, and the CPE detection capability of each antibiotic was evaluated in several terms, including sensitivity and specificity. The drugs highly sensitive to CPE detection were faropenem (FRPM) > 2 µg/mL at 100% and meropenem > 0.25 µg/mL at 98.9%; the highest specificity to CPE detection was for avibactam/ceftazidime (AVI/CAZ) > 8 µg/mL at 100%. The sensitivity and specificity of each card in the AES output were 86.2% and 94.7% for AST-N404 and AST-XN17 and 91.5% and 90.8% for AST-N268 and AST-XN17, respectively. AST using the VITEK2 AST-XN17 card is a useful test method of screening for CPE.
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Affiliation(s)
- Tomokazu Kuchibiro
- Department of Clinical Laboratory, Naga Municipal Hospital, 1282 Uchita, Kinokawa, Wakayama, 649-6414, Japan.
| | - Masaru Komatsu
- Department of Clinical Laboratory Science, Tenri Health Care University, Nara, Japan
| | - Katsutoshi Yamasaki
- Department of Medical Life Science, Kurashiki University of Science and the Arts, Okayama, Japan
| | - Tatsuya Nakamura
- Department of Medical Technology and Sciences Facility of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
| | - Makoto Niki
- Department of Infection Control and Prevention, Osaka City University Hospital, Osaka, Japan
| | - Hisaaki Nishio
- Department of Clinical Laboratory, Shiga Medical Center for Children, Shiga, Japan
| | - Kaneyuki Kida
- Clinical Laboratory, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Masanobu Ohama
- Clinical Laboratory, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Akihiro Nakamura
- Department of Clinical Laboratory Science, Tenri Health Care University, Nara, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
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Takeuchi D, Kerdsin A, Akeda Y, Sugawara Y, Sakamoto N, Matsumoto Y, Motooka D, Ishihara T, Nishi I, Laolerd W, Santanirand P, Yamamoto N, Tomono K, Hamada S. Nationwide surveillance in Thailand revealed genotype-dependent dissemination of carbapenem-resistant Enterobacterales. Microb Genom 2022; 8. [PMID: 35438076 PMCID: PMC9453063 DOI: 10.1099/mgen.0.000797] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Carbapenem-resistant
Enterobacterales
(CRE) are a serious public health threat because of their rapid dissemination. To determine the epidemiological and genetic characteristics of CRE infections in Thailand, we performed whole-genome sequencing of 577 carbapenem-resistant
Klebsiella pneumoniae
isolates and 170 carbapenem-resistant
Escherichia coli
isolates from hospitals across the nation. The four most prevalent carbapenemase genes harboured by these bacteria were bla
NDM-1, bla
NDM-5, bla
OXA-181 and bla
OXA-232. The gene bla
NDM-1 was identified in diverse sequence types. The gene bla
NDM-5 was identified almost exclusively in
E. coli
. The genes bla
OXA-181, bla
OXA-232, and co-carriage of bla
NDM-1 and bla
OXA-232 were found in specific sequence types from certain provinces. Replicon typing revealed the diverse backbones of bla
NDM-1- and bla
NDM-5-harbouring plasmids and successful expansion of bla
NDM-1-harbouring IncN2-type plasmids. Core-genome single-nucleotide polymorphism analysis suggested that bla
OXA-181-, bla
OXA-232-, bla
NDM-5-, and co-carriage of bla
NDM-1 and bla
OXA-232-associated sub-clonal lineages have recently predominated in the provinces from where these isolates were isolated. Thus, we demonstrate genotype-dependent dissemination of CRE in Thailand, which is helpful for establishing infection-control strategies in CRE-endemic areas.
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Affiliation(s)
- Dan Takeuchi
- Japan-Thailand Research Collaboration Center, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Anusak Kerdsin
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Yukihiro Akeda
- Japan-Thailand Research Collaboration Center, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Yo Sugawara
- Japan-Thailand Research Collaboration Center, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Noriko Sakamoto
- Japan-Thailand Research Collaboration Center, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Yuki Matsumoto
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Daisuke Motooka
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Isao Nishi
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Warawut Laolerd
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pitak Santanirand
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Norihisa Yamamoto
- Japan-Thailand Research Collaboration Center, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Shigeyuki Hamada
- Japan-Thailand Research Collaboration Center, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
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Yamamoto M, Ishizu T, Seo Y, Nakagawa D, Sato K, Kawamatsu N, Machino-Ohtsuka T, Hamada-Harimura Y, Sai S, Sugano A, Nishi I, Ieda M. Pathophysiological role of right ventricular function and interventricular functional mismatch in the development of pulmonary edema in acute heart failure. J Cardiol 2021; 79:711-718. [PMID: 34924232 DOI: 10.1016/j.jjcc.2021.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Parameters of cardiac function related to the development of pulmonary edema (PE) in acute heart failure (AHF), including right ventricular (RV) function and a mismatch of interventricular function, are not fully elucidated. The aim of this study was to verify the hypothesis that a relatively preserved RV function compared with left ventricular function may be associated with the development of PE by using two-dimensional speckle tracking echocardiography (2DSTE). METHODS Hospitalized patients with AHF at 11 institutions were enrolled. PE was defined as lung congestion on chest X-ray with hypoxemia. Patients with systolic blood pressure ≥140 mmHg on admission were defined to have hypertensive AHF. Echocardiographic analyses, including 2DSTE, were performed prior to discharge. The index of mismatch between RV and left ventricular systolic function was assessed by interventricular longitudinal strain difference (IVLSD) which was defined as RV free wall longitudinal strain and left ventricular global longitudinal strain. RESULTS Of 610 patients with AHF, 422 (69.2%) had PE. In patients with PE, IVLSD (p = 0.007) and RV fractional area change ratio (p<0.001) was significantly higher than those in patients without PE. In patients with non-hypertensive AHF, RV fractional area change ratio, age, ischemic etiology, and serum brain natriuretic peptide (BNP) levels were independent predictors of PE. In patients with hypertensive AHF, IVLSD, age, and serum BNP levels were independent predictors of PE. CONCLUSIONS Preserved RV function might be one of the underlying mechanisms of the development of PE in AHF. Furthermore, interventricular functional mismatch might be related to the development of PE in hypertensive AHF.
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Affiliation(s)
- Masayoshi Yamamoto
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tomoko Ishizu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Daishi Nakagawa
- Department of Cardiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Kimi Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Naoto Kawamatsu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | | | - Seika Sai
- Division of Cardiology, Hitachinaka General Hospital, Hitachinaka, Japan
| | - Akinori Sugano
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Tomobe, Japan
| | - Isao Nishi
- Division of Cardiology, Kamisu Saiseikai Hospital, Kamisu, Japan
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Kato H, Watanabe H, Koike A, Wu L, Hayashi K, Konno H, Machino T, Nishi I, Sato A, Kawamoto H, Aonuma K, Sankai Y, Ieda M. Effects of Cardiac Rehabilitation With Lumbar-Type Hybrid Assistive Limb on Muscle Strength in Patients With Chronic Heart Failure - A Randomized Controlled Trial. Circ J 2021; 86:60-67. [PMID: 34511585 DOI: 10.1253/circj.cj-21-0381] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Aiming to establish an effective tool in new cardiac rehabilitation programs, we investigated the use of a lumbar-type hybrid assistive limb (HAL) in patients with heart failure (HF) who had difficulty in walking at the usual speed of healthy subjects (≈80 m/min).Methods and Results:We randomly assigned 28 HF patients (age, 73.1±13.8 years) to perform a sit-to-stand exercise with or without HAL. The sit-to-stand exercise was repeated as many times as possible as cardiac rehabilitation therapy over a period of 6-10 days. We measured 5 parameters before and after the completion of cardiac rehabilitation: B-type natriuretic peptide, Short Physical Performance Battery (SPPB), 6-min walking distance (6MWD), 30-s chair-stand test (CS-30), and isometric knee extensor muscle strength. The SPPB and 6MWD were significantly improved, and the CS-30 score was somewhat improved, after the exercise therapy in both the HAL and non-HAL groups. The knee extensor muscle strength improved significantly in the HAL group (0.29±0.11 to 0.35±0.11 kgf/kg, P<0.01), but showed no change in the non-HAL group (0.35±0.11 to 0.35±0.13 kgf/kg, P=0.40). CONCLUSIONS The improved knee extensor muscle strength in the HAL group suggests that the lumbar-type HAL may be an effective tool for cardiac rehabilitation in HF patients with frailty, which is a predictor of poor prognosis in HF.
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Affiliation(s)
- Hidenori Kato
- Department of Rehabilitation, University of Tsukuba Hospital
| | - Hiroki Watanabe
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
| | - Akira Koike
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Longmei Wu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Kosuke Hayashi
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Hirotomo Konno
- Department of Rehabilitation, University of Tsukuba Hospital
| | - Takeshi Machino
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Isao Nishi
- Department of Cardiology, Kamisu Clinical Education and Training Center, University of Tsukuba Hospital
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
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Nakamura A, Nakamura T, Niki M, Kuchibiro T, Nishi I, Komatsu M. Genomic Characterization of ESBL- and Carbapenemase-Positive Enterobacteriaceae Co-harboring mcr-9 in Japan. Front Microbiol 2021; 12:665432. [PMID: 34504474 PMCID: PMC8421803 DOI: 10.3389/fmicb.2021.665432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/08/2021] [Accepted: 07/16/2021] [Indexed: 12/30/2022] Open
Abstract
Worldwide spread of Enterobacteriaceae resistant to colistin, a polypeptide antibacterial drug for last-resort treatment of carbapenemase-producing Enterobacteriaceae (CPE) infections, is concerning. This study aimed to elucidate colistin MICs and molecular characteristics of mcr-1 to mcr-9 of ESBL-producing Escherichia coli (ESBL-Ec) and CPE in Japan and clarify the genomic structure of strains harboring mcr genes (especially mcr-9). This study included 168 ESBL-Ec and 126 CPE strains isolated at Japanese medical facilities. Colistin susceptibility testing and multiplex PCR targeting mcr-1 to mcr-9 were performed for all strains with S1-nuclease pulsed-field gel electrophoresis, Southern blot hybridization, and whole-genome sequencing (WGS) with hybrid assembly performed for mcr gene-carrying strains. Two CPE strains showed a MIC ≥ 4 μg/ml in colistin susceptibility testing, with no known resistance mechanism detected. However, PCR conducted on all target strains detected three mcr-9-carrying strains showing colistin susceptibility. The blaCTX–M–62-positive E. coli THUN648 strain simultaneously carried blaCTX–M–62 and mcr-9 on a 275-kbp plasmid. Besides, blaIMP–6 + blaCTX–M–2-positive Klebsiella pneumoniae THUN262 and blaGES–24-positive Enterobacter kobei THUN627 had mcr-9 encoded on the chromosome. Only THUN627 encoded qseB/C, which is suggested to be a regulatory gene for mcr-9, downstream of mcr-9. However, this strain showed no increased expression of these genes in mRNA quantitative analysis under colistin exposure. Colistin MICs of ESBL-Ec and CPE in Japan were all below 2 μg/ml, which is below the epidemiological cutoff (ECOFF) value (https://eucast.org/) or clinical breakpoint (CB) (CLSI M100-S30) reported for colistin, indicating neither “microbiological” nor “clinical” resistance. Several colistin-susceptible Enterobacteriaceae carrying silent mcr-9 encoded on plasmids and chromosomes have already spread worldwide along with other antimicrobial resistance genes. However, the mechanism of colistin resistance by mcr-9 remains unclear.
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Affiliation(s)
- Akihiro Nakamura
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - Tatsuya Nakamura
- Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
| | - Makoto Niki
- Department of Infection Control and Prevention, Osaka City University Hospital, Osaka, Japan
| | - Tomokazu Kuchibiro
- Department of Clinical Laboratory, Naga Municipal Hospital, Wakayama, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Masaru Komatsu
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, Tenri, Japan
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Kuchibiro T, Komatsu M, Yamasaki K, Nakamura T, Nishio H, Kimura K, Niki M, Kida K, Ohama M, Fukuda N, Sawa K, Nakamura A, Nishi I. Comparison of the performance of three carbapenem inactivation methods for the detection of carbapenemase-producing gram-negative bacilli. J Infect Chemother 2021; 27:1634-1638. [PMID: 34376351 DOI: 10.1016/j.jiac.2021.07.021] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The carbapenem inactivation method test (CIM) was developed as a method for detecting carbapenemase-producing Gram-negative bacilli, and the modified CIM (mCIM) was recommended by the CLSI for as an improved method in M100-S27. However, few studies have evaluated the influence of bacterial species and genotype on its sensitivity and specificity. In this study, we evaluate the performance of these improved modified CIM methods with mCIM. METHODS As strains, clinical isolates from Naga Municipal Hospital and stored strains from the Study of Bacterial Resistance in the Kinki Region of Japan were used. The mCIM, CIM-Tris, and simple CIM (sCIM) test methods were applied to 120 Enterobacterales, 40 Pseudomonas aeruginosa, and 37 Acinetobacter spp. The procedure and criteria for each method were based on the original papers and the CLSI M - 100 S27 documents. RESULTS The sensitivity of the test methods in the detection of carbapenemase in Enterobacterales, Pseudomonas spp., and Acinetobacter spp. was as follows: mCIM, 98.9%, 90.0%, and 76.5%, respectively; CIM-Tris, 94.4%, 100%, 100%; and sCIM 98.9%, 85.0%, 76.5%. All methods showed 100% specificity in Enterobacterales, Pseudomonas spp., and Acinetobacter spp. Each method performed well in the detection of metallo β-lactamase-producing strains, however, the sensitivity tended to be low in the detection of the organisms producing serine-type carbapenemase, such as GES, OXA-23, and OXA-51. CONCLUSIONS Care must be taken when selecting test methods because the sensitivity of the detection differs depending on the bacterial species and genotype.
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Affiliation(s)
- Tomokazu Kuchibiro
- Department of Clinical Laboratory, Naga Municipal Hospital, Wakayama, Japan.
| | - Masaru Komatsu
- Department of Clinical Laboratory Science, Tenri Health Care University, Nara, Japan
| | - Katsutoshi Yamasaki
- Department of Medical Life Science, Kurashiki University of Science and the Arts, Okayama, Japan
| | - Tatsuya Nakamura
- Department of Medical Technology and Sciences Facility of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
| | - Hisaaki Nishio
- Department of Clinical Laboratory, Shiga Medical Center for Children, Shiga, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Makoto Niki
- Department of Infection Control and Prevention, Osaka City University Hospital, Osaka, Japan
| | - Kaneyuki Kida
- Clinical Laboratory, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Masanobu Ohama
- Clinical Laboratory, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Nozomi Fukuda
- Department of Clinical Laboratory, Osaka Police Hospital, Osaka, Japan
| | - Kana Sawa
- Department of Clinical Laboratory, Osaka Police Hospital, Osaka, Japan
| | - Akihiro Nakamura
- Department of Clinical Laboratory Science, Tenri Health Care University, Nara, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
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9
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Shinoda Y, Sato A, Adach T, Nishi I, Nogami A, Aonuma K, Ieda M. Early clinical experience of radiofrequency catheter ablation using an audiovisual telesupport system. Heart Rhythm 2021; 17:870-875. [PMID: 32354452 DOI: 10.1016/j.hrthm.2020.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 01/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND An audiovisual telesupport system that enables real-time audiovisual communications between 2 long-distance hospitals is one method of telemedicine. The usefulness and safety of radiofrequency catheter ablation (RFCA) using an audiovisual telesupport system has not been well established. OBJECTIVE The purpose of this study was to evaluate the effectiveness and safety of RFCA using an audiovisual telesupport system. METHODS An audiovisual telesupport system using a strictly secured virtual network was established between Kamisu Saiseikai Hospital (operator with 10 years' experience and 800 procedures) and the University of Tsukuba (advisor with >20 years' experience and 8000 procedures). We evaluated 19 initial consecutive patients who underwent RFCA using this system for tachyarrhythmia: 10 with atrial fibrillation (AF), 5 with paroxysmal supraventricular tachycardia (PSVT), 3 with premature ventricular contraction (PVC), and 1 with atrial flutter. Electrophysiological and procedural characteristics were retrospectively assessed. RESULTS Acute success was achieved in all 19 patients without any major complications, with the advisor's audiovisual assistance. Mean procedure time and fluoroscopic time were 161 ± 44 minutes and 24 ± 14 minutes for AF, 110 ± 17 minutes and 28 ± 8 minutes for PVC, and 132 ± 19 minutes and 32 ± 2 minutes for PSVT, respectively. There was no recurrence of clinical arrhythmia in 17 of the 19 patients (89%) during 13 ± 9 month follow-up. CONCLUSION An audiovisual telesupport system for RFCA is a useful and safe method that enabled the electrophysiologist with limited human resources to make an optimal decision regarding procedural strategy and endpoint with the remote advisor's audiovisual assistance.
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Affiliation(s)
- Yasutoshi Shinoda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Internal Medicine, Kamisu Saiseikai Hospital, Kamisu, Japan
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| | - Toru Adach
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Isao Nishi
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Internal Medicine, Kamisu Saiseikai Hospital, Kamisu, Japan
| | - Akihiko Nogami
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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10
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Yamamoto M, Seo Y, Ishizua T, Nakagawa D, Sato K, Machino-Ohtsuka T, Nishi I, Hamada-Harimura Y, Sai S, Sugano A, Baba M, Higuchi H, Aonuma K, Ohte N, Ieda M. Comparison of Soluble ST2, Pentraxin-3, Galectin-3, and High-Sensitivity Troponin T of Cardiovascular Outcomes in Patients With Acute Decompensated Heart Failure. J Card Fail 2021; 27:1240-1250. [PMID: 34129951 DOI: 10.1016/j.cardfail.2021.05.025] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/21/2021] [Accepted: 05/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Data regarding a direct comparison of soluble suppression of tumorigenesis-2 (sST2), pentraxin 3 (PTX3), galectin-3 (Gal-3), and high-sensitivity troponin T of cardiovascular outcome in patients with heart failure (HF) are lacking. METHODS AND RESULTS A total of 616 hospitalized patients with HF were evaluated prospectively. Biomarker data were obtained in the stable predischarge condition. sST2 levels were associated with age, sex, body mass index, inferior vena cava diameter, B-type natriuretic peptide (BNP), PTX3, C-reactive protein, and Gal-3 levels. During follow-up, 174 (28.4%) primary composite end points occurred, including 58 cardiovascular deaths and 116 HF rehospitalizations. sST2 predicted the end point after adjustment for 13 clinical variables (hazard ratio 1.422; 95% confidence interval [CI] 1.064 to 1.895, P = .018). The association between sST2 and the end point was no longer statistically significant after adjustment for BNP (P = .227), except in the subgroup of patients with preserved ejection fraction (hazard ratio 1.925, 95% CI 1.102-3.378, P = .021). Gal-3 and high-sensitivity troponin T predicted the risk for the end point after adjustment for age and sex, but were not significant after adjustment for clinical variables. The prognostic value of PTX3 was not observed (age and sex adjusted, P = .066). CONCLUSIONS This study did not show significant additional value of biomarkers to BNP for risk stratification, except sST2 in patients with preserved ejection fraction.
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Affiliation(s)
- Masayoshi Yamamoto
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| | - Tomoko Ishizua
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Daishi Nakagawa
- Department of Cardiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Kimi Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Isao Nishi
- Division of Cardiology, Kamisu Saiseikai Hospital, Ibaraki, Japan
| | | | - Seika Sai
- Division of Cardiology, Hitachinaka General Hospital, Ibaraki, Japan
| | - Akinori Sugano
- Division of Cardiology, Tsukuba Medical Center Hospital, Ibaraki, Japan
| | - Masako Baba
- Department of Cardiology, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | - Haruhiko Higuchi
- Department of Cardiology, Hitachi, Ltd., Hitachi General Hospital, Ibaraki, Japan
| | - Kazutaka Aonuma
- Department of Cardiology, Hitachi, Ltd., Hitachi General Hospital, Ibaraki, Japan
| | - Nobuyuki Ohte
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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11
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Nakamura A, Fukuda S, Kusuki M, Watari H, Shimura S, Kimura K, Nishi I, Komatsu M. Evaluation of five Legionella urinary antigen detection kits including new Ribotest Legionella for simultaneous detection of ribosomal protein L7/L12. J Infect Chemother 2021; 27:1533-1535. [PMID: 34088604 DOI: 10.1016/j.jiac.2021.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/09/2021] [Revised: 05/10/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
Urinary antigen tests are a widely used rapid diagnostic method for Legionella pneumonia. However, conventional urinary antigen tests are unable to detect anything other than Legionella pneumophila serogroup 1. The Ribotest Legionella (Ribotest) can detect all serogroups by using antibodies recognizing L. pneumophila ribosomal protein L7/L12 in addition to the conventional L. pneumophila serogroup 1 lipopolysaccharide. The aim of this study was to evaluate the performance of Ribotest against conventional urinary antigen tests, including the detection of Legionellaceae other than L. pneumophila. We investigated the detection sensitivity of various kits using in-vitro culture-soluble antigen extracts of ATCC strains and 22 clinical isolates collected from multiple medical facilities in the Kinki region of Japan. For L. pneumophila serogroup 1, four kits, including Ribotest, had a detection sensitivity of 105 CFU/mL, with only Check Legionella having a sensitivity of 106 CFU/mL. L. pneumophila non-serogroup 1 and Legionellaceae of other species were undetectable by the four conventional kits, whereas Ribotest could detect them with a sensitivity of 105-108 CFU/mL. The Ribotest was also able to detect other species such as Legionella hackeliae, Legionella feeleii, Legionella anisa, Fluoribacter bozemanae, and Fluoribacter dumoffii, but the detection sensitivity of L. hackeliae and L. feeleii was 108 CFU/mL, which was much lower than that of the other strains. The Ribotest has high potential to be applied as a rapid diagnostic method for pneumonia caused by other species of Legionella and Fluoribacter.
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Affiliation(s)
- Akihiro Nakamura
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, Tenri, Japan.
| | - Saori Fukuda
- Department of Clinical Laboratory, Tenri Hospital, Tenri, Japan
| | - Mari Kusuki
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Hideo Watari
- Department of Clinical Laboratory, Otemae Hospital, Osaka, Japan
| | - Satoshi Shimura
- Department of Clinical Laboratory, Otemae Hospital, Osaka, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Masaru Komatsu
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, Tenri, Japan
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12
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Sugawara Y, Akeda Y, Hagiya H, Zin KN, Aye MM, Takeuchi D, Matsumoto Y, Motooka D, Nishi I, Tomono K, Hamada S. Characterization of bla NDM-5-harbouring Klebsiella pneumoniae sequence type 11 international high-risk clones isolated from clinical samples in Yangon General Hospital, a tertiary-care hospital in Myanmar. J Med Microbiol 2021; 70. [PMID: 34038339 DOI: 10.1099/jmm.0.001348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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
Fifteen Klebsiella pneumoniae isolates harbouring bla NDM genes were identified from blood and sputum specimens of patients at a tertiary-care facility (Yangon General Hospital, Yangon, Myanmar) in 2018. Two of the isolates belonged to sequence type (ST) 11, an international high-risk clone. Whole-genome sequencing and phylogenetic analyses revealed that these two isolates were clustered together with other ST11 isolates originating from other countries. The isolates harboured the bla NDM-5 gene on an IncFII-type plasmid that is prevalent among carbapenemase-producing Enterobacteriaceae in Yangon but has rarely been found in other ST11 isolates. Our data suggests the regional presence of the ST11 international high-risk clone and its acquisition of an endemic bla NDM-5-carrying plasmid.
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Affiliation(s)
- Yo Sugawara
- Japan-Thailand Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Yukihiro Akeda
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan.,Japan-Thailand Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Hideharu Hagiya
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Khwar Nyo Zin
- Clinical Laboratory Department, Yangon General Hospital, Yangon, Myanmar
| | - Mya Mya Aye
- Bacteriology Research Division, Department of Medical Research, Yangon, Myanmar
| | - Dan Takeuchi
- Japan-Thailand Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Yuki Matsumoto
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Daisuke Motooka
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Japan
| | - Kazunori Tomono
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Shigeyuki Hamada
- Japan-Thailand Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
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13
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Sugawara Y, Hagiya H, Akeda Y, Takeuchi D, Sakamoto N, Matsumoto Y, Motooka D, Nishi I, Tomono K, Hamada S. Community spread and acquisition of clinically relevant Escherichia coli harbouring blaNDM among healthy Japanese residents of Yangon, Myanmar. J Antimicrob Chemother 2021; 76:1448-1454. [PMID: 33758942 DOI: 10.1093/jac/dkab070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/18/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Carbapenemase-producing Enterobacterales (CPE) are spreading in hospitals, environment and retail foods in Yangon, Myanmar. OBJECTIVES To investigate whether CPE colonize healthy individuals living in Yangon and whether clinical-related strains are spreading in the community. METHODS CPE was isolated from faecal samples obtained from healthy Japanese residents of Yangon with no history of hospitalization. Isolates were subjected to WGS using short- and long-read sequencers and compared with those previously isolated in Yangon. RESULTS Six Escherichia coli strains harbouring blaNDM-1 or blaNDM-5 belonging to five different STs-ST10, ST38, ST48, ST410 and ST8453-were isolated from 69 volunteers. The ST38 isolates were related to those previously isolated from retail food in Yangon. The ST410 and ST8453 isolates were highly related to previous Yangon isolates including those of clinical and food origins. CONCLUSIONS The analysis suggested the acquisition of blaNDM-positive E. coli, which are disseminating in a clinical setting and through retail foods, by healthy residents in Yangon.
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Affiliation(s)
- Yo Sugawara
- Japan-Thailand Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Hideharu Hagiya
- Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yukihiro Akeda
- Japan-Thailand Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan.,Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita, Japan
| | - Dan Takeuchi
- Japan-Thailand Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Noriko Sakamoto
- Japan-Thailand Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Yuki Matsumoto
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Daisuke Motooka
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Japan
| | - Kazunori Tomono
- Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shigeyuki Hamada
- Japan-Thailand Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
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14
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Kageyama M, Hagiya H, Ueda Y, Ohtani K, Fukumori Y, Inoue N, Wakamiya N, Yoneda N, Kimura K, Nagasawa M, Nakagami F, Nishi I, Sugimoto K, Rakugi H. Disseminated gonococcal infection in a Japanese man with complement 7 deficiency with compound heterozygous variants: A case report. Medicine (Baltimore) 2021; 100:e25265. [PMID: 33787610 PMCID: PMC8021336 DOI: 10.1097/md.0000000000025265] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/04/2021] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Complement deficiency are known to be predisposed to disseminated gonococcal infection (DGI). We herein present a case of DGI involving a Japanese man who latently had a complement 7 deficiency with compound heterozygous variants. PATIENT CONCERNS A previously healthy 51-year-old Japanese man complained of sudden-onset high fever. Physical examination revealed various skin lesions including red papules on his trunk and extremities, an impetigo-like pustule on left forearm, and tendinitis of his right forefinger. DIAGNOSIS Blood culture testing detected gram-negative cocci, which was confirmed to be Neisseria gonorrhoeae based on mass spectrometry and a pathogen-specific PCR test. INTERVENTIONS Screening tests for underlying immunocompromised factors uncovered that complement activities (CH50) was undetectable. With a suspicion of a congenital complement deficiency, genetic analysis revealed rare single nucleotide variants in complement 7 (C7), including c.281-1G>T and a novel variant c.1454C>T (p.A485V). CH50 was normally recovered by adding purified human C7 to the patient's serum, supporting that the patient has C7 deficiency with compound heterozygous variants. OUTCOMES Under a diagnosis of DGI, the patient underwent an antibiotic treatment with cefotaxime for a week and was discharged without any sequela. LESSONS DGI is a rare sexually-transmitted infection that potentially induces systemic complications. Complement immunity usually defeats N. gonorrhoeae and prevents the organism from causing DGI. This case highlighted the importance of suspecting a complement deficiency when a person develops DGI.
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Affiliation(s)
| | - Hideharu Hagiya
- Department of General Medicine
- Division of Infection Control and Prevention, Osaka University Hospital
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - Yasutaka Ueda
- Department of Hematology and Oncology, Osaka University Hospital
| | - Katsuki Ohtani
- The Japanese Association for Complement Research
- Department of Clinical Nutrition, Rakuno Gakuen University
| | - Yasuo Fukumori
- Department of Molecular Genetics, Wakayama Medical University
- Laboratory section, The Japanese Association for Complement Research
| | - Norimitsu Inoue
- The Japanese Association for Complement Research
- Department of Molecular Genetics, Wakayama Medical University
| | - Nobutaka Wakamiya
- The Japanese Association for Complement Research
- Department of Medicine and Physiology, Rakuno Gakuen University
| | - Nanoka Yoneda
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | | | | | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
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15
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Watanabe H, Koike A, Kato H, Wu L, Hayashi K, Kubota H, Konno H, Nishi I, Kawamoto H, Sato A, Matsumura A, Aonuma K, Sankai Y, Ieda M. Efficacy of cardiac rehabilitation with motion assistance from wearable cyborg hybrid assistive limb in patients with chronic heart failure: a randomized controlled trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Recent Cochrane Systematic Review suggested that the participation in cardiac rehabilitation is associated with approximately 20% lower cardiovascular mortality and morbidity. Exercise therapy is the key component of cardiac rehabilitation programs. In recent years, innovative technologies have been introduced into the field of rehabilitation, and a typical example is the wearable cyborg Hybrid Assistive Limb (HAL). The wearable cyborg HAL provides motion assistance based on detection of bioelectrical signals on the skin surface when muscle forces are generated. The lumbar-type HAL is expected to expand the therapeutic options for severe cardiac patients who have difficulty in performing usual cardiac rehabilitation programs, such as bicycle pedaling or walking.
Purpose
We aim to compare the efficacy of exercise therapy performed with motion assistance from a lumbar-type HAL versus conventional training (sit-to-stand exercise without HAL) in patients with chronic heart failure.
Methods
This clinical trial is a randomized, non-blinded, and controlled study. Twenty-eight heart failure patients (73.1±13.8 years) who have difficulty in walking at the usual walking speed of healthy subjects were randomly assigned to 2 groups (HAL group or control group) with a 1:1 allocation ratio and performed sit-to stand exercise either with HAL or without HAL for 5 to 30 minutes once a day, and 6 to 10 days during the study period. The brain natriuretic peptide (BNP), isometric knee extensor strength, standing ability (30-seconds chair-stand test: CS-30), short physical performance battery (SPPB) and 6-minute walking distance (6MWD) were measured before and after the completion of cardiac rehabilitation. Cardiac events such as death, re-hospitalization, myocardial infarction and worsening of angina pectoris and heart failure during 1 year after discharge were evaluated.
Results
There was no significant difference in the number of days of exercise therapy between the two groups. BNP, SPPB and 6MWD were improved in both groups. In the HAL group, the isometric knee extensor strength (0.29±0.11 vs 0.35±0.11 kgf/kg, p=0.003) significantly improved and CS-30 (5.5±5.1 vs 8.2±5.3, p=0.054) tended to improve. However, in the control group, either the isometric knee extensor strength (0.35±0.11 vs 0.36±0.14 kgf/kg, p=0.424) or CS-30 (6.0±4.3 vs 9.2±6.2, p=0.075) did not significantly change. HAL group showed significantly more improvement in the isometric knee extensor strength than control group (p=0.045). Cardiac events occurred in 20% in the HAL group and 43% in the control group.
Conclusion
The improvement in isometric knee extensor strength with the assistance from lumbar-type HAL suggests that exercise therapy using this device may be useful in chronic heart failure patients with flail or sarcopenia, a strong poor prognostic factor in these patients.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This work was supported in part by a grant-in-aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan (JSPS KAKENHI grant number JP17K09485) and funded by the ImPACT Program of the Council for Science, Technology and Innovation (Cabinet Office, Government of Japan) (grant number 2017-PM05-03-01).
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Affiliation(s)
- H Watanabe
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - A Koike
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - H Kato
- Department of Rehabilitation, University of Tsukuba Hospital, Tsukuba, Japan
| | - L Wu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - K Hayashi
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - H Kubota
- Master's Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of, Tsukuba, Japan
| | - H Konno
- Department of Rehabilitation, University of Tsukuba Hospital, Tsukuba, Japan
| | - I Nishi
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - H Kawamoto
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - A Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - A Matsumura
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - K Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Y Sankai
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - M Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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16
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Takayanagi Y, Koike A, Kubota H, Wu L, Nishi I, Sato A, Aonuma K, Kawakami Y, Ieda M. Pulse wave transit time during exercise testing reflects the severity of heart disease in cardiac patients. Drug Discov Ther 2020; 14:21-26. [PMID: 32062635 DOI: 10.5582/ddt.2019.01082] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The pulse wave transit time (PWTT) is easily measured as the time from the R wave of an electrocardiogram to the arrival of the pulse wave measured by an oxygen saturation monitor at the earlobe. We investigated whether the change of PWTT during exercise testing reflects cardiopulmonary function. Eighty-nine cardiac patients who underwent cardiopulmonary exercise testing (CPX) were enrolled. We analyzed the change of PWTT during exercise and the relationship between the shortening of the PWTT and CPX parameters. PWTT was significantly shortened from rest to peak exercise (204.6 ± 33.6 vs. 145.6 ± 26.4 msec, p < 0.001) in all of the subjects. The patients with heart failure had significantly higher PWTT at peak exercise than the patients without heart failure (152.7 ± 27.1 vs. 140.4 ± 24.8 msec, p = 0.031). The shortening of PWTT from rest to peak exercise showed significant positive correlations with the peak O2 uptake (VO2) (r = 0.56, p < 0.001), anaerobic threshold (r = 0.40, p = 0.016), and % increase of systolic blood pressure during exercise (r = 0.75, p < 0.001), and a negative correlation with the slope of the increase in ventilation versus the increase in CO2 output (VE-VCO2 slope) (r = - 0.42, p = 0.010) in the patients with heart failure. PWTT was shortened during exercise as the exercise intensity increased. In the patients with heart failure, the shortening of PWTT from rest to peak exercise was smaller in those with lower exercise capacity and those with higher VE-VCO2 slope, an established index known to reflect the severity of heart failure.
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Affiliation(s)
- Yuta Takayanagi
- Department of Clinical Laboratory, University of Tsukuba Hospital, Tsukuba, Japan
| | - Akira Koike
- Medical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshi Kubota
- Master's Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Longmei Wu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Isao Nishi
- Department of Cardiology, Kamisu Clinical Education and Training Center, University of Tsukuba, Kamisu, Japan
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasushi Kawakami
- Department of Clinical Laboratory, University of Tsukuba Hospital, Tsukuba, Japan
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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17
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Hagiya H, Sugawara Y, Tsutsumi Y, Akeda Y, Yamamoto N, Sakamoto N, Shanmugakani RK, Abe R, Takeuchi D, Nishi I, Ishii Y, Hamada S, Tomono K. In Vitro Efficacy of Meropenem-Cefmetazole Combination Therapy against New Delhi Metallo-β-lactamase-producing Enterobacteriaceae. Int J Antimicrob Agents 2020; 55:105905. [PMID: 31991221 DOI: 10.1016/j.ijantimicag.2020.105905] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Limited treatment options complicate management of infections with New Delhi metallo-β-lactamase (NDM)-producing organisms. The efficacy of combination therapy with meropenem (MEM) and cefmetazole (CMZ) was assessed against NDM-producing Enterobacteriaceae. MATERIALS AND METHODS Twelve Escherichia coli clinical isolates harbouring blaNDM-1 and a positive control E. coli BAA-2469 harbouring blaNDM-1 were studied. Minimum inhibitory concentrations (MICs) of MEM, ertapenem (ERT) and CMZ were determined by broth microdilution. Checkerboard and time-kill assays were performed to confirm the in vitro efficacy of the MEM/CMZ combination. Scanning electron microscopy, kinetic studies and whole-genome sequence analysis were used to determine the antimicrobial resistance mechanisms. RESULTS MICs of MEM, ERT and CMZ in monotherapy ranged from 8 to 32, 16 to 128, and 32 to 512 µg/mL, respectively. In the checkerboard assay, MEM/ERT resulted in no synergy, whereas MEM/CMZ showed a synergistic effect in all the tested isolates. Furthermore, the MIC of MEM in combination decreased by 2- to 8-fold compared with that of MEM alone. The time-kill study revealed a bactericidal effect in 4 of 13 isolates at 24 h. Scanning electron microscopy showed spheroidisation of the bacterial cell in the MEM/CMZ combination; this was not observed in single antibiotic conditions. Kinetic studies indicated CMZ was a better antagonist for NDM-1 than ERT. Whole-genome sequence analysis did not reveal any explainable differences between isolates susceptible and those non-susceptible to combination therapy. CONCLUSION In vitro studies showed the potential effectiveness of MEM/CMZ combination therapy against NDM-producing organisms.
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Affiliation(s)
- Hideharu Hagiya
- Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Osaka, Japan; Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Yo Sugawara
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.
| | - Yuko Tsutsumi
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan; Meiji Seika Pharma Co., Ltd, Pharmaceutical Research Center, Yokohama, Japan.
| | - Yukihiro Akeda
- Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Osaka, Japan; Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.
| | - Norihisa Yamamoto
- Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Noriko Sakamoto
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.
| | - Rathina Kumar Shanmugakani
- Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Ryuichiro Abe
- Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Osaka, Japan. abyaryu-@hotmail.co.jp
| | - Dan Takeuchi
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan.
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan.
| | - Shigeyuki Hamada
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.
| | - Kazunori Tomono
- Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Osaka, Japan.
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18
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Hamada-Harimura Y, Seo Y, Ishizu T, Nishi I, Machino-Ohtsuka T, Yamamoto M, Sugano A, Sato K, Sai S, Obara K, Yoshida I, Aonuma K. Incremental Prognostic Value of Right Ventricular Strain in Patients With Acute Decompensated Heart Failure. Circ Cardiovasc Imaging 2019; 11:e007249. [PMID: 30354477 DOI: 10.1161/circimaging.117.007249] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Although 2-dimensional strain analyses based on speckle tracking echocardiography have been used to detect myocardial deformation, the prognostic impact of 2-dimensional strain is unclear in patients with acute decompensated heart failure (HF). We investigated whether left ventricular and right ventricular (RV) strain parameters assessed by speckle tracking echocardiography provide incremental prognostic information in hospitalized patients because of acute decompensated HF. METHODS AND RESULTS Six hundred eighteen patients (age, 72±13 years; 38% women; ejection fraction, 46±16%) hospitalized for acute decompensated HF underwent clinical and echocardiographic evaluation just before discharge. We performed strain analyses of left ventricular global longitudinal strain and left ventricular global circumferential strain. We also analyzed RV longitudinal strain only from the free wall (RV-fwLS) and from all segments of the RV global longitudinal strain wall by using Tomtec software. The primary composite end point was cardiovascular death and readmission for HF. There were 34.8% cardiac events during a median follow-up of 427 days. In multivariate Cox models, among echocardiographic parameters, only impaired RV-fwLS (≥-13.1%; hazard ratio, 1.51; 95% CI, 1.12-2.04; P=0.01) was independently associated with cardiac events. Adding RV-fwLS to clinical risk evaluation (age, New York Heart Association class III/IV, blood urea nitrogen, and brain natriuretic peptide) markedly improved prognostic utility and consequently increased net reclassification improvement by 0.30 ( P=0.01). CONCLUSIONS RV-fwLS is an independent predictor of cardiac events in acute decompensated HF and provides greater prognostic power than standard echocardiographic parameters.
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Affiliation(s)
- Yoshie Hamada-Harimura
- Department of Cardiology, Graduate School of Comprehensive Human Sciences (Y.H.-H., S.S.), University of Tsukuba, Tsukuba, Japan
| | - Yoshihiro Seo
- Department of Cardiology, Faculty of Medicine (Y.S., T.I., T.M.-O., M.Y., K.S., K.A.), University of Tsukuba, Tsukuba, Japan
| | - Tomoko Ishizu
- Department of Cardiology, Faculty of Medicine (Y.S., T.I., T.M.-O., M.Y., K.S., K.A.), University of Tsukuba, Tsukuba, Japan
| | - Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba Hospital, Tsuchiura, Japan (I.N.)
| | - Tomoko Machino-Ohtsuka
- Department of Cardiology, Faculty of Medicine (Y.S., T.I., T.M.-O., M.Y., K.S., K.A.), University of Tsukuba, Tsukuba, Japan
| | - Masayoshi Yamamoto
- Department of Cardiology, Faculty of Medicine (Y.S., T.I., T.M.-O., M.Y., K.S., K.A.), University of Tsukuba, Tsukuba, Japan
| | - Akinori Sugano
- Department of Cardiology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan (A.S.)
| | - Kimi Sato
- Department of Cardiology, Faculty of Medicine (Y.S., T.I., T.M.-O., M.Y., K.S., K.A.), University of Tsukuba, Tsukuba, Japan
| | - Seika Sai
- Department of Cardiology, Graduate School of Comprehensive Human Sciences (Y.H.-H., S.S.), University of Tsukuba, Tsukuba, Japan
| | - Kenichi Obara
- Department of Cardiology, Ryugasaki Saiseikai General Hospital, Ryugasaki, Japan (K.O.)
| | - Ikuo Yoshida
- Department of Cardiology, Moriya Daiichi General Hospital, Moriya, Japan (I.Y.)
| | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine (Y.S., T.I., T.M.-O., M.Y., K.S., K.A.), University of Tsukuba, Tsukuba, Japan
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19
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Hagiya H, Kimura K, Okuno H, Hamaguchi S, Morii D, Yoshida H, Mitsui T, Nishi I, Tomono K. Bacteremia due to high-level daptomycin-resistant Corynebacterium striatum: A case report with genetic investigation. J Infect Chemother 2019; 25:906-908. [PMID: 31101531 DOI: 10.1016/j.jiac.2019.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 02/18/2019] [Revised: 04/05/2019] [Accepted: 04/10/2019] [Indexed: 11/17/2022]
Abstract
Corynebacterium striatum, generally considered an opportunistic organism in humans, has recently been known to develop high-level daptomycin resistance (HLDR) shortly after drug exposure. To date, however, only several such clinical isolates have been described in the literature and clinical background of the resistant pathogen remains to be elucidated. Here, we report a case involving a C. striatum strain with HLDR harboring novel nucleotide mutations, together with a review of the relevant literature. To the best of our knowledge, this is the first well-investigated clinical report from Japan including a genetic investigation. Considering the rapid emergence of HLDR C. striatum in vitro experiment, there could be a number of underreporting cases. Scrupulous attention is required when administering daptomycin for the treatment of C. striatum infections, even if the organism has initially exhibited susceptibility.
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Affiliation(s)
- Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Japan.
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Hideo Okuno
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Shigeto Hamaguchi
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Daiichi Morii
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Tomomi Mitsui
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
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20
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Machino-Ohtsuka T, Seo Y, Ishizu T, Hamada-Harimura Y, Yamamoto M, Sato K, Sai S, Sugano A, Obara K, Yoshida I, Nishi I, Aonuma K, Ieda M. Clinical utility of the 2016 ASE/EACVI recommendations for the evaluation of left ventricular diastolic function in the stratification of post-discharge prognosis in patients with acute heart failure. Eur Heart J Cardiovasc Imaging 2019; 20:1129-1137. [DOI: 10.1093/ehjci/jez082] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 04/09/2019] [Indexed: 01/07/2023] Open
Abstract
Abstract
Aims
Left ventricular diastolic dysfunction (LVDD) has prognostic significance in heart failure (HF). We aimed to assess the impact of LVDD grade stratified by the updated 2016 echocardiographic algorithm (DD2016) on post-discharge outcomes in patients admitted for acute HF and compare with the previous 2009 algorithm (DD2009).
Methods and results
The study included 481 patients hospitalized for acute decompensated HF. Comprehensive echocardiography and LVDD evaluation were performed just before hospital discharge. The primary endpoint was a composite of cardiovascular death and readmission for HF. The concordance between DD2016 and DD2009 was moderate (κ = 0.44, P < 0.001); the reclassification rate was 39%. During the follow-up (median: 15 months), 127 (26%) patients experienced the primary endpoint. In the Kaplan–Meier analysis, Grade III in DD2016 showed a lower event-free survival rate than Grades I and II (log rank, P < 0.001 and P = 0.048, respectively) and was independently associated with a higher incidence of the primary endpoint than Grade I [hazard ratio 1.89; 95% confidence interval (CI) 1.17–3.04; P = 0.009]. Grade II or III in DD2016, reflecting elevation of left ventricular (LV) filling pressure, added an incremental predictive value of the primary endpoint to clinical variables irrespective of LV ejection fraction. DD2016 was comparable to DD2009 in predicting the endpoint (net reclassification improvement = 11%; 95% CI −7% to 30%, P = 0.23).
Conclusion
Despite simplification of the algorithm for LVDD evaluation, the prognostic value of DD2016 for post-discharge cardiovascular events in HF patients was maintained and not compromised in comparison with DD2009.
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Affiliation(s)
- Tomoko Machino-Ohtsuka
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Yoshihiro Seo
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Tomoko Ishizu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Yoshie Hamada-Harimura
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Masayoshi Yamamoto
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Kimi Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Seika Sai
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Akinori Sugano
- Department of Cardiology, Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki, Japan
| | - Kenichi Obara
- Department of Cariology, Ryugasaki Saiseikai General Hospital, 1-1, Nakazato, Ryugasaki, Ibaraki, Japan
| | - Ikuo Yoshida
- Department of Cardiology, Moriya Daiichi General Hospital, Moriya, 1-17, Matsumaedai, Moriya, Ibaraki, Japan
| | - Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba Hospital, Tsukuba, Japan
| | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, Japan
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, Japan
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21
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Sugano A, Seo Y, Ishizu T, Sai S, Yamamoto M, Hamada-Harimura Y, Machino-Ohtsuka T, Obara K, Nishi I, Aonuma K, Nogami A. Soluble ST2 and brain natriuretic peptide predict different mode of death in patients with heart failure and preserved ejection fraction. J Cardiol 2019; 73:326-332. [DOI: 10.1016/j.jjcc.2018.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/30/2018] [Accepted: 10/13/2018] [Indexed: 01/09/2023]
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22
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Hagiya H, Yoneda N, Kimura K, Mitsui T, Ueda A, Sunada A, Nishi I, Nakagami F, Rakugi H, Tomono K. Clinical impact of extended blood culture examination: Too much of a good thing. J Infect Chemother 2019; 25:559-562. [PMID: 30904462 DOI: 10.1016/j.jiac.2019.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/14/2018] [Revised: 02/13/2019] [Accepted: 03/04/2019] [Indexed: 11/25/2022]
Abstract
Blood culture is the most critical examination for diagnosing bacterial infections. The longer the blood culture incubation period, the higher the chances of identifying bacterial strains. However, unnecessary extension of the incubation period can burden the capacity of the instrument and merely result in the detection of contaminant bacteria having no clinical significance. This study aimed to optimize the blood culture incubation period using the currently available continuous-monitoring automated blood culture instrument. This was a 2-year retrospective study performed at Osaka University Hospital (January 1, 2016 to December 31, 2017). The BD BACTEC™ FX blood culture system (Becton Dickinson, Sparks, MD, USA) and BD BACTEC™ Plus series blood culture bottles were used. All blood cultures were incubated for more than 12 consecutive days. We reviewed the clinical data of cases that tested positive between 6 and 12 days of incubation. During the study period, 14,822 sets of blood culture were drawn. Of 1751 sets testing positive, 95.7% (1665 sets) became positive within 5 days of incubation. The overall contamination rate (false positives) after 6 days of incubation was 80.2% (69/86 sets). Based on the positive blood culture results, antimicrobials were changed in 7.0% (6/86) of the sets, and a diagnosis of infectious disease was made in only one case. There was no death associated with the extended blood culture results. In conclusion, the clinical impact of extended blood culture incubation for 6 days or more was limited, and a routine extension of the incubation period might be unnecessary.
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Affiliation(s)
- Hideharu Hagiya
- Department of General Internal Medicine, Osaka University Hospital, Osaka, Japan; Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan.
| | - Nanoka Yoneda
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Tomomi Mitsui
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Akiko Ueda
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Atsuko Sunada
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Futoshi Nakagami
- Department of General Internal Medicine, Osaka University Hospital, Osaka, Japan
| | - Hiromi Rakugi
- Department of General Internal Medicine, Osaka University Hospital, Osaka, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan
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23
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Kimura K, Hagiya H, Yamamoto N, Yoshida H, Akeda Y, Nishi I, Tomono K. Pasteurella multocida multiple intrapelvic abscesses in a young woman with uterine cervical cancer. J Infect Chemother 2019; 25:197-199. [DOI: 10.1016/j.jiac.2018.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 06/22/2018] [Accepted: 07/30/2018] [Indexed: 01/30/2023]
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24
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Yamamoto M, Seo Y, Ishizu T, Nishi I, Hamada-Harimura Y, Machino-Ohtsuka T, Sato K, Sai S, Nakatsukasa T, Sugano A, Baba M, Obara K, Aonuma K, Ieda M. Different Impact of Changes in Left Ventricular Ejection Fraction Between Heart Failure Classifications in Patients With Acute Decompensated Heart Failure. Circ J 2019; 83:584-594. [DOI: 10.1253/circj.cj-18-0881] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Yoshihiro Seo
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Tomoko Ishizu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center
| | - Yoshie Hamada-Harimura
- Department of Cardiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | | | - Kimi Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Seika Sai
- Department of Cardiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | | | | | - Masako Baba
- Department of Cardiology, Ibaraki Prefectural Central Hospital
| | - Kenichi Obara
- Division of Cardiology, Ryugasaki Saiseikai General Hospital
| | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
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25
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Shanmugakani RK, Akeda Y, Sugawara Y, Laolerd W, Chaihongsa N, Sirichot S, Yamamoto N, Hagiya H, Morii D, Fujiya Y, Nishi I, Yoshida H, Takeuchi D, Sakamoto N, Malathum K, Santanirand P, Tomono K, Hamada S. PCR-Dipstick-Oriented Surveillance and Characterization of mcr-1- and Carbapenemase-Carrying Enterobacteriaceae in a Thai Hospital. Front Microbiol 2019; 10:149. [PMID: 30800104 PMCID: PMC6375898 DOI: 10.3389/fmicb.2019.00149] [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: 07/11/2018] [Accepted: 01/21/2019] [Indexed: 01/31/2023] Open
Abstract
Colistin is used as an alternative therapeutic for carbapenemase-producing Enterobacteriaceae (CPE) infections which are spreading at a very high rate due to the transfer of carbapenemase genes through mobile genetic elements. Due to the emergence of mcr-1, the plasmid-mediated colistin resistance gene, mcr-1-positive Enterobacteriaceae (MCRPEn) pose a high risk for the transfer of mcr-1-carrying plasmid to CPE, leading to a situation with no treatment alternatives for infections caused by Enterobacteriaceae possessing both mcr-1 and carbapenemase genes. Here, we report the application of PCR-dipstick-oriented surveillance strategy to control MCRPEn and CPE by conducting the PCR-dipstick technique for the detection of MCRPEn and CPE in a tertiary care hospital in Thailand and comparing its efficacy with conventional surveillance method. Our surveillance results showed a high MCRPEn (5.9%) and CPE (8.7%) carriage rate among the 219 rectal swab specimens examined. Three different CPE clones were determined by pulsed-field gel electrophoresis (PFGE) whereas only two MCRPEn isolates were found to be closely related as shown by single nucleotide polymorphism-based phylogenetic analysis. Whole genome sequencing (WGS) and plasmid analysis showed that MCRPEn carried mcr-1 in two plasmids types—IncX4 and IncI2 with ~99% identity to the previously reported mcr-1-carrying plasmids. The identification of both MCRPEn and CPE in the same specimen indicates the plausibility of plasmid-mediated transfer of mcr-1 genes leading to the emergence of colistin- and carbapenem-resistant Enterobacteriaceae. The rapidity (<2 h) and robust sensitivity (100%)/specificity (~99%) of PCR-dipstick show that this specimen-direct screening method could aid in implementing infection control measures at the earliest to control the dissemination of MCRPEn and CPE.
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Affiliation(s)
- Rathina Kumar Shanmugakani
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan.,Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan.,Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Yukihiro Akeda
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan.,Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan.,Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Yo Sugawara
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Warawut Laolerd
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Narong Chaihongsa
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suntariya Sirichot
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Norihisa Yamamoto
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan.,Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan.,Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Hideharu Hagiya
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan.,Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan.,Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Daiichi Morii
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan.,Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Yoshihiro Fujiya
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan.,Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan.,Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Isao Nishi
- Laboratory of Clinical Investigation, Osaka University Hospital, Suita, Japan
| | - Hisao Yoshida
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan.,Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan.,Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Dan Takeuchi
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Noriko Sakamoto
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Kumthorn Malathum
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pitak Santanirand
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kazunori Tomono
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Japan.,Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Shigeyuki Hamada
- Research Institute for Microbial Diseases, Osaka University, Suita, Japan
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26
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Nishi I, Seo Y, Hamada-Harimura Y, Yamamoto M, Ishizu T, Sugano A, Sato K, Sai S, Obara K, Suzuki S, Koike A, Aonuma K, Ieda M. Geriatric nutritional risk index predicts all-cause deaths in heart failure with preserved ejection fraction. ESC Heart Fail 2019; 6:396-405. [PMID: 30706996 PMCID: PMC6437432 DOI: 10.1002/ehf2.12405] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022] Open
Abstract
AIMS The objective of the study was to evaluate whether the geriatric nutritional risk index (GNRI) at discharge may be helpful in predicting the long-term prognosis of patients hospitalized with heart failure (HF) with preserved ejection fraction (HFpEF, left ventricular ejection fraction ≥50%), a common HF phenotype in the elderly. METHODS AND RESULTS Overall, 110 elderly HFpEF patients (≥65 years) from the Ibaraki Cardiovascular Assessment Study-HF (n = 838) were enrolled. The mean age was 78.5 ± 7.2 years, and male patients accounted for 53.6% (n = 59). All-cause mortality was compared between the low GNRI (<92) with moderate or severe nutritional risk group and the high GNRI (≥92) with no or low nutritional risk group. Cox proportional hazard regression models were constructed to evaluate the influence of the GNRI on all-cause death with the following covariates using forward stepwise selection: age, sex, nutritional status based on the GNRI as a categorical variable, history of HF hospitalization, haemoglobin level, estimated glomerular filtration rate, log brain natriuretic peptide levels (logBNP), history of hypertension, log C-reactive protein levels, left ventricular ejection fraction, left ventricular mass index, and the New York Heart Association functional classification (I/II or III class). The prognostic value of the GNRI was compared with that of serum albumin using C-statistics. The GNRI was added to the logBNP, serum albumin or the body mass index was added to the logBNP, and the C-statistic was compared using DeLong's test. Cox regression analysis revealed that age and a low GNRI were independent predictors of all-cause death (P < 0.05, n = 103; hazard ratio = 1.095, 95% confidence interval = 1.031-1.163, for age, and hazard ratio = 3.075, 95% confidence interval = 1.244-7.600, for the GNRI). DeLong's test for the two correlated receiver operating characteristic curves [area under the receiver operating characteristic curve (AUROC) of serum albumin, 0.71; AUROC of the GNRI, 0.75] demonstrated significant differences between the groups (P = 0.038). Adding the GNRI to the logBNP increased the AUROC for all-cause death significantly (0.71 and 0.80, respectively; P = 0.040, n = 105). The addition of serum albumin or the body mass index to the logBNP did not significantly increase the AUROC for all-cause death (P = 0.082 and P = 0.29, respectively). CONCLUSIONS Nutritional screening using the GNRI at discharge is helpful to predict the long-term prognosis of elderly HFpEF patients.
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Affiliation(s)
- Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba Hospital, Tsuchiura, Japan.,Department of Cardiology, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Yoshihiro Seo
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoshie Hamada-Harimura
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masayoshi Yamamoto
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tomoko Ishizu
- Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akinori Sugano
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kimi Sato
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Seika Sai
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kenichi Obara
- Division of Cardiology, Ryugasaki Saiseikai General Hospital, Ryugasaki, Japan
| | - Shoji Suzuki
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Akira Koike
- Medical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazutaka Aonuma
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masaki Ieda
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Hagiya H, Maeda T, Kusakabe S, Kawasaki K, Hori Y, Kimura K, Ueda A, Yoshioka N, Sunada A, Nishi I, Morii E, Kanakura Y, Tomono K. A fatal case of Exophiala dermatitidis disseminated infection in an allogenic hematopoietic stem cell transplant recipient during micafungin therapy. J Infect Chemother 2019; 25:463-466. [PMID: 30679025 DOI: 10.1016/j.jiac.2018.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 08/06/2018] [Revised: 12/14/2018] [Accepted: 12/23/2018] [Indexed: 01/14/2023]
Abstract
Exophiala dermatitidis is a dematiaceous fungus that is increasingly becoming the cause of fungal infection in immunocompromised patients. However, the risk factors and optimal treatment modality for E. dermatitidis infection are unknown to date. Herein, we present a fatal case of E. dermatitidis infection in an adult patient that developed after allogeneic hematopoietic stem cell transplantation for chronic active Epstein-Barr virus infection. The dematiaceous fungus caused a breakthrough fungemia despite prophylactic administration of micafungin. Although the patient was intensively treated with liposomal-amphotericin B and voriconazole, serum level of beta-D-glucan continuously increased, and the patient eventually died because of cerebral hemorrhage. An autopsy found multiple involvements of the fungal infection at the bilateral lungs, thoracic cavities, diaphragm, and thyroid. To the best of our knowledge, this is the first reported case of E. dermatitidis infection involving these tissues as determined via autopsy. This case highlights the importance of attention for Exophiala infection in immunocompromised individuals in those given antifungal therapy with echinocandins.
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Affiliation(s)
- Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan.
| | - Tetsuo Maeda
- Department of Hematology, Osaka University Hospital, Osaka, Japan
| | | | - Keisuke Kawasaki
- Department of Pathology, Osaka University Hospital, Osaka, Japan
| | - Yumiko Hori
- Department of Pathology, Osaka University Hospital, Osaka, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Akiko Ueda
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Nori Yoshioka
- Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan; Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Atsuko Sunada
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Hospital, Osaka, Japan
| | - Yuzuru Kanakura
- Department of Hematology, Osaka University Hospital, Osaka, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan
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Hagiya H, Sugawara Y, Kimura K, Hamaguchi S, Nishi I, Hayashi M, Akeda Y, Tomono K. Emergence of daptomycin non-susceptible coagulase-negative Staphylococci in patients with cardiovascular device infections: Two cases report investigated by whole genome analysis. Medicine (Baltimore) 2018; 97:e13487. [PMID: 30544442 PMCID: PMC6310605 DOI: 10.1097/md.0000000000013487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Daptomycin (DAP) is a key drug for treating severe Staphylococcus infections. The emergence of DAP non-susceptible Staphylococcus aureus has been widely recognized in clinical situations, although the clinical status of DAP non-susceptible coagulase-negative Staphylococcus (CoNS) infections is unclear. We encountered 2 cases of cardiovascular device infections that were associated with DAP non-susceptible CoNS. PATIENT CONCERNS The first case involved a 60-year-old woman with a pump pocket infection in a left ventricular assist device. DAP non-susceptible Staphylococcus capitis subsp. ureolyticus was isolated from a blood culture after treatment using vancomycin (10 days) and DAP (6 days). The second case involved a 71-year-old man with an aortic graft infection. DAP non-susceptible S capitis subsp. ureolyticus was detected in pus after treatment using vancomycin (2 weeks) and DAP (1 week) without complete removal and debridement. DIAGNOSIS Cardiovascular device infections caused by DAP non-susceptible CoNS. INTERVENTIONS AND OUTCOMES Whole genome sequencing of these strains revealed multiple mutations in genes that are related to DAP-non-susceptibility in S aureus, which created amino acid substitutions in mprF, dltAB, dltD, rpoC, yycG, cls2, pgsA, and vraSR. To the very best of our knowledge, the substitution patterns were not identical to those previously reported in DAP non-susceptibile S aureus. LESSONS Clinicians should be cautious regarding the emergence of DAP non-susceptible CoNS, especially in cases with implanted prosthetic devices, inadequate debridement, and prior usage of vancomycin and DAP. Further studies are needed to understand the relevance of these genetic changes and DAP-non-susceptibility in CoNS strains.
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Affiliation(s)
- Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital
| | - Yo Sugawara
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka
| | - Shigeto Hamaguchi
- Division of Infection Control and Prevention, Osaka University Hospital
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Osaka
| | - Masahiro Hayashi
- Center for Conservation of Microbial Genetic Resource, Gifu University, Gifu, Japan
| | - Yukihiro Akeda
- Division of Infection Control and Prevention, Osaka University Hospital
- Japan-Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital
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29
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Pak YJ, Koike A, Watanabe H, Terai T, Kubota H, Takahashi M, Konno H, Kato J, Nishi I, Sato A, Kawamoto H, Aonuma K, Ieda M, Sankai Y. Effects of a cyborg-type robot suit HAL on cardiopulmonary burden during exercise in normal subjects. Eur J Appl Physiol 2018; 119:487-493. [PMID: 30499055 DOI: 10.1007/s00421-018-4040-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/27/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND The hybrid assistive limb (HAL) is the world's first cyborg-type robot suit that provides motion assistance to physically challenged patients. HAL is expected to expand the possibilities of exercise therapy for severe cardiac patients who have difficulty in moving on their own legs. As a first step, we examined whether or not the motion assistance provided by HAL during exercise could effectively reduce the cardiopulmonary burden in healthy subjects. METHODS A total of ten healthy male adults (35 ± 12 years) underwent cardiopulmonary exercise testing (CPX) on a cycle ergometer with or without assistance from HAL. The CPX protocol consisted of four 3-min stages performed in a continuous sequence: rest, 0 W, 40 W, and 80 W. The heart rate (HR), blood pressure, oxygen uptake (VO2), minute ventilation (VE), and gas exchange ratio (R) were monitored during the CPX. RESULTS At 0 W, the HR, VO2, and VE were significantly higher when HAL was used. At 80 W, however, the HR (107 ± 14 vs 114 ± 14 beats/min, p < 0.01), systolic blood pressure (141 ± 15 vs 155 ± 20 mmHg, p < 0.01), VO2 (17.6 ± 2.4 vs 19.0 ± 2.5 mL/min/kg, p < 0.05), and R (0.88 ± 0.04 vs 0.95 ± 0.09, p < 0.05) were significantly lower when HAL was used. CONCLUSIONS HAL has the potential to reduce cardiopulmonary burden during moderate-intensity exercise and can, therefore, be used as a support for exercise therapy. Further studies on cardiac patients are expected to contribute to the establishment of a new exercise therapy program using HAL.
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Affiliation(s)
- Yo Joon Pak
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Akira Koike
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. .,Medical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| | - Hiroki Watanabe
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Tomoko Terai
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroshi Kubota
- Master's Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | | | - Hirotomo Konno
- Tsukuba University Hospital Rehabilitation Center, Tsukuba, Japan
| | - Jo Kato
- Department of Cardiology, Mito Kyodo General Hospital, Mito, Japan
| | - Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba Hospital, Tsuchiura, Japan
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroaki Kawamoto
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoshiyuki Sankai
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
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30
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Kimura K, Hagiya H, Nishi I, Yoshida H, Tomono K. Roseomonas mucosa bacteremia in a neutropenic child: A case report and literature review. IDCases 2018; 14:e00469. [PMID: 30479963 PMCID: PMC6249398 DOI: 10.1016/j.idcr.2018.e00469] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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] [Received: 08/15/2018] [Revised: 11/09/2018] [Accepted: 11/09/2018] [Indexed: 11/25/2022] Open
Abstract
Roseomonas species is rarely found to be pathogenic to humans and there are few clinical cases that have been described in the literature. We report a case of Roseomonas mucosa bacteremia that involved a 9-year-old Japanese boy who was in a condition of febrile neutropenia caused by chemotherapy for cerebellar medulloblastoma. Conventional phenotyping failed to identify the organism; however, genetic analysis using 16S rDNA sequencing confirmed the pathogen to be R. mucosa. The patient recovered following treatment by meropenem without any complications. A literature review of pediatric cases of Roseomonas bacteremia identified 12 other documented cases, and these revealed that a common clinical situation for the infection is an immunocompromised state with malignancy and/or an indwelling intravenous catheter. Because of the low number of cases, the overall picture of Roseomonas bacteremia in children remains to be elucidated; however, the prognosis of the infection appears to be satisfactory.
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Affiliation(s)
- Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Hospital, Japan.,Department of Pediatrics, Osaka University Hospital, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
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31
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Affiliation(s)
- Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan
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32
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Qin R, Koike A, Nagayama O, Takayanagi Y, Wu L, Nishi I, Kato Y, Sato A, Yamashita T, Aonuma K, Ieda M. Clinical significance of respiratory compensation during exercise testing in cardiac patients. Biosci Trends 2018; 12:432-437. [PMID: 30101836 DOI: 10.5582/bst.2018.01165] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Ventilation (VE) increases linearly with the increase of carbon dioxide output (VCO2) during cardiopulmonary exercise testing. VE-VCO2 slope rises in parallel with exercise intensity, reaches a turning point (called the RC point), then steepens because of respiratory compensation for lactic acidosis. While this RC point can be identified universally, it is undetectable in some patients. In this study we evaluated whether the respiratory compensation during exercise testing has clinical significance in cardiac patients. In total, 152 cardiac patients with a respiratory exchange ratio at peak exercise (peak R) of between 1.10 and 1.20 were enrolled. Cardiopulmonary parameters were compared between patients who manifested the RC point (n = 118) and those who did not (n = 34). The peak R did not significantly differ between these two groups. Compared to the patients without the RC point, those with the RC point had a higher oxygen uptake at peak exercise (peak VO2) (20.2 ± 5.3 vs 13.6 ± 3.4 mL/min/kg, p < 0.001), higher anaerobic threshold (AT) (12.4 ± 3.2 vs 9.2 ± 2.3 mL/min/kg, p < 0.001), and lower VE-VCO2 slope (31.7 ± 5.8 vs 37.8 ± 9.6, p = 0.001). Brain natriuretic peptide (BNP) tended to be lower in the patients with the RC point (175.4 ± 364.7 vs 327.9 ± 381.1 pg/mL, p = 0.067). Peak VO2, the marker of cardiopulmonary function, was found to be the independent predictor of the presence of the RC point. The present findings suggest that the phenomenon of respiratory compensation during heavy exercise indicates better cardiopulmonary function in cardiac patients within a prescribed range of effort.
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Affiliation(s)
- Rujie Qin
- Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Science, University of Tsukuba
| | - Akira Koike
- Medical Science, Faculty of Medicine, University of Tsukuba.,Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | - Yuta Takayanagi
- Department of Clinical Laboratory, University of Tsukuba Hospital
| | - Longmei Wu
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba
| | | | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
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33
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Yamamoto M, Seo Y, Ishizu T, Nishi I, Hamada-Harimura Y, Machino-Ohtsuka T, Higuchi H, Sai S, Nakatsukasa T, Sugano A, Baba M, Obara K, Aonuma K. Comparison of effects of aldosterone receptor antagonists spironolactone and eplerenone on cardiovascular outcomes and safety in patients with acute decompensated heart failure. Heart Vessels 2018; 34:279-289. [DOI: 10.1007/s00380-018-1250-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/24/2018] [Indexed: 11/29/2022]
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34
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Takeuchi D, Akeda Y, Yoshida H, Hagiya H, Yamamoto N, Nishi I, Yoshioka N, Sugawara Y, Sakamoto N, Shanmugakani RK, Deguchi M, Tomono K, Hamada S. Genomic reorganization by IS26 in a bla
NDM-5-bearing FII plasmid of Klebsiella pneumoniae isolated from a patient in Japan. J Med Microbiol 2018; 67:1221-1224. [DOI: 10.1099/jmm.0.000817] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Dan Takeuchi
- 1Japan–Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Yukihiro Akeda
- 2Division of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
- 1Japan–Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Hisao Yoshida
- 2Division of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hideharu Hagiya
- 2Division of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Norihisa Yamamoto
- 2Division of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Isao Nishi
- 3Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Nori Yoshioka
- 2Division of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
- 3Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan
| | - Yo Sugawara
- 1Japan–Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Noriko Sakamoto
- 1Japan–Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Rathina Kumar Shanmugakani
- 2Division of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Matsuo Deguchi
- 2Division of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazunori Tomono
- 2Division of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Shigeyuki Hamada
- 1Japan–Thailand Research Collaboration Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
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35
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Yamamoto R, Miyagawa S, Hagiya H, Kimura K, Nishi I, Yamamoto N, Yoshida H, Akeda Y, Tomono K, Toda K, Sawa Y. Silent Native-valve Endocarditis Caused by Propionibacterium acnes. Intern Med 2018; 57:2417-2420. [PMID: 29607974 PMCID: PMC6148182 DOI: 10.2169/internalmedicine.9833-17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
We describe a rare case of Propionibacterium acnes native-valve endocarditis that silently progressed in a 67-year-old man with hybrid dialysis. The patient was scheduled for kidney transplantation, and pre-operative investigation incidentally detected a vegetative structure at his native mitral valve that had increased in size. He underwent cardiac surgery and P. acnes was detected in cultures of a resected cardiac valve specimen and blood. This case highlights that P. acnes can silently cause infective endocarditis in a native-valve, and that physicians should consider the possibility of infection when P. acnes is isolated in blood cultures.
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Affiliation(s)
- Rintaro Yamamoto
- Department of Cardiovascular Surgery, Osaka University Hospital, Japan
| | - Shigeru Miyagawa
- Department of Cardiovascular Surgery, Osaka University Hospital, Japan
| | - Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Norihisa Yamamoto
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Yukihiro Akeda
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Koichi Toda
- Department of Cardiovascular Surgery, Osaka University Hospital, Japan
| | - Yoshiki Sawa
- Department of Cardiovascular Surgery, Osaka University Hospital, Japan
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36
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Himi T, Koike A, Nagayama O, Kato Y, Nishi I, Sato A, Yamashita T, Aonuma K. Clinical Significance of the Presence of Oscillatory Breathing Both at Rest and During Exercise in Cardiac Patients. Int Heart J 2018; 59:713-718. [DOI: 10.1536/ihj.17-335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Tomoko Himi
- Institute of Clinical Medicine, Graduate School of Comprehensive Human Science, University of Tsukuba
- Kawaguchi Kogyo General Hospital
| | - Akira Koike
- Medical Science, Faculty of Medicine, University of Tsukuba
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | | | - Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
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Hagiya H, Kimura K, Nishi I, Yoshida H, Yamamoto N, Akeda Y, Tomono K. Emergence of Carbapenem Non-susceptible Campylobacter coli after Long-term Treatment against Recurrent Bacteremia in a Patient with X-linked Agammaglobulinemia. Intern Med 2018; 57:2077-2080. [PMID: 29491300 PMCID: PMC6096023 DOI: 10.2169/internalmedicine.0312-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We herein report a case of recurrent Campylobacter coli bacteremia in a 37-year-old Japanese man with X-linked agammaglobulinemia (XLA). The patient experienced seven episodes of C. coli bacteremia over one year, with an erythematous rash intermittently emerged on the lower limbs. Although hospitalization for intravenous treatment was repeatedly recommended, he obstinately declined it. Following long-term oral antibiotic treatment with tebipenem and faropenem for the persistent infection, C. coli showed elevated minimum inhibitory concentrations to meropenem, a key drug for severe campylobacteriosis. Physicians should note that the overuse of antibiotics can lead to the emergence of carbapenem-non-susceptible Campylobacter strains.
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Affiliation(s)
- Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
- Department of Pediatrics, Osaka University Hospital, Japan
| | - Norihisa Yamamoto
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Yukihiro Akeda
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
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Kuchibiro T, Komatsu M, Yamasaki K, Nakamura T, Nishio H, Nishi I, Kimura K, Niki M, Ono T, Sueyoshi N, Kita M, Kida K, Ohama M, Satoh K, Toda H, Mizutani T, Fukuda N, Sawa K, Nakai I, Kofuku T, Orita T, Watari H, Shimura S, Fukuda S, Nakamura A, Wada Y. Evaluation of the modified carbapenem inactivation method for the detection of carbapenemase-producing Enterobacteriaceae. J Infect Chemother 2018; 24:262-266. [DOI: 10.1016/j.jiac.2017.11.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/12/2017] [Accepted: 11/19/2017] [Indexed: 11/24/2022]
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39
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Nishi I, Seo Y, Hamada-Harimura Y, Sato K, Sai S, Yamamoto M, Ishizu T, Sugano A, Obara K, Wu L, Suzuki S, Koike A, Aonuma K. Utility of Nutritional Screening in Predicting Short-Term Prognosis of Heart Failure Patients. Int Heart J 2018; 59:354-360. [PMID: 29479009 DOI: 10.1536/ihj.17-073] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Controlling nutritional status (CONUT) uses 2 biochemical parameters (serum albumin and cholesterol level), and 1 immune parameter (total lymphocyte count) to assess nutritional status. This study examined if CONUT could predict the short-term prognosis of heart failure (HF) patients.A total of 482 (57.5%) HF patients from the Ibaraki Cardiovascular Assessment Study-HF (n = 838) were enrolled (298 men, 71.7 ± 13.6 years). Blood samples were collected at admission, and nutritional status was assessed using CONUT. CONUT scores were defined as follows: 0-1, normal; 2-4, light; 5-8, moderate; and 9-12, severe degree of undernutrition. Accordingly, 352 (73%) patients had light-to-severe nutritional disturbances. The logarithmically transformed plasma brain natriuretic peptide (log BNP) concentration was significantly higher in the moderate-severe nutritional disturbance group (2.92 ± 0.42) compared to the normal group (2.72 ± 0.45, P < 0.01). CONUT scores were significantly higher in the in-hospital death patients [4 (3-8), n = 14] compared with patients who were discharged following symptom alleviation [3 (1-5), n = 446, P < 0.05]. With the exception of transferred HF patients (n = 22), logistic regression analysis that incorporated the CONUT score and the log BNP, showed that a higher CONUT score (P = 0.019) and higher log BNP (P = 0.009) were predictors of in-hospital death, and the median duration of hospital stay was 20 days.Our results demonstrate the usefulness of CONUT scores as predictors of short-term prognosis in hospitalized HF patients.
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Affiliation(s)
- Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba Hospital.,Department of Cardiology, National Hospital Organization Kasumigaura Medical Center
| | - Yoshihiro Seo
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
| | | | - Kimi Sato
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
| | - Seika Sai
- Department of Cardiology, Hitachi, Ltd., Hitachinaka General Hospital
| | | | - Tomoko Ishizu
- Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba
| | - Akinori Sugano
- Division of Cardiology, Ryugasaki Saiseikai General Hospital
| | - Kenichi Obara
- Division of Cardiology, Ryugasaki Saiseikai General Hospital
| | - Longmei Wu
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center
| | - Shoji Suzuki
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center
| | - Akira Koike
- Medical Science, Faculty of Medicine, University of Tsukuba
| | - Kazutaka Aonuma
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba
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Hagiya H, Kimura K, Nishi I, Yamamoto N, Yoshida H, Akeda Y, Tomono K. Desulfovibrio desulfuricans bacteremia: A case report and literature review. Anaerobe 2018; 49:112-115. [DOI: 10.1016/j.anaerobe.2017.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/11/2017] [Accepted: 12/30/2017] [Indexed: 10/18/2022]
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41
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Toda H, Satoh K, Komatsu M, Fukuda S, Nakamura T, Jikimoto T, Nishio H, Yamasaki K, Maede T, Orita T, Sueyoshi N, Kita M, Toyokawa M, Nishi I, Akagi M, Higuchi T, Kofuku T, Nakai I, Ono T, Shimakawa K, Hikita Y, Moro K, Kida K, Oohama M, Wada Y, Tobe T, Kamisako T, Tanaka Y. Laboratory surveillance of antimicrobial resistance and multidrug resistance among Streptococcus pneumoniae isolated in the Kinki region of Japan, 2001-2015. J Infect Chemother 2018; 24:171-176. [PMID: 29361416 DOI: 10.1016/j.jiac.2017.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 07/17/2017] [Revised: 11/17/2017] [Accepted: 12/15/2017] [Indexed: 11/30/2022]
Abstract
The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced among children in Japan in 2010. There are no long-term multicenter surveillance studies of antimicrobial resistance in S. pneumoniae before and after the introduction of PCV7. Therefore, we examined chronological trends in antimicrobial resistance among 4534 strains of S. pneumoniae isolated from both children and adults in the Kinki region of Japan during 2001-2015. High-level penicillin and third-generation cephalosporin resistance in S. pneumoniae increased among both children and adults during the period before the introduction of PCV7 (2001-2010). Besides penicillin and cephalosporin, pneumococcal carbapenem and macrolide resistance increased among children. The rate of resistance to these antibiotics was higher among children than among adults. The introduction of PCV7 decreased the rate of non-susceptibility to β-lactam antibiotics and the rate of multidrug resistant S. pneumoniae among children, but not among adults.
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Affiliation(s)
- Hirofumi Toda
- Department of Clinical Laboratory, Kindai University Hospital, Japan; Laboratory of Molecular Medical Microbiology, Department of Biomedical Informatics, Osaka University Graduate School of Medicine, Japan.
| | - Kaori Satoh
- Department of Clinical Laboratory, Kindai University Hospital, Japan
| | - Masaru Komatsu
- Department of Clinical Laboratory Science, Tenri Health Care University, Japan
| | - Saori Fukuda
- Department of Clinical Pathology, Tenri Hospital, Japan
| | - Tatsuya Nakamura
- Department of Clinical Laboratory, Kobe University Hospital, Japan
| | - Takumi Jikimoto
- Department of Clinical Laboratory, Kobe University Hospital, Japan
| | - Hisaaki Nishio
- Department of Clinical Laboratory, Shiga Medical Center for Adults, Japan
| | - Katsutoshi Yamasaki
- Department of Medical Life Science, Kurashiki University of Science and the Arts, Japan
| | - Takuya Maede
- Bacteriological Testing Section of the Central Laboratory, FALCO Biosystems Ltd., Japan
| | - Tamaki Orita
- Department of Clinical Laboratory, Takarazuka City Hospital, Japan
| | - Noriyuki Sueyoshi
- Department of Clinical Laboratory, Japan Community Health Care Organization Shiga Hospital, Japan
| | - Machiko Kita
- Department of Clinical Laboratory, Japan Community Health Care Organization Shiga Hospital, Japan
| | - Masahiro Toyokawa
- Preparing Section for New Faculty of Medical Sciences, Fukushima Medical University, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Masahiro Akagi
- Department of Clinical Laboratory, Osaka Police Hospital, Japan
| | - Takefumi Higuchi
- Laboratory for Clinical Investigation, Kyoto University Hospital, Japan
| | - Tomomi Kofuku
- Department of Clinical Laboratory, Sumitomo Hospital, Japan
| | - Isako Nakai
- Department of Clinical Laboratory, Sumitomo Hospital, Japan
| | - Tamotsu Ono
- Department of Clinical Laboratory, Japanese Red Cross Kyoto Daini Hospital, Japan
| | - Koichi Shimakawa
- Satellite Laboratory Testing Unit, Kansai Division, SRL, Inc., Japan
| | - Yoshie Hikita
- Satellite Laboratory Testing Unit, Kansai Division, SRL, Inc., Japan
| | - Kunihiko Moro
- Department of Clinical Laboratory, Hikone Municipal Hospital, Japan
| | - Kaneyuki Kida
- Department of Clinical Laboratory, Japanese Red Cross Otsu Hospital, Japan
| | - Masanobu Oohama
- Department of Clinical Laboratory, Japanese Red Cross Otsu Hospital, Japan
| | - Yasunao Wada
- Department of Clinical Laboratory, Hyogo Medical University Hospital, Japan
| | - Toru Tobe
- Laboratory of Molecular Medical Microbiology, Department of Biomedical Informatics, Osaka University Graduate School of Medicine, Japan
| | - Toshinori Kamisako
- Department of Clinical Laboratory Medicine, Kindai University Faculty of Medicine, Japan
| | - Yuji Tanaka
- Department of Clinical Laboratory Medicine, Kindai University Faculty of Medicine, Japan
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42
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Takayanagi Y, Koike A, Nagayama O, Nagamine A, Qin R, Kato J, Nishi I, Himi T, Kato Y, Sato A, Yamashita T, Aonuma K. Clinical significance of the overshoot phenomena of respiratory gas indices during recovery from maximal exercise testing. J Cardiol 2017; 70:598-606. [PMID: 28528994 DOI: 10.1016/j.jjcc.2017.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/09/2017] [Accepted: 03/30/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Yuta Takayanagi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Akira Koike
- Medical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| | | | - Arisa Nagamine
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Rujie Qin
- Institute of Clinical Medicine, Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan
| | - Jo Kato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Isao Nishi
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Tomoko Himi
- Institute of Clinical Medicine, Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan; Kawaguchi Kogyo General Hospital, Kawaguchi, Japan
| | - Yuko Kato
- The Cardiovascular Institute, Tokyo, Japan
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | - Kazutaka Aonuma
- Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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43
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Yamamoto N, Asada R, Kawahara R, Hagiya H, Akeda Y, Shanmugakani R, Yoshida H, Yukawa S, Yamamoto K, Takayama Y, Ohnishi H, Taniguchi T, Matsuoka T, Matsunami K, Nishi I, Kase T, Hamada S, Tomono K. Prevalence of, and risk factors for, carriage of carbapenem-resistant Enterobacteriaceae among hospitalized patients in Japan. J Hosp Infect 2017; 97:212-217. [DOI: 10.1016/j.jhin.2017.07.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/15/2017] [Indexed: 01/22/2023]
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44
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Sugano A, Seo Y, Ishizu T, Yamamoto M, Hamada Y, Nishi I, Aonuma K, Nogami A, Iesaka Y. Interaction Between Mineralocorticoid Receptor Antagonist and Soluble ST2 in Heart Failure with Preserved Ejection Fraction. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.08.062] [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]
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45
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Sai S, Seo Y, Nakatsukasa T, Yamamoto M, Nishi I, Isizu T, Aonuma K. Long-term Tolvaptan Use Contributes to Improve Clinical Outcomes in More Advanced Heart Failure Patients. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.08.314] [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]
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46
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Nishi I, Seo Y, Hamada Y, Sato K, Sai S, Yamamoto M, Ishizu T, Sugano A, Obara K, Aonuma K. Geriatric Nutritional Risk Index Might Predict All-Cause Deaths in Elderly Patients With Heart Failure With Preserved Ejection Fraction Requiring Hospitalization. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.08.401] [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: 11/30/2022]
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47
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Sugawara Y, Akeda Y, Sakamoto N, Takeuchi D, Motooka D, Nakamura S, Hagiya H, Yamamoto N, Nishi I, Yoshida H, Okada K, Zin KN, Aye MM, Tonomo K, Hamada S. Genetic characterization of blaNDM-harboring plasmids in carbapenem-resistant Escherichia coli from Myanmar. PLoS One 2017; 12:e0184720. [PMID: 28910381 PMCID: PMC5598989 DOI: 10.1371/journal.pone.0184720] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [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: 06/07/2017] [Accepted: 08/29/2017] [Indexed: 11/19/2022] Open
Abstract
The bacterial enzyme New Delhi metallo-β-lactamase hydrolyzes almost all β-lactam antibiotics, including carbapenems, which are drugs of last resort for severe bacterial infections. The spread of carbapenem-resistant Enterobacteriaceae that carry the New Delhi metallo-β-lactamase gene, blaNDM, poses a serious threat to public health. In this study, we genetically characterized eight carbapenem-resistant Escherichia coli isolates from a tertiary care hospital in Yangon, Myanmar. The eight isolates belonged to five multilocus-sequence types and harbored multiple antimicrobial-resistance genes, resulting in resistance against nearly all of the antimicrobial agents tested, except colistin and fosfomycin. Nine plasmids harboring blaNDM genes were identified from these isolates. Multiple blaNDM genes were found in the distinct Inc-replicon types of the following plasmids: an IncA/C2 plasmid harboring blaNDM-1 (n = 1), IncX3 plasmids harboring blaNDM-4 (n = 2) or blaNDM-7 (n = 1), IncFII plasmids harboring blaNDM-4 (n = 1) or blaNDM-5 (n = 3), and a multireplicon F plasmid harboring blaNDM-5 (n = 1). Comparative analysis highlighted the diversity of the blaNDM-harboring plasmids and their distinct characteristics, which depended on plasmid replicon types. The results indicate circulation of phylogenetically distinct strains of carbapenem-resistant E. coli with various plasmids harboring blaNDM genes in the hospital.
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Affiliation(s)
- Yo Sugawara
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
- * E-mail: (YA); (YS)
| | - Yukihiro Akeda
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
- * E-mail: (YA); (YS)
| | - Noriko Sakamoto
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Dan Takeuchi
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Daisuke Motooka
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Shota Nakamura
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Norihisa Yamamoto
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation, Osaka University Hospital, Suita, Japan
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Kazuhisa Okada
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Khwar Nyo Zin
- Clinical Laboratory Department, Yangon General Hospital, Yangon, Myanmar
| | - Mya Mya Aye
- Bacteriology Research Division, Department of Medical Research, Yangon, Myanmar
| | - Kazunori Tonomo
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Japan
| | - Shigeyuki Hamada
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
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48
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Yamamoto M, Seo Y, Ishizu T, Nishi I, Hamada-Harimura Y, Machino-Ohtsuka T, Sato K, Sai S, Sugano A, Obara K, Aonuma K. Effect of Dipeptidyl Peptidase-4 Inhibitors on Cardiovascular Outcome and Cardiac Function in Patients With Diabetes and Heart Failure - Insights From the Ibaraki Cardiac Assessment Study-Heart Failure (ICAS-HF) Registry. Circ J 2017; 81:1662-1669. [PMID: 28592726 DOI: 10.1253/circj.cj-17-0240] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although experimental animal studies report many pleiotropic effects of dipeptidyl peptidase-4 inhibitors (DPP-4i), their prognostic value has not been demonstrated in clinical trials.Methods and Results:Among 838 prospectively enrolled heart failure (HF) patients hospitalized for acute decompensated HF, 79 treated with DPP-4i were compared with 79 propensity score-matched non-DPP-4i diabetes mellitus (DM) patients. The primary endpoint was all-cause mortality; the secondary endpoint was a composite of cardiovascular death and hospitalization. During follow-up (423±260 days), 8 patients (10.1%) in the DPP-4i group and 13 (16.5%) in the non-DPP-4i group died (log-rank, P=0.283). The DPP-4i group did not have a significantly higher rate of all-cause mortality (log-rank, P=0.283), or cardiovascular death or hospitalization (log-rank, P=0.425). In a subgroup analysis of HF with preserved ejection fraction (HFpEF; n=75), the DPP-4i group had a significantly better prognosis than the non-DPP-4i group regarding the primary endpoint (log-rank, P=0.021) and a tendency to have better prognosis regarding the secondary endpoint (log-rank, P=0.119). In patients with HF with reduced EF (n=83), DPP-4i did not result in better prognosis. CONCLUSIONS DPP-4i did not increase the risk of adverse clinical outcomes in patients with DM and HF. DPP-4i may be beneficial in HFpEF.
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Affiliation(s)
- Masayoshi Yamamoto
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Yoshihiro Seo
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Tomoko Ishizu
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba Hospital
| | - Yoshie Hamada-Harimura
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Tomoko Machino-Ohtsuka
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Kimi Sato
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Seika Sai
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Akinori Sugano
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Kenichi Obara
- Division of Cardiology, Ryugasaki Saiseikai General Hospital
| | - Kazutaka Aonuma
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
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49
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Nishi I, Seo Y, Hamada-Harimura Y, Sato K, Sai S, Yamamoto M, Ishizu T, Sugano A, Obara K, Wu L, Suzuki S, Koike A, Aonuma K. Nutritional screening based on the controlling nutritional status (CONUT) score at the time of admission is useful for long-term prognostic prediction in patients with heart failure requiring hospitalization. Heart Vessels 2017; 32:1337-1349. [PMID: 28573538 DOI: 10.1007/s00380-017-1001-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 05/26/2017] [Indexed: 11/30/2022]
Abstract
The objective of the study was to clarify whether controlling nutritional status (CONUT) is useful for predicting the long-term prognosis of patients hospitalized with heart failure (HF). A total of 482 (57.5%) HF patients from the Ibaraki Cardiovascular Assessment Study-HF (N = 838) were enrolled (298 men, 71.7 ± 13.6 years). At admission, blood samples were collected and nutritional status assessed using CONUT. CONUT scores were defined as follows: 0-1, normal; 2-4, light; 5-8, moderate; and 9-12, severe undernutrition. Accordingly, 352 (73%) patients had light-to-severe nutritional disturbances. In the follow-up period [median 541.5 (range 354-786) days], 109 deaths were observed. A Kaplan-Meier analysis revealed that all-cause deaths occurred more frequently in HF patients with nutritional disturbances [n = 93 (26.4%)] than in those with normal nutrition [n = 16 (12.3%); log-rank p < 0.001]. The Cox proportional hazard analyses revealed that a per point increase in the CONUT score was associated with an increased risk of all-cause death (hazard ratio 1.142; 95% confidence interval, 1.044-1.249) after controlling simultaneously for age, sex, previous history of HF hospitalization, log brain natriuretic peptide, and use of therapeutic agents at admission (tolvaptan and aldosterone antagonists). This study suggests that nutritional screening using CONUT scores is helpful in predicting the long-term prognosis of patients hospitalized with HF in a multicenter registry setting.
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Affiliation(s)
- Isao Nishi
- Department of Cardiology, Tsuchiura Clinical Education and Training Center, University of Tsukuba Hospital, Tsuchiura, Japan.
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center, 2-7-14 Shimotakatsu, Tsuchiura, Ibaraki, 300-8585, Japan.
| | - Yoshihiro Seo
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | - Kimi Sato
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Seika Sai
- Department of Cardiology, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka, Japan
| | - Masayoshi Yamamoto
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tomoko Ishizu
- Department of Clinical Laboratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akinori Sugano
- Division of Cardiology, Ryugasaki Saiseikai General Hospital, Ryugasaki, Japan
| | - Kenichi Obara
- Division of Cardiology, Ryugasaki Saiseikai General Hospital, Ryugasaki, Japan
| | - Longmei Wu
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center, 2-7-14 Shimotakatsu, Tsuchiura, Ibaraki, 300-8585, Japan
| | - Shoji Suzuki
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center, 2-7-14 Shimotakatsu, Tsuchiura, Ibaraki, 300-8585, Japan
| | - Akira Koike
- Medical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazutaka Aonuma
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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50
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Hagiya H, Yoshida H, Yamamoto N, Kimura K, Ueda A, Nishi I, Akeda Y, Tomono K. Mycoplasma hominisperiaortic abscess following heart-lung transplantation. Transpl Infect Dis 2017; 19. [DOI: 10.1111/tid.12697] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/20/2016] [Accepted: 12/31/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Hideharu Hagiya
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
| | - Hisao Yoshida
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
| | - Norihisa Yamamoto
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation; Osaka University Hospital; Osaka Japan
| | - Akiko Ueda
- Laboratory for Clinical Investigation; Osaka University Hospital; Osaka Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation; Osaka University Hospital; Osaka Japan
| | - Yukihiro Akeda
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
| | - Kazunori Tomono
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
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