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Tamai N, Shinjoh M, Oikawa H, Hamada R, Morio T, Koinuma G, Takahashi T. Invasive pneumococcal disease caused by non-vaccine Streptococcus pneumoniae serotype 24B in an immunocompetent child. Radiol Case Rep 2024; 19:1642-1645. [PMID: 38327552 PMCID: PMC10847835 DOI: 10.1016/j.radcr.2024.01.048] [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: 12/13/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
Invasive pneumococcal disease typically occurs in immunocompromised patients, although some vaccine strains of Streptococcus pneumoniae have been reported to cause invasive pneumococcal disease in immunocompetent vaccine recipients. In this study, we presented a case of a 16-month-old immunocompetent patient with lung abscess and empyema caused by nonvaccine S. pneumoniae serotype 24B. A consolidation occupying the right upper lobe in the chest computed tomography results, as observed at presentation, changed to thick-walled cavitary lesions at the end of a month of intravenous antibiotics, and antibiotics were continued for a total of two months. To the best of our knowledge this is the first report that focuses on the risk of invasive pneumococcal disease caused by S. pneumoniae serotype 24B in an immunocompetent child.
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Affiliation(s)
- Naotaka Tamai
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hiroyuki Oikawa
- Pediatrics, Ariake child clinic, Ariake Garden Medical Mall 1F, 2-1-7 Ariake, Koto-ku, Tokyo 135-0063, Japan
| | - Riku Hamada
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Nephrology and Rheumatology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8561, Japan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Goro Koinuma
- Division of Pulmonology, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Center for developmental neurology, Shin-yurigaoka General Hospital, 255 Furusawa, Asao-ku, Kawasaki-shi, Kanagawa 215-0026, Japan
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Oikawa H, Morooka Y, Furuichi M, Shinjoh M, Nozaki S, Nishi E, Yaginuma M, Inoguchi T, Tomita K, Furuno K, Takahashi T. Catheter-associated urinary tract infection and urinary tract abnormalities in young children: A retrospective study. J Infect Chemother 2024; 30:194-200. [PMID: 37805098 DOI: 10.1016/j.jiac.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION Studies investigating the role of urinary tract abnormalities in the development of catheter-associated urinary tract infections (CAUTI) in young children are limited. Thus, in the present study, we aimed to determine whether there is an association between CAUTI and urinary tract abnormalities. METHODS We performed abdominal imaging studies on all patients aged <6 years with CAUTI admitted to the pediatric intensive care units (PICU) and high care unit (HCU) at Keio university or Fukuoka Children's Hospital from April 1, 2018 to July 31, 2022. Among 40 children who developed CAUTI, 13 (33 %) had abnormal urogenital images. Further, two case-control studies were conducted before and after propensity score matching, and the groups were compared using multivariable logistic regression models to analyze the effects of various factors on CAUTI development. RESULTS In the multivariate logistic regression models, abnormal urogenital images (OR 5.30 [95 % CI, 2.40-11.7] and OR 3.44 [95 % CI, 1.16-9.93]) and duration of catheterization >10 days (OR 2.76 [95 % CI, 1.28-5.96] and OR 3.44 [95 % CI, 1.16-9.93]) were found to be significantly associated with development of CAUTI, both before (39 cases, 459 controls) and after propensity score matching (36 cases, 72 controls). Further, CAUTI in young children in the PICU or HCU was significantly associated with imaging abnormalities of the urinary tract. CONCLUSIONS These results suggest that not only the presence of catheters, but also urinary tract malformations may contribute to the development of CAUTI in young children.
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Affiliation(s)
- Hiroyuki Oikawa
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, Tokyo, Japan
| | - Yuya Morooka
- Fukuoka Children's Hospital, Kashiiteriha, Fukuoka higashiku, Fukuoka, 813-0017, Japan
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, Tokyo, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, Tokyo, Japan.
| | - Shotaro Nozaki
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, Tokyo, Japan
| | - Emiri Nishi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, Tokyo, Japan
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, Tokyo, Japan
| | - Tomohiro Inoguchi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, Tokyo, Japan
| | - Kentaro Tomita
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, Tokyo, Japan
| | - Kenji Furuno
- Fukuoka Children's Hospital, Kashiiteriha, Fukuoka higashiku, Fukuoka, 813-0017, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, Tokyo, Japan
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Shinjoh M, Togo K, Hayamizu T, Yonemoto N, Morii J, Perdrizet J, Kamei K. Cost-effectiveness analysis of 20-valent pneumococcal conjugate vaccine for routine pediatric vaccination programs in Japan. Expert Rev Vaccines 2024; 23:485-497. [PMID: 38682661 DOI: 10.1080/14760584.2024.2345670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND The Japanese National Immunization Program currently includes the pediatric 13 valent pneumococcal conjugate vaccine (PCV13) to prevent pneumococcal infections. We aimed to evaluate the cost-effectiveness of 20-valent PCV (PCV20) as a pediatric vaccine versus PCV13. METHODS A decision-analytic Markov model was used to estimate expected costs, quality-adjusted life-years (QALYs), and prevented cases and deaths caused by invasive pneumococcal disease, pneumonia, and acute otitis media over a ten-year time horizon from the societal and healthcare payer perspectives. RESULTS PCV20 was dominant, i.e. less costly and more effective, over PCV13 (gained 294,599 QALYs and reduced Japanese yen [JPY] 352.6 billion [2.6 billion United States dollars, USD] from the societal perspective and JPY 178.9 billion [USD 1.4 billion] from the payer perspective). Sensitivity and scenario analyses validated the robustness of the base scenario results. When comparing PCV20 with PCV13, the threshold analysis revealed an incremental cost-effectiveness ratio that was within the threshold value (JPY 5 million/QALY) at a maximum acquisition cost of JPY 74,033 [USD 563] (societal perspective) and JPY 67,758 [USD 515] (payer perspective). CONCLUSIONS As a pediatric vaccine, PCV20 was dominant over PCV13 regardless of the study perspective.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Kanae Togo
- Health and Value, Pfizer Japan Inc, Tokyo, Japan
| | | | | | - Junko Morii
- HEOR, Real World Evidence, IQVIA Solutions G.K, Tokyo, Japan
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Kawata K, Shima H, Shinjoh M, Yamazaki F, Kurosawa T, Yaginuma M, Takada H, Shimada H. Pneumocystis jirovecii pneumonia after CD4+ T-cell recovery subsequent to CD19-targeted chimeric antigen receptor T-cell therapy: A case report and brief review of literature. Cancer Rep (Hoboken) 2023; 6:e1885. [PMID: 37563749 PMCID: PMC10598253 DOI: 10.1002/cnr2.1885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/20/2023] [Accepted: 07/28/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND CD19-targeted chimeric antigen receptor (CAR)-T cell therapy involves administration of patient-derived T cells that target B cells, resulting in B-cell depletion and aplasia. In immunity against Pneumocystis jirovecii (Pj), CD4+ T cells and, more recently, B cells, are generally considered important. Antigen presentation by B cells to CD4+ T cells is particularly important. Trimethoprim-sulfamethoxazole (TMP/SMX) for Pj pneumonia (PJP) prophylaxis is generally discontinued when the CD4+ T-cell count is >200/μL. Here we report the first case, to our knowledge, of PJP in a patient with a CD4+ T cell count of >200/μL after CAR-T cell therapy. CASE A 14-year-old girl developed hemophagocytic lymphohistiocytosis (HLH) after cord blood transplantation (CBT) for relapsed precursor B-cell acute lymphoblastic leukemia (B-ALL). Twenty-one months after CBT, she was diagnosed with combined second relapse in the bone marrow and central nervous system. The patient was treated with CD19-targeted CAR-T cell therapy for the relapse. After CAR-T cell therapy, the patient remained in remission and continued to receive TMP/SMX for PJP prophylaxis. Seven months after CAR-T cell therapy, CD4+ T cells recovered and TMP/SMX was discontinued. The B-cell aplasia persisted. Ten months after CAR-T cell therapy, the patient developed PJP. The patient was also considered to have macrophage hyperactivation at the onset of PJP. Treatment with immunoglobulin, TMP/SMX, and prednisolone was initiated, and the patient's symptoms rapidly ameliorated. CONCLUSION The patient in the present case developed PJP despite a CD4+ T-cell count of >200/μL after CAR-T cell therapy, probably because of inadequate CD4+ T-cell activation caused by B-cell depletion after CAR-T cell therapy and repeated abnormal macrophage immune responses after CBT. It is important to determine the duration of TMP/SMX for prophylaxis after CAR-T cell therapy according to each case, as well as the CD4+ T-cell count.
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Affiliation(s)
- Kento Kawata
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Haruko Shima
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Masayoshi Shinjoh
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Fumito Yamazaki
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Takumi Kurosawa
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Mizuki Yaginuma
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Hiroshi Takada
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Hiroyuki Shimada
- Department of PediatricsKeio University School of MedicineTokyoJapan
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Ishiwada N, Shinjoh M, Kusama Y, Arakawa H, Ohishi T, Saitoh A, Suzuki A, Tsutsumi H, Nishi J, Hoshino T, Mitsuda T, Miyairi I, Iwamoto-Kinoshita N, Kobayashi H, Satoh K, Shimizu A, Takeshita K, Tanaka T, Tamura D, Tokunaga O, Tomita K, Nagasawa K, Funaki T, Furuichi M, Miyata I, Yaginuma M, Yamaguchi Y, Yamamoto S, Uehara S, Kurosaki T, Okada K, Ouchi K. Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022. Pediatr Infect Dis J 2023; 42:e369-e376. [PMID: 37566891 DOI: 10.1097/inf.0000000000004041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
The members of the Japanese Society for Pediatric Infectious Diseases and the Japanese Society of Pediatric Pulmonology have developed Guidelines for the Management of Respiratory Infectious Diseases in Children with the objective of facilitating appropriate diagnosis, treatment and prevention of respiratory infections in children. The first edition was published in 2004 and the fifth edition was published in 2022. The Guideline 2022 consists of 2 parts, clinical questions and commentary, and includes general respiratory infections and specific infections in children with underlying diseases and severe infections. This executive summary outlines the clinical questions in the Guidelines 2022, with reference to the Japanese Medical Information Distribution Service Manual. All recommendations are supported by a systematic search for relevant evidence and are followed by the strength of the recommendation and the quality of the evidence statements.
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Affiliation(s)
- Naruhiko Ishiwada
- From the Editor of the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
- Committee member for English journals for the Japanese Society for Pediatric Infectious Diseases, Tokyo, Japan
| | - Masayoshi Shinjoh
- From the Editor of the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Yoshiki Kusama
- Committee member for English journals for the Japanese Society for Pediatric Infectious Diseases, Tokyo, Japan
| | - Hirokazu Arakawa
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Tomohiro Ohishi
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Akihiko Saitoh
- Committee member for English journals for the Japanese Society for Pediatric Infectious Diseases, Tokyo, Japan
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Akira Suzuki
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Hiroyuki Tsutsumi
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Junichiro Nishi
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Tadashi Hoshino
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Toshihiro Mitsuda
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Isao Miyairi
- Committee member for English journals for the Japanese Society for Pediatric Infectious Diseases, Tokyo, Japan
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Noriko Iwamoto-Kinoshita
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Hisato Kobayashi
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Kouichiro Satoh
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Akihiko Shimizu
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Kenichi Takeshita
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Takaaki Tanaka
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Daisuke Tamura
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Osamu Tokunaga
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Kentaro Tomita
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Koo Nagasawa
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Takanori Funaki
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Muhehiro Furuichi
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Ippei Miyata
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Mizuki Yaginuma
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Yoshio Yamaguchi
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Shota Yamamoto
- Collaborator for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Suzuko Uehara
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Tomomichi Kurosaki
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Kenji Okada
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
| | - Kazunobu Ouchi
- Editorial committee member for the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022, Tokyo, Japan
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Kimura N, Ohnishi T, Hachiya R, Shinjoh M, Fukushima H. Chronic Recurrent Multifocal Osteomyelitis Presenting With Fever of Unknown Origin. Indian Pediatr 2023; 60:681-684. [PMID: 37565440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Affiliation(s)
- Naoki Kimura
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Takuma Ohnishi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
| | - Rumi Hachiya
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Masayoshi Shinjoh
- Keio Children's Hospital and Perinatal Center, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Fukushima
- Department of Postgraduate Medical Education, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
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Yamada M, Macedo C, Louis K, Shi T, Landsittel D, Nguyen C, Shinjoh M, Michaels MG, Feingold B, Mazariegos GV, Green M, Metes D. Distinct association between chronic Epstein-Barr virus infection and T cell compartments from pediatric heart, kidney, and liver transplant recipients. Am J Transplant 2023; 23:1145-1158. [PMID: 37187296 DOI: 10.1016/j.ajt.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/23/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023]
Abstract
Chronic Epstein-Barr virus (EBV) infection after pediatric organ transplantation (Tx) accounts for significant morbidity and mortality. The risk of complications, such as posttransplant lymphoproliferative disorders, in high viral load (HVL) carriers is the highest in heart Tx recipients. However, the immunologic signatures of such a risk have been insufficiently defined. Here, we assessed the phenotypic, functional, and transcriptomic profiles of peripheral blood CD8+/CD4+ T cells, including EBV-specific T cells, in 77 pediatric heart, kidney, and liver Tx recipients and established the relationship between memory differentiation and progression toward exhaustion. Unlike kidney and liver HVL carriers, heart HVL carriers displayed distinct CD8+ T cells with (1) up-regulation of interleukin-21R, (2) decreased naive phenotype and altered memory differentiation, (3) accumulation of terminally exhausted (TEX PD-1+T-bet-Eomes+) and decrease of functional precursors of exhausted (TPEX PD-1intT-bet+) effector subsets, and (4) transcriptomic signatures supporting the phenotypic changes. In addition, CD4+ T cells from heart HVL carriers displayed similar changes in naive and memory subsets, elevated Th1 follicular helper cells, and plasma interleukin-21, suggesting an alternative inflammatory mechanism that governs T cell responses in heart Tx recipients. These results may explain the different incidences of EBV complications and may help improve the risk stratification and clinical management of different types of Tx recipients.
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Affiliation(s)
- Masaki Yamada
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Camila Macedo
- Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kevin Louis
- Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Kidney Transplant Department, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Tiange Shi
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Douglas Landsittel
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Indiana, Pennsylvania, USA
| | - Christina Nguyen
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Marian G Michaels
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian Feingold
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - George V Mazariegos
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Green
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Diana Metes
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Shinjoh M, Furuichi M, Tsuzuki S, Iqbal A, Fukushima N, Soen S, Fukushima H, Kobayashi K, Yamada G, Narabayashi A, Tsunematsu K, Maeda N, Shimoyamada M, Yoshida M, Kuramochi Y, Shibata A, Yamaguchi Y, Yaginuma M, Takahashi T, Ishikane M, Sugaya N. Effectiveness of inactivated influenza and COVID-19 vaccines in hospitalized children in 2022/23 season in Japan - The first season of co-circulation of influenza and COVID-19. Vaccine 2023:S0264-410X(23)00785-5. [PMID: 37419851 DOI: 10.1016/j.vaccine.2023.06.082] [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: 06/08/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Abstract
We have analyzed the inactivated vaccine effectiveness (VE)for preventing influenza hospitalization by test-negative design in the 2022/23 season. This is the first season of co-circulation of influenza and COVID-19, and a unique period because all inpatients received COVID-19 screening. Among 536 children hospitalized with fever, none were positive for both influenza and SARS-CoV-2. The adjusted VE for preventing influenza A for all children, the 6-12-year-old group, and those with underlying diseases was 34 % (95 %CI, -16 %-61 %, n = 474), 76 % (95 % CI, 21 %-92 %, n = 81), and 92 % (95 % CI, 30 %-99 %, n = 86), respectively. Only 1 out of 35 hospitalized cases with COVID-19, and 42 out of 429 controls, had been immunized with COVID-19 vaccine. This is the first report showing influenza VE by age group in children in this limited season. We still recommend the inactivated influenza vaccine for children based on the significant VE in subgroup analysis.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Division of Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Keio Pediatric Influenza Research Group, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Shinya Tsuzuki
- Disease Control and Prevention Center, AMR Clinical Reference Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
| | - Asef Iqbal
- Department of Pediatrics, National Hospital Organization, Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan.
| | - Naoya Fukushima
- Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Sachiko Soen
- Department of Pediatrics, Tokyo Metropolitan Otsuka Hospital, 2-8-1 Minamiotsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Hiroyuki Fukushima
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano Ichikawa, Chiba 272-0824, Japan.
| | - Ken Kobayashi
- Department of Pediatrics, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama, 221-0855 Kanagawa, Japan.
| | - Go Yamada
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Kenichiro Tsunematsu
- Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0061, Japan.
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
| | - Motoko Shimoyamada
- Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-0911, Japan.
| | - Makoto Yoshida
- Department of Pediatrics, Sano Kosei General Hospital, 1728 Horigome-chou, Sano-city, Tochigi 327-8511, Japan.
| | - Yuu Kuramochi
- Department of Pediatrics, Ota Memorial Hospital, 455-1 Ohshimacho, Ota City, Gunma 273-8585, Japan.
| | - Akimichi Shibata
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi 326-0843, Japan.
| | - Yoshio Yamaguchi
- Department of Clinical Research, Department of Infection and Allergy, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomaturi, Utsunomiya-City, Tochigi 320-8580, Japan.
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
| | - Norio Sugaya
- Keio Pediatric Influenza Research Group, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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9
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Shioji Y, Yaginuma M, Ota M, Inoguchi T, Furuichi M, Shinjoh M, Takahashi T. Gram staining to detect Gardnerella vaginalis urinary tract infection in a child. Pediatr Int 2023; 65:e15607. [PMID: 37674296 DOI: 10.1111/ped.15607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 09/08/2023]
Affiliation(s)
- Yuki Shioji
- Department of Pediatrics, Keio University of Medicine, Tokyo, Japan
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University of Medicine, Tokyo, Japan
| | - Masahi Ota
- Department of Pediatrics, Keio University of Medicine, Tokyo, Japan
| | | | | | | | - Takao Takahashi
- Department of Pediatrics, Keio University of Medicine, Tokyo, Japan
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10
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Furuichi M, Yaginuma M, Shinjoh M, Ohnishi T, Takahashi T, Iwata S. Be aware of Extended-spectrum β-lactamase-producing Escherichia coli in neonates and Listeria monocytogenes in young children with bacterial meningitis in Japan. J Pediatric Infect Dis Soc 2022; 12:165-168. [PMID: 36525391 DOI: 10.1093/jpids/piac135] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Nationwide surveillance of pediatric bacterial meningitis in Japan from 2019 to 2021 revealed two uncommon situations not covered by the recommended empiric treatment that were not rare in Japan, namely, extended-spectrum β-lactamase-producing-producing Escherichia coli in neonates and Listeria monocytogenes in children older than 1 month.
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Affiliation(s)
- Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Takuma Ohnishi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
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11
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Shinjoh M, Furuichi M, Kobayashi H, Yamaguchi Y, Maeda N, Yaginuma M, Kobayashi K, Nogayama T, Chiga M, Oshima M, Kuramochi Y, Yamada G, Narabayashi A, Ookawara I, Nishida M, Tsunematsu K, Kamimaki I, Shimoyamada M, Yoshida M, Shibata A, Nakata Y, Taguchi N, Mitamura K, Takahashi T. Trends in effectiveness of inactivated influenza vaccine in children by age groups in seven seasons immediately before the COVID-19 era. Vaccine 2022; 40:3018-3026. [PMID: 35450780 PMCID: PMC8995322 DOI: 10.1016/j.vaccine.2022.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/08/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022]
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Hisato Kobayashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Yoshio Yamaguchi
- Department of Clinical Research, Department of Infection and Allergy, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomaturi, Utsunomiya-City, Tochigi 320-8580, Japan.
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan.
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Ken Kobayashi
- Department of Pediatrics, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-ku, Yokohama 221-0855, Kanagawa, Japan.
| | - Taisuke Nogayama
- Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
| | - Michiko Chiga
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Mio Oshima
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan.
| | - Yuu Kuramochi
- Department of Pediatrics, Ota Memorial Hospital, 455-1 Ohshimacho, Ota City, Gunma 273-8585, Japan.
| | - Go Yamada
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan; Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan.
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, 8-2 Outemachi, Aoi-ku, Shizuoka 420-0853, Japan.
| | - Mitsuhiro Nishida
- Department of Pediatrics, Shizuoka City Shimizu Hospital, 1231 Miyakami, Shimizu-ku, Shizuoka-shi, Shizuoka 424-8636, Japan.
| | - Kenichiro Tsunematsu
- Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0061, Japan.
| | - Isamu Kamimaki
- Department of Pediatrics, National Hospital Organization, Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan.
| | - Motoko Shimoyamada
- Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-0911, Japan.
| | - Makoto Yoshida
- Department of Pediatrics, Sano Kosei General Hospital, 1728 Horigome-chou, Sano-city, Tochigi 327-8511, Japan.
| | - Akimichi Shibata
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, 284-1 Yobe-cho, Ashikaga, Tochigi 326-0843, Japan.
| | - Yuji Nakata
- Department of Pediatrics, Nippon Koukan Hospital, 1-2-1Koukan-Dori, Kawasaki, Kanagawa 210-0852, Japan.
| | - Nobuhiko Taguchi
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa 220-8581, Japan.
| | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo 110-8645, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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12
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Kimiya T, Shinjoh M, Asanuma H, Inoguchi T, Takahashi T. High success rate of nocturnal enuresis treatment during the stay-home period for COVID-19. Int J Urol 2022; 29:617-622. [PMID: 35240721 PMCID: PMC9111710 DOI: 10.1111/iju.14852] [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: 11/11/2021] [Accepted: 02/20/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To clarify whether enuresis treatment was more effective during the stay-home period for the coronavirus disease 2019 pandemic, when restrictions on activities enabled patients to concentrate on treatment. METHODS We performed a retrospective, nonrandomized cohort study for monosymptomatic enuresis during the coronavirus disease 2019 pandemic (March-June 2020) and a 2-year comparator period (March-June 2018 and March-June 2019). Primary outcome was treatment response, defined as a change in the number of wet nights per week within 6 months following enrollment. The time-dependent occurrence of treatment response was evaluated with the Kaplan-Meier method and the log-rank test. The Cox proportional hazards regression model was used to identify risk factors for treatment response. The range of appropriate sample sizes for this primary outcome was 39-48. RESULTS Of our 41 enrolled patients, 28 (68%) were male and mean age was 8.8 years. The complete response rate was 73% during the coronavirus disease 2019 pandemic period and 27% during the comparator period. Log-rank tests showed a higher cumulative incidence of complete response in the pandemic period (P = 0.020). Cox regression analysis identified treatment during the coronavirus disease 2019 pandemic (hazard ratio 2.533; 95% confidence interval 1.069-6.006) and dinner before 19:00 (hazard ratio 4.184; 95% confidence interval 1.56-11.252) as significantly associated with treatment response. CONCLUSIONS The rate of enuresis treatment response was uncommonly high during the stay-home period for the coronavirus disease 2019 pandemic. Restrictions on daily life may provide opportunities to concentrate on treatments for chronic illnesses, leading to more success.
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Affiliation(s)
- Takahisa Kimiya
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Asanuma
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Tomohiro Inoguchi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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13
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Uno S, Takano Y, Iketani O, Abiko T, Miwa T, Nanki K, Kurihara T, Tamura Y, Ara M, Uwamino Y, Shinjoh M, Mori T, Hasegawa N. Digestive Decolonization of Colorectal Carriage of Vancomycin-resistant Enterococcus faecium in a Japanese Adult. Intern Med 2022; 61:249-252. [PMID: 34176828 PMCID: PMC8851193 DOI: 10.2169/internalmedicine.6088-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Patients with vancomycin-resistant Enterococcus (VRE) colonization should be managed in an isolation room with contact precautions. We herein report a patient whose colorectal carriage of VRE was successfully decolonized using concomitant bowel irrigation with polyethylene glycol, probiotics, and oral antimicrobials, linezolid and orally-administered daptomycin, for release from isolation and contact precautions. We therefore would like to suggest a potential strategy for managing patients with VRE colonization.
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Affiliation(s)
- Shunsuke Uno
- Department of Infectious Diseases, Keio University School of Medicine, Japan
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
| | - Yaoko Takano
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
| | - Osamu Iketani
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
| | - Tomohiro Abiko
- Department of Neurosurgery, Keio University School of Medicine, Japan
| | - Tomoru Miwa
- Department of Neurosurgery, Keio University School of Medicine, Japan
| | - Kosaku Nanki
- Division of Gastroenterology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Tomohiro Kurihara
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Japan
| | - Yuko Tamura
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
| | - Miyuki Ara
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
| | - Yoshifumi Uwamino
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
- Department of Laboratory Medicine, Keio University School of Medicine, Japan
| | - Masayoshi Shinjoh
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
- Department of Pediatrics, Keio University School of Medicine, Japan
| | - Takehiko Mori
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Japan
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, Japan
- Division of Infectious Diseases and Infection Control, Keio University Hospital, Japan
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14
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Inoguchi T, Yaginuma M, Shinjoh M, Takahashi G, Yamagishi H. A case of multisystem inflammatory syndrome in children refractory to intravenous immunoglobulin. Pediatr Int 2022; 64:e15152. [PMID: 35727901 DOI: 10.1111/ped.15152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/25/2021] [Accepted: 01/17/2022] [Indexed: 01/05/2023]
Affiliation(s)
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University of Medicine, Tokyo, Japan
| | | | - Goro Takahashi
- Department of Pediatrics, Keio University of Medicine, Tokyo, Japan
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15
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Iqbal A, Fujimura T, Shinjoh M, Furuichi M, Iimori T, Umeyama T, Ishida T, Morinaga S, Kamimaki I, Ohkusu K, Takahashi T. The first case report of pediatric acute appendicitis caused by "Candidatus Actinobaculum timonae". J Infect Chemother 2021; 28:451-454. [PMID: 34887179 DOI: 10.1016/j.jiac.2021.11.023] [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: 09/10/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
A 14-year-old boy presented to the hospital with pain in the right lower abdomen. His condition was diagnosed as acute appendicitis. An emergency operation was performed, and histopathological examination revealed an actinomycete-related organism in the excised appendicitis specimen. On 16S rRNA gene sequence analysis, "Candidatus Actinobaculum timonae" was identified, which is the first known case in a pediatric patient.
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Affiliation(s)
- Asef Iqbal
- Department of Pediatrics, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako city Saitama, Japan
| | - Takumi Fujimura
- Department of Pediatric Surgery, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako city Saitama, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo, Japan
| | - Takashi Iimori
- Department of Pediatrics, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako city Saitama, Japan
| | - Tomoshige Umeyama
- Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo, Japan
| | - Tsuyoshi Ishida
- Department of Diagnostic Pathology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako city Saitama, Japan
| | - Shojiro Morinaga
- Department of Diagnostic Pathology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako city Saitama, Japan
| | - Isamu Kamimaki
- Department of Pediatrics, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako city Saitama, Japan
| | - Kiyofumi Ohkusu
- Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku Shinjuku-ku, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo, Japan
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16
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Tamura D, Kurosaki M, Shinjoh M, Nishimura H, Yamagishi H, Yamagata T. Lack of persisting antibody in a post-transplant patient after vaccine-strain varicella. Pediatr Transplant 2021; 25:e14070. [PMID: 34120389 DOI: 10.1111/petr.14070] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/16/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND LAVV have historically been avoided in children after solid organ transplantation. However, it has been reported that post-transplant, children without severe immunosuppression can generate anti-varicella antibody after immunization but the duration of the response is not clear. Furthermore, the origin of the varicella virus in immunosuppressed patients who develop varicella after vaccination is often unclear. CLINICAL PROGRESS A female child received LAVV 30 months after a living donor liver transplant at the age of 2 months. Varicella rash appeared on the trunk 16 days after vaccination and gradually spread over the body. The patient was treated with intravenous acyclovir followed by oral therapy and recovered fully. The virus detected in blisters was derived from the vaccine-type strain. Paired sera before and after the onset of varicella showed an increase in antibody titer. However, 2 years after onset, the antibody titer decreased to undetectable again. CONCLUSIONS This was an informative case of varicella due to vaccine strain attenuated virus. Antibody levels were not maintained over many years. Although varicella was caused by the vaccine-type strain, repeated vaccinations may be necessary for post-transplant patients who develop varicella.
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Affiliation(s)
- Daisuke Tamura
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | | | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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17
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Shinjoh M, Furuichi M, Narabayashi A, Kamei A, Yoshida N, Takahashi T. Risk factors in pediatric hospitalization for influenza A and B during the seven seasons immediately before the COVID-19 era in Japan. J Infect Chemother 2021; 27:1735-1742. [PMID: 34454832 DOI: 10.1016/j.jiac.2021.08.020] [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] [Received: 04/27/2021] [Revised: 08/10/2021] [Accepted: 08/19/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The risk factors in pediatric influenza immediately before the COVID-19 era are not well understood. This study aims to evaluate the risk factors for hospitalization in pediatric influenza A and B for the recent seasons. METHODS Children with a fever of ≥38 °C and laboratory-confirmed influenza at 20 hospitals in outpatient settings in Japan in the 2013/14 to 2019/20 seasons were retrospectively reviewed. Possible risk factors, including gender, age, comorbidities, nursery school or kindergarten attendance, earlier diagnosis, no immunization, lower regional temperature, earlier season, and period of onset, were evaluated using binary logistic regression methods. RESULTS A total of 13,040 (type A, 8861; B, 4179) children were evaluated. Significant risk factors (p < 0.05) in multivariate analyses were young age, lower regional temperature, earlier season, respiratory illness (adjusted odds ratio [aOR]:2.76, 95% confidence interval [CI]:1.84-4.13), abnormal behavior and/or unusual speech (aOR:2.78, 95% CI:1.61-4.80), and seizures at onset (aOR:16.8, 95% CI:12.1-23.3) for influenza A; and young age, lower regional temperature, respiratory illness (aOR:1.99, 95% CI:1.00-3.95), history of febrile seizures (aOR:1.73, 95% CI:1.01-2.99), and seizures at onset (aOR:9.74, 95% CI:5.44-17.4) for influenza B. CONCLUSIONS In addition to previously known factors, including young age, seizures, and respiratory illness, abnormal behavior and/or unusual speech and lower regional temperature are new factors. Negative immunization status was not a risk factor for hospitalization. A better understanding of risk factors may help improve the determination of indications for hospitalization during the future co-circulation of influenza and COVID-19.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawa-dori, Kawasaki-ku, Kawasaki City, Kanagawa, 210-0013, Japan.
| | - Akinobu Kamei
- Department of Pediatrics, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-ku, Yokohama, Kanagawa, 221-0855, Japan.
| | - Naoko Yoshida
- Department of Tropical Medicine and Parasitology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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18
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Oyanagi T, Tomita K, Furuichi M, Shinjoh M, Yamagishi H. Successful resuscitation from SARS-CoV-2 infection in a child after Rastelli operation. Pediatr Int 2021; 63:730-732. [PMID: 34089270 DOI: 10.1111/ped.14479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Takayuki Oyanagi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Tomita
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Yamagishi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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19
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Shinjoh M, Sugaya N, Yamaguchi Y, Ookawara I, Nakata Y, Narabayashi A, Furuichi M, Yoshida N, Kamei A, Kuramochi Y, Shibata A, Shimoyamada M, Nakazaki H, Maejima N, Yuasa E, Araki E, Maeda N, Ohnishi T, Nishida M, Taguchi N, Yoshida M, Tsunematsu K, Shibata M, Hirano Y, Sekiguchi S, Kawakami C, Mitamura K, Takahashi T. Influenza vaccine effectiveness against influenza A in children based on the results of various rapid influenza tests in the 2018/19 season. PLoS One 2021; 16:e0249005. [PMID: 33770132 PMCID: PMC7997015 DOI: 10.1371/journal.pone.0249005] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 03/09/2021] [Indexed: 11/18/2022] Open
Abstract
During influenza epidemics, Japanese clinicians routinely conduct rapid influenza diagnostic tests (RIDTs) in patients with influenza-like illness, and patients with positive test results are treated with anti-influenza drugs within 48 h after the onset of illness. We assessed the vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) in children (6 months-15 years old, N = 4243), using a test-negative case-control design based on the results of RIDTs in the 2018/19 season. The VE against influenza A(H1N1)pdm and A(H3N2) was analyzed separately using an RIDT kit specifically for detecting A(H1N1)pdm09. The adjusted VE against combined influenza A (H1N1pdm and H3N2) and against A(H1N1)pdm09 was 39% (95% confidence interval [CI], 30%-46%) and 74% (95% CI, 39%-89%), respectively. By contrast, the VE against non-A(H1N1)pdm09 influenza A (presumed to be H3N2) was very low at 7%. The adjusted VE for preventing hospitalization was 56% (95% CI, 16%-77%) against influenza A. The VE against A(H1N1)pdm09 was consistently high in our studies. By contrast, the VE against A(H3N2) was low not only in adults but also in children in the 2018/19 season.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Norio Sugaya
- Department of Pediatrics, Keiyu Hospital, Kanagawa, Japan
- * E-mail:
| | - Yoshio Yamaguchi
- Institute of Clinical Research & Department of Infection and Allergy, National Hospital Organization Tochigi Hospital, Tochigi, Japan
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Yuji Nakata
- Department of Pediatrics, Nippon Koukan Hospital, Kanagawa, Japan
| | | | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Naoko Yoshida
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Akinobu Kamei
- Department Pediatrics, Yokohama Municipal Citizen’s Hospital, Kanagawa, Japan
| | - Yuu Kuramochi
- Department of Pediatrics, Subaru Health Insurance Society Ota Memorial Hospital, Gunma, Japan
| | - Akimichi Shibata
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
| | | | - Hisataka Nakazaki
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Naohiko Maejima
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
| | - Erika Yuasa
- Department of Pediatrics, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Eriko Araki
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takuma Ohnishi
- Department of Pediatrics, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Mitsuhiro Nishida
- Department of Pediatrics, Shizuoka City Shimizu Hospital, Shizuoka, Japan
| | | | - Makoto Yoshida
- Department of Pediatrics, Sano Kosei General Hospital, Tochigi, Japan
| | | | - Meiwa Shibata
- Department of Pediatrics, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Yasuhiro Hirano
- Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan
| | | | | | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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Maeda N, Mori N, Shinjoh M, Komiyama O, Takahashi T. Comparison of 0.5% chlorhexidine gluconate alcohol with 10% povidone-iodine for skin disinfection in children to prevent blood culture contamination. J Infect Chemother 2021; 27:1027-1032. [PMID: 33727027 DOI: 10.1016/j.jiac.2021.02.027] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Various disinfectants, such as povidone iodine (PVI)1, alcohol preparations, and chlorhexidine gluconate ethanol (CHG-ALC), are used for disinfection prior to blood sampling for culture. METHODS This retrospective cohort study compared the usefulness and effectiveness of CHG-ALC and PVI in pediatric venipuncture. We applied 0.5% w/v CHG-ALC or 10% PVI as an antiseptic for phlebotomies on pediatric outpatients and inpatients with suspected bacterial infection between November 2017 and April 2019. We conducted logistic regression analysis to define the differences associated with the choice of disinfectant, collection site, and the staff member collecting the blood sample (explanatory variables) and the presence of contamination (objective variable). Based on these results, we performed propensity score matching. RESULTS The total number of specimens was 1460. The propensity score matching indicated that CHG-ALC reduced the incidence of blood culture contamination more effectively than PVI (0.4%, 2/479 cultures versus 2.5%, 12/479 cultures; relative risk, 0.163 [95% confidence interval, 0.036 to 0.733]; P = 0.012). There were no differences in the contamination rates between cultures of blood drawn from a vascular catheter and those of blood obtained percutaneously. Higher contamination rates were found when junior residents performed the venipuncture. CONCLUSIONS Compared with PVI, CHG-ALC dries rapidly with no pigmentation and has a long-lasting antiseptic effect. Overall, CHG-ALC skin preparations were more efficacious than the PVI preparations for blood sampling in children.
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Affiliation(s)
- Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-Ku, Tokyo, 152-8902, Japan.
| | - Nobuaki Mori
- Department of General Internal Medicine and Infectious Diseases, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-Ku, Tokyo, 152-8902, Japan.
| | - Masayoshi Shinjoh
- Department of Pediatrics, School of Medicine, Keio University, 35, Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Osamu Komiyama
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-Ku, Tokyo, 152-8902, Japan.
| | - Takao Takahashi
- Department of Pediatrics, School of Medicine, Keio University, 35, Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
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21
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Kimiya T, Shinjoh M, Miyata A, Takahashi T. Pertussis Epidemic in Lower-Grade Schoolchildren Without Preschool Vaccination Boosters. Indian Pediatr 2021; 58:73-74. [PMID: 33452779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We investigated the characteristics of patients with pertussis who did not receive preschool vaccination boosters. Fifteen patients with laboratory-confirmed pertussis and 29 pertussis-negative patients were compared. All pertussis-positive patients, but only 17% of pertussis-negative patients, were elementary school age and older. There is a need to study the utility of routine preschool pertussis vaccine booster in Japan.
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Affiliation(s)
- Takahisa Kimiya
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo and Saiwai Pediatric Clinic, Tachikawa-shi, Tokyo, Japan.
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Akiko Miyata
- Saiwai Pediatric Clinic, Tachikawa-shi, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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22
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Bandi R, Lathiya R, Lingappa L, Konanki R, Kimiya T, Shinjoh M, Miyata A, Takahashi T, Shah S, Kaul A, Shah R, Maddipoti S. Herbal Medicine-Induced Seizures in Children: Single-Center Experience Over 18 Months. Indian Pediatr 2021; 58:71-73. [PMID: 33452778 PMCID: PMC7840423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2024]
Abstract
Many common household herbal preparations may have seizurogenic ingredients. We report 15 children with seizures following exposure to such compounds: oral ingestion of liquid preparation in 13, and local application of balm and Eucalyptus oil ingestion in one each. All children, except one, had generalized seizures. This study highlights the need to address this history during evaluation of first seizure, and increase awareness of seizurogenic potential of such preparations.
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Affiliation(s)
- Ramya Bandi
- Department of Neurology, Rainbow Children’s Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, 500 034 India
| | - Rini Lathiya
- Department of Genetics, Rainbow Children’s Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, 500 034 India
| | - Lokesh Lingappa
- Department of Neurology, Rainbow Children’s Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, 500 034 India
| | - Ramesh Konanki
- Department of Neurology, Rainbow Children’s Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, 500 034 India
| | - Takahisa Kimiya
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Saiwai Pediatric Clinic, Tachikawa-shi, Tokyo, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Akiko Miyata
- Saiwai Pediatric Clinic, Tachikawa-shi, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Sachin Shah
- Surya Mother and Child Superspecialty Hospital, Pune, Maharashtra, 411 057 India
| | - Amita Kaul
- Surya Mother and Child Superspecialty Hospital, Pune, Maharashtra, 411 057 India
| | - Rima Shah
- Surya Mother and Child Superspecialty Hospital, Pune, Maharashtra, 411 057 India
| | - Sankeerth Maddipoti
- Surya Mother and Child Superspecialty Hospital, Pune, Maharashtra, 411 057 India
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23
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Shinjoh M, Yamaguchi Y, Furuichi M, Yaginuma M, Takahashi T, Iwata S. Recent trends in pediatric bacterial meningitis in Japan, 2016-2018 - S. agalactiae has been the most common pathogen. J Infect Chemother 2020; 26:1033-1041. [PMID: 32546331 DOI: 10.1016/j.jiac.2020.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/25/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Haemophilus influenzae type b (Hib) vaccine and pneumococcal conjugated vaccine (PCV) have been widely used since 2010 in Japan. The overall incidence of bacterial meningitis decreased thereafter. Streptococcus agalactiae has become the main organism. OBJECTIVES The purpose of the present study was to investigate the incidence rate per 1000 admissions of bacterial meningitis and the change in causative organisms in subsequent years. METHODS A cross-sectional, multicenter, non-interventional retrospective study regarding pediatric bacterial meningitis was conducted in Japan in 2019. We analyzed the epidemiological and clinical data for 2016-2018, and compared the information obtained in our previous nationwide survey database. We also investigated the risk factors for disease outcome. RESULTS In the 2016-2018 surveys, 197 patients from 153 hospitals from all prefectures were evaluated. S. agalactiae (0-3 months, 39%), Streptococcus pneumoniae (2-112 months, 20%), and E. coli (0-136 months, 13%) were the main organisms. The total number of patients hospitalized with bacterial meningitis per 1000 admissions decreased from 1.00 to 1.68 in 2000-2010 to 0.38 in 2013-2015, bu remained stable thereafter (0.35-0.40 in 2016-2018). Only one case with Neisseria meningitidis was reported. Nine cases with death were reported, including four cases with S. agalactiae. Risk factors for death and sequelae were consciousness disturbance, duration of convulsion, low CSF glucose levels, and disuse of dexamethasone (p < 0.05). CONCLUSIONS The incidence in pediatric bacterial meningitis remained low, and S. agalactiae remains the most common cause of bacterial meningitis in Japan since 2012. S. pneumoniae is the most common cause after 3 months of age.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Yoshio Yamaguchi
- Department of Clinical Research, National Hospital Organization, Tochigi Medical Center, 1-10-37 Nakatomatsuri, Utsunomiya-city, Tochigi, Japan.
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Mizuki Yaginuma
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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24
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Shinjoh M, Sugaya N, Furuichi M, Araki E, Maeda N, Isshiki K, Ohnishi T, Nakamura S, Yamada G, Narabayashi A, Nishida M, Taguchi N, Nakata Y, Yoshida M, Tsunematsu K, Shibata M, Munenaga T, Hirano Y, Ookawara I, Sekiguchi S, Kobayashi Y, Yamaguchi Y, Yoshida N, Mitamura K, Takahashi T. Effectiveness of inactivated influenza vaccine in children by vaccine dose, 2013-18. Vaccine 2019; 37:4047-4054. [PMID: 31186191 DOI: 10.1016/j.vaccine.2019.05.090] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 02/01/2019] [Revised: 05/19/2019] [Accepted: 05/31/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES We assessed the vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) by vaccine dose in children aged 6 months to 12 years for whom two doses are recommended in Japan to ascertain the appropriate vaccine doses. METHODS VE was assessed according to a test-negative case-control design based on rapid influenza diagnostic test (RIDT) results. Children aged 6 months to 12 years with a fever ≥38 °C who had received an RIDT in outpatient clinics of 24 hospitals were enrolled for all five seasons since 2013/14. VE by vaccine dose (none vs. once or twice, and once vs. twice) was analyzed. RESULTS In the dose analysis, 20,033 children were enrolled. Both one- and two-dose regimens significantly reduced cases in preventing any influenza, influenza A, and influenza B, but there was no significant difference in adjusted VE between one- and two-dose regimens overall (adjusted OR, 0.560 [95% CI, 0.505-0.621], 0.550 [95% CI, 0.516-0.586]), 0.549 [95% CI, 0.517-0.583], and 1.014 [95% CI, 0.907-1.135], for none vs. once, none vs. twice, none vs. once or twice, and once vs. twice for any influenza, respectively). Both one- and two-dose regimens significantly reduced cases with any influenza and influenza A every season. Also, both regimens significantly reduced cases of any influenza, influenza A, and influenza B among children aged 1-12 years, especially among those aged 1-5 years. In the 2013/14, 2015/16, and 2016/17 seasons, however, only the two-dose regimen was significantly effective in preventing influenza B. Both one- and two-dose regimens significantly reduced cases involving hospitalization due to any influenza and influenza A. CONCLUSIONS Both one- and two-doses regimens of IIV were effective in preventing influenza for children aged 6 months to 12 years. The two-dose regimen was more effective against influenza B in some seasons.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Norio Sugaya
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, 220-0012 Kanagawa, Japan; Department of Infection Control, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, 220-0012 Kanagawa, Japan
| | - Munehiro Furuichi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Eriko Araki
- Pediatrics, Yokohama City Municipal Hospital, 56 Okazawacho, Hodogaya-ku, Yokohama-city, Kanagawa 240-8555, Japan
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-0021, Japan
| | - Kyohei Isshiki
- Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-8522, Japan
| | - Takuma Ohnishi
- Department of Pediatrics, National Hospital Organization Saitama National Hospital, 2-1 Suwa, Wako-shi, Saitama 321-0102, Japan
| | - Shoko Nakamura
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo 170-8476, Japan
| | - Go Yamada
- Pediatrics, Saiseikai Utsunomiya Hospital, #201, 3-9-11 Nishiki, Utsunomiya-shi, Tochigi 321-0967, Japan
| | - Atsushi Narabayashi
- Department of Pediatrics, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki City, Kanagawa 210-0013, Japan
| | - Mitsuhiro Nishida
- Department of Pediatrics, Shizuoka City Shimizu Hospital, 1231 Miyakami, Shimizu-ku, Shizuoka-shi, Shizuoka 424-8636, Japan
| | - Nobuhiko Taguchi
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa 220-8581, Japan
| | - Yuji Nakata
- Department of Pediatrics, Nippon Koukan Hospital, 1-2-1 Koukandori, Kawasaki, Kanagawa 210-0852, Japan
| | - Makoto Yoshida
- Department of Pediatrics, Sano Kousei General Hospital, 1728 Horigome-cho, Sano City, Tochigi 327-8511, Japan
| | - Kenichiro Tsunematsu
- Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0062, Japan
| | - Meiwa Shibata
- Division of Pediatrics, Yokohama Rosai Hospital, 3211 Kozukue-Cho, Kohoku-ku, Yokohama 222-0036, Japan
| | - Takeshi Munenaga
- Department of Pediatrics, Ota Memorial Hospital, 455-1 Oshima-chou, Ota-shi, Gumma 373-8585, Japan
| | - Yasuhiro Hirano
- Department of Pediatrics, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka-Shi, Kanagawa 254-0065, Japan
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, 8-2 Outemachi, Aoi-ku, Shizuoka 420-0853, Japan
| | - Shinichiro Sekiguchi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yasuaki Kobayashi
- Department of Pediatrics, Japanese Red Cross Ashikaga Hospital, 284-1, Yobecho, Ashikaga, Tochigi 326-0843, Japan
| | - Yoshio Yamaguchi
- Institute of Clinical Research, Department of Infection & Allergy, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomatsuri, Utsunomiya-shi, Tochigi 320-8580, Japan
| | - Naoko Yoshida
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, 2-23-16 Higashi-Ueno, Taito-ku, Tokyo 110-8645, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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25
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Kobayashi H, Shinjoh M, Sudo K, Kato S, Morozumi M, Koinuma G, Takahashi T, Takano Y, Tamura Y, Hasegawa N. Nosocomial infection by human bocavirus and human rhinovirus among paediatric patients with respiratory risks. J Hosp Infect 2019; 103:341-348. [PMID: 31078633 DOI: 10.1016/j.jhin.2019.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 02/08/2019] [Accepted: 05/01/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Nosocomial infections by respiratory viruses undetected by rapid tests are not often diagnosed. For paediatric patients with background diseases, nosocomial infection could be fatal. AIM To determine the relationship between developing symptoms by respiratory viruses undetectable by rapid tests and respiratory risks and to improve the management of infection control. METHODS Two episodes of nosocomial infection by human bocavirus (HBoV) and human rhinovirus (HRV) were retrospectively investigated in a tertiary hospital paediatric ward in Japan. Viruses were identified by polymerase chain reaction to determine infection control management. When viruses of the same species were detected from different patients, the virus homology was investigated. The relationship between respiratory risks and developing symptoms was statistically investigated. FINDINGS Three and four patients with respiratory risks in the HBoV and HRV outbreaks, respectively, developed respiratory symptoms. The nucleotide sequences of two patients in the HBoV outbreak and all four patients in the HRV outbreak were phylogenetically close. In both outbreaks, the patients with respiratory risks developed significantly more symptoms than those without any risk (P = 0.035 and 0.018, respectively). After the patients with respiratory infection were separated from those with respiratory risks, no additional nosocomial infection occurred. CONCLUSION Patients with respiratory risks easily develop respiratory symptoms and acquire severe symptoms of nosocomial infection by those viruses. In a paediatric ward, we should adopt not only standard precautions but also isolation management of the patients with respiratory symptoms, even if they have negative results in rapid tests.
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Affiliation(s)
- H Kobayashi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan; Division of Pulmonology, National Center for Child Health and Development, Tokyo, Japan
| | - M Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan; Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan.
| | - K Sudo
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo, Japan
| | - S Kato
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo, Japan
| | - M Morozumi
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - G Koinuma
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan; Division of Pulmonology, National Center for Child Health and Development, Tokyo, Japan
| | - T Takahashi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Y Takano
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - Y Tamura
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - N Hasegawa
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
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26
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Koinuma G, Shinjoh M, Kageyama T, Nakazawa M, Kamimaki I. Round pneumonia due to Chlamydia pneumoniae in a child. Radiol Case Rep 2019; 14:436-438. [PMID: 30701012 PMCID: PMC6348194 DOI: 10.1016/j.radcr.2019.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/08/2019] [Accepted: 01/13/2019] [Indexed: 11/25/2022] Open
Abstract
Round pneumonia is a disease commonly recognized in the pediatric age group, especially under the age of 8 years. Streptococcus pneumoniae is the most common agent causing this characteristic type of pneumonia. We herein report a case of a 6-year-old boy with only mild cough and low-grade fever who was then diagnosed with round pneumonia due to Chlamydia pneumoniae. He had multiple round opacities in the right lower lung field, and the symptoms subsided soon after oral administration of antibiotics.
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27
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Shinjoh M, Sugaya N, Yamaguchi Y, Iibuchi N, Kamimaki I, Goto A, Kobayashi H, Kobayashi Y, Shibata M, Tamaoka S, Nakata Y, Narabayashi A, Nishida M, Hirano Y, Munenaga T, Morita K, Mitamura K, Takahashi T. Inactivated influenza vaccine effectiveness and an analysis of repeated vaccination for children during the 2016/17 season. Vaccine 2018; 36:5510-5518. [DOI: 10.1016/j.vaccine.2018.07.065] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/26/2018] [Accepted: 07/25/2018] [Indexed: 01/13/2023]
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Kimiya T, Shinjoh M, Anzo M, Takahashi H, Sekiguchi S, Sugaya N, Takahashi T. Effectiveness of inactivated quadrivalent influenza vaccine in the 2015/2016 season as assessed in both a test-negative case-control study design and a traditional case-control study design. Eur J Pediatr 2018; 177:1009-1017. [PMID: 29680993 DOI: 10.1007/s00431-018-3145-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/09/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022]
Abstract
UNLABELLED Both traditional case-control studies (TCCSs) and test-negative case-control studies (TNCCSs) are commonly used to assess influenza vaccine effectiveness (VE). To compensate for the fact that observational studies are susceptible to bias, we combined both methods to assess VE in one geographical area during the 2015/2016 season, when influenza A (H1N1)pdm was dominant. Our TNCCS covered 331 children aged 6 months to 15 years who visited our hospital with fever, including 182 with influenza, and our TCCS covered 812 pediatric outpatients aged 6 months to 15 years, including 214 with influenza. Influenza infection and vaccination history were reviewed, and VE was calculated as (1 - odds ratio) × 100. In the TNCCS, VE against influenza A was 68% (95% CI 47-81) overall, and 70% (48-83) for those given two doses; against influenza B, VE was 37% (- 12-64) overall and 49% (2-74) for two doses. In the TCCS, VE against influenza A was 44% (15-63) overall and 44% (13-64) for two doses, and VE against influenza B was 24% (- 19-52) overall and 41% (3-64) for two doses. CONCLUSION Both studies confirmed significant VE against influenza A, significant two-dose VE against influenza B, and better two-dose VE than one-dose VE. What is Known: • Influenza vaccine effectiveness (VE) varies from year to year. • Observational studies are conventionally used for VE assessment. However, they are inherently susceptible to bias and confounding. What is New: • This is the first report of influenza VE assessment using more than one observational study and performed in a specific area during the same season. • VE estimates obtained in our traditional case-control study were lower than those in our test-negative case-control study, but both studies found significant VE against influenza.
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Affiliation(s)
- Takahisa Kimiya
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan.
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Makoto Anzo
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan
| | - Hiroki Takahashi
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan
| | - Shinichiro Sekiguchi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Norio Sugaya
- Department of Pediatrics, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
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29
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Ohnishi T, Shinjoh M, Ohara H, Kawai T, Kamimaki I, Mizushima R, Kamada K, Itakura Y, Iguchi S, Uzawa Y, Yoshida A, Kikuchi K. Purulent lymphadenitis caused by Staphylococcus argenteus, representing the first Japanese case of Staphylococcus argenteus (multilocus sequence type 2250) infection in a 12-year-old boy. J Infect Chemother 2018; 24:925-927. [PMID: 29709375 DOI: 10.1016/j.jiac.2018.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 02/12/2018] [Revised: 03/26/2018] [Accepted: 03/30/2018] [Indexed: 10/17/2022]
Abstract
Staphylococcus argenteus is a novel species separated from a strain of coagulase-positive, non-pigmented S. aureus. Although S. argenteus has been reported to occur globally, multilocus sequence type (ST) 2250 is mainly found in Northeastern Thailand. Because conventional biochemical testing misidentifies this pathogen as S. aureus, multilocus sequence typing (MLST) or nucA sequencing is recommended to distinguish between S. argenteus and S. auereus. The patient was a previously healthy 12-year-old boy who was admitted because of right inguinal lymphadenitis and cellulitis. Although intravenous cefazolin was administered, his lymphadenitis worsened and formed an abscess on day 6 of hospitalization. Incision and drainage were performed on day 7 of hospitalization. Cefazolin was changed to oral cefaclor, and the patient was successfully treated over a period of 5 weeks. No recurrence was observed throughout 12-months of follow-up. He had a history of right axillary lymph node abscess 2 months before this admission, which was successfully treated with incision, drainage, and antibiotic therapy. He has lived in Japan since birth and never traveled abroad. He had no opportunity to interact with foreigners. His immune function, especially neutrophil function, was tested and we did not find any dysfunction. First, methicillin-sensitive S. aureus was misidentified from the abscess culture. Subsequently, the causative agent was re-identified as S. argenteus ST2250 based on MLST. To our knowledge, this is the first case of S. argenteus ST2250 infection in Japan. This pathogen should be taken into consideration in the diagnosis if the patient has atypical non-pigmented S. aureus.
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Affiliation(s)
- Takuma Ohnishi
- Department of Pediatrics, National Hospital Organization Saitama National Hospital, 2-1 Suwa, Wako-shi, Saitama, 321-0102, Japan.
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Hirotoshi Ohara
- Department of Plastic Surgery, National Hospital Organization Saitama National Hospital, 2-1 Suwa, Wako-shi, Saitama, 321-0102, Japan.
| | - Toshinao Kawai
- Division of Immunology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Isamu Kamimaki
- Department of Pediatrics, National Hospital Organization Saitama National Hospital, 2-1 Suwa, Wako-shi, Saitama, 321-0102, Japan.
| | - Ryo Mizushima
- Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Keisuke Kamada
- Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Yasutomo Itakura
- Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Shigekazu Iguchi
- Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Yutaka Uzawa
- Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Atsushi Yoshida
- Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Ken Kikuchi
- Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
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Sugaya N, Shinjoh M, Nakata Y, Tsunematsu K, Yamaguchi Y, Komiyama O, Takahashi H, Mitamura K, Narabayashi A, Takahashi T. Three-season effectiveness of inactivated influenza vaccine in preventing influenza illness and hospitalization in children in Japan, 2013–2016. Vaccine 2018; 36:1063-1071. [DOI: 10.1016/j.vaccine.2018.01.024] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 12/27/2017] [Accepted: 01/10/2018] [Indexed: 11/28/2022]
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Shinjoh M, Sakiyama Y, Sekiguchi S, Takahashi T. Successful discontinuation of immunoglobulin G replacement at age 10 in a patient with immunoglobulin G2 deficiency. SAGE Open Med Case Rep 2017; 5:2050313X17736421. [PMID: 29051818 PMCID: PMC5639965 DOI: 10.1177/2050313x17736421] [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: 08/16/2016] [Accepted: 09/18/2016] [Indexed: 11/15/2022] Open
Abstract
CONTEXT Immunoglobulin G2 deficiency that persists beyond the age of 6 years is likely to be permanent. CASE REPORT We report on a young Japanese female, diagnosed as having immunoglobulin G2 deficiency and low anti-pneumococcal immunoglobulin G2 antibody levels when 3 years old, with a subsequent medical history of frequent respiratory infections and asthma. Monthly intravenous immunoglobulin replacement therapy was started at 4 years of age. After 8 years of age, an anti-pneumococcal immunoglobulin G2 trough level could be maintained with administration intervals longer than 6 weeks, and after 9 years and 10 months of age, therapy was discontinued. The frequency of hospital admissions was reduced by the introduction of the replacement therapy (from 8.4 times/year before the introduction to 1.1 times/year during the therapy). The patient was also able to discontinue daily medications for asthma, and serum immunoglobulin G2 was maintained at a normal level even after the cessation of replacement therapy. CONCLUSION Termination of immunoglobulin replacement therapy in a patient with a symptomatic immunoglobulin G2 deficiency is possible, even for a child older than 6 years.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | | | | | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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Sugaya N, Shinjoh M, Kawakami C, Yamaguchi Y, Yoshida M, Baba H, Ishikawa M, Kono M, Sekiguchi S, Kimiya T, Mitamura K, Fujino M, Komiyama O, Yoshida N, Tsunematsu K, Narabayashi A, Nakata Y, Sato A, Taguchi N, Fujita H, Toki M, Myokai M, Ookawara I, Takahashi T. Trivalent inactivated influenza vaccine effective against influenza A(H3N2) variant viruses in children during the 2014/15 season, Japan. ACTA ACUST UNITED AC 2016; 21:30377. [PMID: 27784529 PMCID: PMC5291153 DOI: 10.2807/1560-7917.es.2016.21.42.30377] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 12/29/2015] [Accepted: 06/25/2016] [Indexed: 11/29/2022]
Abstract
The 2014/15 influenza season in Japan was characterised by predominant influenza A(H3N2) activity; 99% of influenza A viruses detected were A(H3N2). Subclade 3C.2a viruses were the major epidemic A(H3N2) viruses, and were genetically distinct from A/New York/39/2012(H3N2) of 2014/15 vaccine strain in Japan, which was classified as clade 3C.1. We assessed vaccine effectiveness (VE) of inactivated influenza vaccine (IIV) in children aged 6 months to 15 years by test-negative case–control design based on influenza rapid diagnostic test. Between November 2014 and March 2015, a total of 3,752 children were enrolled: 1,633 tested positive for influenza A and 42 for influenza B, and 2,077 tested negative. Adjusted VE was 38% (95% confidence intervals (CI): 28 to 46) against influenza virus infection overall, 37% (95% CI: 27 to 45) against influenza A, and 47% (95% CI: -2 to 73) against influenza B. However, IIV was not statistically significantly effective against influenza A in infants aged 6 to 11 months or adolescents aged 13 to 15 years. VE in preventing hospitalisation for influenza A infection was 55% (95% CI: 42 to 64). Trivalent IIV that included A/New York/39/2012(H3N2) was effective against drifted influenza A(H3N2) virus, although vaccine mismatch resulted in low VE.
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Hosoda A, Gatayama R, Moriyama S, Ishii N, Yamada K, Matsuzaki Y, Shinjoh M. The first case of recurrent ultra late onset group B streptococcal sepsis in a 3-year-old child. IDCases 2016; 7:16-18. [PMID: 27920985 PMCID: PMC5133645 DOI: 10.1016/j.idcr.2016.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/11/2016] [Accepted: 11/11/2016] [Indexed: 12/29/2022] Open
Abstract
Group B streptococcus (GBS) is a commonly recognized cause of sepsis and meningitis in neonatal and young infants. Invasive GBS infection is classified into early onset GBS disease (EOD, day 0-6), late onset GBS disease (LOD, day 7-89) and ultra late onset GBS disease (ULOD, after 3 months of age). ULOD is uncommon and recurrence is especially rare. We present the first recurrent case of ULOD GBS sepsis in 3-year-old girl with a past medical history of hydrops fetalis and thoracic congenital lymphatic dysplasia. The first episode presented as sepsis at 2 years 8 months of age. The second episode occurred as sepsis with encephalopathy at 3 years 1 months of age. During each episode, the patient was treated using intravenous antimicrobials and her condition improved. Serotype examination was not performed in the first episode, but GBS type V was serotyped in the second episode. ULOD over 1 year of age is quite rare and may recur.
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Affiliation(s)
- Ai Hosoda
- Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan; Department of Pediatrics, Sano Kousei General Hospital, Tochigi, Japan
| | - Ryohei Gatayama
- Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan
| | - Shiori Moriyama
- Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan
| | - Noriyuki Ishii
- Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan
| | - Kenichiro Yamada
- Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan
| | - Youhei Matsuzaki
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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Fujita H, Shinjoh M, Ishii T, Awazu M. Utility of fractional excretion of urea in the differential diagnosis of acute kidney injury in children. Pediatr Nephrol 2016; 31:1349-53. [PMID: 26993815 DOI: 10.1007/s00467-016-3366-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/03/2016] [Accepted: 03/03/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The fractional excretion of sodium (FENa) has been used as an index for the differential diagnosis of acute tubular necrosis (ATN) and prerenal acute kidney injury (AKI). The reliability of this index, however, decreases with the use of the diuretic agent furosemide. The fractional excretion of urea nitrogen (FEUN) has been shown to be useful in such settings in adults. The objective of this study was to examine whether FEUN is also useful in these settings in children. METHODS We assessed 102 episodes of AKI in 74 children, classifying these into three groups based on history, physical examination, urine examination and subsequent clinical course: (1) prerenal AKI without furosemide (N = 37), (2) prerenal AKI with furosemide (N = 32) and (3) ATN (N = 33). RESULTS Of the 37 prerenal AKI episodes without furosemide, 35 showed low FENa of <1 %, with an overall average of 0.35 ± 0.11 %, whereas prerenal AKI with furosemide (1.63 ± 0.37 %) and ATN (8.76 ± 2.11 %) were associated with a higher FENa. FEUN in the clinical setting of prerenal AKI was lower than that in ATN (27.9 ± 2.1 vs. 51.6 ± 3.8 %, respectively) and, in contrast to FENa, not significantly different between the categories of prerenal AKI with and without furosemide (29.2 ± 3.1 vs. 25.1 ± 2.9, respectively). The sensitivity of FEUN <35 % was 75 % in prerenal AKI with furosemide, whereas that of FENa was 53 %. CONCLUSIONS FEUN is useful in detecting prerenal AKI in children administered furosemide.
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Affiliation(s)
- Hisayo Fujita
- Department of Pediatrics, Hiratsuka Kyosai Hospital, Kanagawa, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomohiro Ishii
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Midori Awazu
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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35
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Tetsuka N, Tomita K, Matsumura K, Shinjoh M, Kimura T, Ispas G, Ito K, Mizuguchi K, Funaki T, Furuichi M, Nakagawa H, Rusch S, Lounis N, Houtmeyers E, Bollekens J, Shishido A, Nakayama Y, Goto S, Takahashi T, Sugaya N, Miyairi I. Respiratory Syncytial Virus Kinetics and Medical Resources Utilization in Hospitalized Infants and Children in Japan. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shinjoh M, Sugaya N, Yamaguchi Y, Tomidokoro Y, Sekiguchi S, Mitamura K, Fujino M, Shiro H, Komiyama O, Taguchi N, Nakata Y, Yoshida N, Narabayashi A, Myokai M, Sato M, Furuichi M, Baba H, Fujita H, Sato A, Ookawara I, Tsunematsu K, Yoshida M, Kono M, Tanaka F, Kawakami C, Kimiya T, Takahashi T, Iwata S. Effectiveness of Trivalent Inactivated Influenza Vaccine in Children Estimated by a Test-Negative Case-Control Design Study Based on Influenza Rapid Diagnostic Test Results. PLoS One 2015; 10:e0136539. [PMID: 26317334 PMCID: PMC4552891 DOI: 10.1371/journal.pone.0136539] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [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: 02/03/2015] [Accepted: 08/05/2015] [Indexed: 01/20/2023] Open
Abstract
We assessed vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza in children 6 months to 15 years of age in 22 hospitals in Japan during the 2013-14 season. Our study was conducted according to a test-negative case-control design based on influenza rapid diagnostic test (IRDT) results. Outpatients who came to our clinics with a fever of 38 °C or over and had undergone an IRDT were enrolled in this study. Patients with positive IRDT results were recorded as cases, and patients with negative results were recorded as controls. Between November 2013 and March 2014, a total of 4727 pediatric patients (6 months to 15 years of age) were enrolled: 876 were positive for influenza A, 66 for A(H1N1)pdm09 and in the other 810 the subtype was unknown; 1405 were positive for influenza B; and 2445 were negative for influenza. Overall VE was 46% (95% confidence interval [CI], 39-52). Adjusted VE against influenza A, influenza A(H1N1)pdm09, and influenza B was 63% (95% CI, 56-69), 77% (95% CI, 59-87), and 26% (95% CI, 14-36), respectively. Influenza vaccine was not effective against either influenza A or influenza B in infants 6 to 11 months of age. Two doses of influenza vaccine provided better protection against influenza A infection than a single dose did. VE against hospitalization influenza A infection was 76%. Influenza vaccine was effective against influenza A, especially against influenza A(H1N1)pdm09, but was much less effective against influenza B.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Norio Sugaya
- Department of Paediatrics, Keiyu Hospital, Yokohama, Kanagawa, Japan
- * E-mail:
| | - Yoshio Yamaguchi
- Department of Clinical Research, National Hospital Organization, Utsunomiya, Tochigi Medical Center, Tochigi, Japan
| | - Yuka Tomidokoro
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, Toshima-ku, Tokyo, Japan
| | - Shinichiro Sekiguchi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Keiko Mitamura
- Department of Pediatrics, Eiju General Hospital, Taito-ku, Tokyo, Japan
| | - Motoko Fujino
- Department of Pediatrics, Saiseikai Central Hospital, Minato-ku, Tokyo, Japan
| | - Hiroyuki Shiro
- Department of Pediatrics, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Osamu Komiyama
- Department of Pediatrics, National Hospital Organization, Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Nobuhiko Taguchi
- Department of Paediatrics, Keiyu Hospital, Yokohama, Kanagawa, Japan
| | - Yuji Nakata
- Department of Pediatrics, Nippon Kokan Hospital, Kawasaki, Kanagawa, Japan
| | - Naoko Yoshida
- Department of Pediatrics, Kyosai Tachikawa Hospital, Tachikawa, Tokyo, Japan
| | - Atsushi Narabayashi
- Department of Paediatrics, Kawasaki Municipal Hospital, Kawasaki, Kanagawa, Japan
| | - Michiko Myokai
- Department of Pediatrics, Shizuoka City Shimizu Hospital, Shizuoka, Shizuoka, Japan
| | - Masanori Sato
- Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan
| | - Munehiro Furuichi
- Department of Pediatrics, Saitama City Hospital, Saitama, Saitama, Japan
| | - Hiroaki Baba
- Department of Pediatrics, Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital, Ota, Gunma, Japan
| | - Hisayo Fujita
- Department of Pediatrics, Hiratsuka Kyosai Hospital, Hiratsuka, Kanagawa, Japan
| | - Akihiro Sato
- Department of Pediatrics, Yokohama Municipal Citizen's hospital, Yokohama, Kanagawa, Japan
| | - Ichiro Ookawara
- Department of Pediatrics, Japanese Red Cross Shizuoka Hospital, Shizuoka, Shizuoka, Japan
| | | | - Makoto Yoshida
- Department of Pediatrics, Sano Kousei General Hospital, Sano, Tochigi, Japan
| | - Mio Kono
- Department of Pediatrics, National Hospital Organization Saitama National Hospital, Wako, Saitama, Japan
| | - Fumie Tanaka
- Department of Pediatrics, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan
| | | | - Takahisa Kimiya
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, Toshima-ku, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Satoshi Iwata
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department of Infectious Diseases, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Takahashi N, Shinjoh M, Tomita H, Fujino A, Sugita K, Katohno Y, Kuroda T, Kikuchi K. Catheter-related blood stream infection caused by Dermacoccus barathri, representing the first case of Dermacoccus infection in humans. J Infect Chemother 2015; 21:613-6. [PMID: 26044303 DOI: 10.1016/j.jiac.2015.04.007] [Citation(s) in RCA: 11] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 04/09/2015] [Accepted: 04/10/2015] [Indexed: 11/18/2022]
Abstract
A 7-year-old boy undergoing home parenteral nutrition with totally implantable central venous access device for chronic intestinal pseudo-obstruction experienced repeated episodes of fever with a temperature above 39.0 °C despite the antibiotic treatment. The fever was considered to be catheter-related blood stream infections, as no other etiology could be justified. Repeated blood culture tests revealed negative after 1-week incubation, whereas some samples of blood collected from the central venous catheter yielded positive and gram-positive rods were detected. These bacteria were detected repeatedly, then the central venous access device was removed with consideration for the possibility of this bacteria being a pathogen. Thereafter, the fever did not recur and the blood culture tests were negative. The causative agent was identified as Dermacoccus barathri based on the 16S rRNA gene sequence and phylogenetic analysis of 6118-bp concatenated sequences of 4 housekeeping genes. Genus Dermacoccus are one form of Actinomycetes isolated from human skin and water, but human infection with Dermacoccus spp. has not been previously reported and the pathogenicity of the bacteria remains unclear. To our knowledge, this is the first reported case of Dermacoccus infection in humans.
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Affiliation(s)
- Nobuhiro Takahashi
- Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Hirofumi Tomita
- Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Akihiro Fujino
- Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kayoko Sugita
- Center for Infectious Diseases and Infection Control, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yasuhiro Katohno
- Central Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Ken Kikuchi
- Department of Infection Control Science, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
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Shoji K, Shinjoh M, Horikoshi Y, Tang J, Watanabe Y, Sugita K, Tame T, Iwata S, Miyairi I, Saitoh A. High rate of inducible clindamycin resistance in Staphylococcus aureus isolates--a multicenter study in Tokyo, Japan. J Infect Chemother 2014; 21:81-3. [PMID: 25454215 DOI: 10.1016/j.jiac.2014.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 09/15/2014] [Accepted: 10/01/2014] [Indexed: 11/25/2022]
Abstract
The resistance of Staphylococcus aureus (S. aureus) to antibiotics is an increasing problem. Clindamycin has been used as empiric therapy for the rising incidence of community-acquired methicillin-resistant S. aureus (MRSA). As such, the local rate of inducible resistance against clindamycin is an important consideration. This multicenter study was conducted to identify the incidence of inducible clindamycin resistance of S. aureus isolates in Tokyo, the most populous city in Japan. A total of 2408 adult and pediatric samples were collected from a university hospital and two pediatric hospitals between January 2011 and December 2011. Among the 2341 samples analyzed, the incidence of inducible clindamycin resistance in erythromycin-resistant and clindamycin-susceptible/intermediate isolates was found to be 91% (n = 585), a figure much higher compared to most reports from other countries. In conclusion, we found a very high rate of inducible clindamycin resistance in macrolide-resistant S. aureus isolates in our geographic area.
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Affiliation(s)
- Kensuke Shoji
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
| | - Masayoshi Shinjoh
- Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan; Center for Infectious Diseases and Infection Control, School of Medicine, Keio University, Tokyo, Japan
| | - Yuho Horikoshi
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Julian Tang
- Department of Education for Clinical Research, National Center for Child Health and Development, Japan
| | - Yasushi Watanabe
- Division of Microbiology, Department of Clinical Laboratory Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kayoko Sugita
- Center for Infectious Diseases and Infection Control, School of Medicine, Keio University, Tokyo, Japan
| | - Tomoyuki Tame
- Division of Microbiology, Department of Laboratory, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Satoshi Iwata
- Center for Infectious Diseases and Infection Control, School of Medicine, Keio University, Tokyo, Japan
| | - Isao Miyairi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiko Saitoh
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan; Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Yamada M, Yamazawa K, Sekiguchi S, Shinjoh M, Tomita K, Takenouchi T, Takahashi T. A Pediatric Case of Antibiotic-Associated Hemorrhagic Colitis Caused by Klebsiella Oxytoca. Glob Pediatr Health 2014; 1:2333794X14550525. [PMID: 27335905 PMCID: PMC4804693 DOI: 10.1177/2333794x14550525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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40
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Mori T, Hasegawa N, Sugita K, Shinjoh M, Nakamoto N, Shimizu T, Hori S, Iketani O, Fujiwara H, Takano Y, Iwata S. Clinical features of bacteremia due to Campylobacter jejuni. Intern Med 2014; 53:1941-4. [PMID: 25175126 DOI: 10.2169/internalmedicine.53.2559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The clinical features of bacteremia due to Campylobacter jejuni (C. jejuni) have yet to be fully elucidated. METHODS AND RESULTS The cases of C. jejuni bacteremia were retrospectively reviewed during a twelve-year period in a single institute. C. jejuni was identified in 7 patients through blood cultures, and disease onset occurred between June and October. Except for 2 previously healthy individuals, 5 patients had underlying diseases (chronic liver diseases, n=3; hematological malignancies, n=2). All patients were febrile, but 2 patients did not present with gastrointestinal symptoms. C. jejuni isolates were susceptible to gentamicin and macrolides, but about half of them were resistant to fluoroquinolones. Disease outcomes were favorable, and no deaths related to C. jejuni bacteremia were observed. CONCLUSION These results suggest that C. jejuni bacteremia could occur primarily or secondarily to gastroenteritis with a seasonal peak and that prognosis would be favorable regardless of the underlying diseases.
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Affiliation(s)
- Takehiko Mori
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Japan
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Shoji K, Shinjoh M, Horikoshi Y, Sugita K, Iwata S, Tame T, Watanabe Y, Miyairi I, Saitoh A. P122 A high rate of inducible resistance against clindamycin in Staphylococcus aureus isolates in children: A multicenter study in Japan. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70366-2] [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: 11/28/2022]
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Kimiya T, Yagihashi T, Shinjoh M, Kai A, Sato Y. Presence of Epstein-Barr virus in cerebrospinal fluid from patients with aseptic meningitis appears to be common. Infection 2013; 41:1045-6. [PMID: 23435718 DOI: 10.1007/s15010-013-0420-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 02/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- T Kimiya
- Department of Pediatrics, Tokyo Metropolitan Ohtsuka Hospital, 2-8-1 Minamiohtsuka, Toshima-ku, Tokyo, 170-8476, Japan,
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Shinjoh M. [Infectious diseases: progress in diagnosis and treatment. Topics: II. Measures to prevent the outbreaks; 1. Changes in medical care for influenza: before and after the H1N1 pandemic]. ACTA ACUST UNITED AC 2012; 101:3114-22. [PMID: 23342582 DOI: 10.2169/naika.101.3114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, School of Medicine, Keio University, Japan
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Shinjoh M, Iketani O, Watanabe K, Shimojima N, Kudo M, Yamagishi H, Shimada H, Sugita K, Takahashi T, Mori T, Hasegawa N, Iwata S. Safety and efficacy of linezolid in 16 infants and children in Japan. J Infect Chemother 2012; 18:591-6. [PMID: 22460827 DOI: 10.1007/s10156-012-0405-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 02/29/2012] [Indexed: 11/25/2022]
Abstract
Linezolid, an oxazolidinone antibiotic, exhibits a broad spectrum of activity against Gram-positive bacteria. It has been licensed for adult use in Japan since 2006 for MRSA infections, and has also been used off-label for pediatric patients. At our university hospital, a total of 16 infants and children (including one non-Japanese Asian) were administered linezolid owing to infection with multidrug-resistant Gram-positive bacteria, after consent had been provided. All patients had severe underlying diseases or indications for surgery. Eighty-eight percent of the causal microorganisms were methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant coagulase-negative Staphylococcus and all were sensitive to linezolid. Linezolid was administered because the antecedent anti-MRSA medications were ineffective or contraindicated, or intravenous-to-oral switch therapy was requested owing to cardiac or orthopedic surgical-site infections. The median duration of administration was 13 days (range 3-31 days). The overall efficacy was 91 % (10/11) in those for whom efficacy could be evaluated. Only two patients (both teen-aged) encountered linezolid-related adverse effects (13 %, 2/16). One patient showed elevation of liver enzymes (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]), requiring that administration be withdrawn, but enzyme levels returned to normal after the patient had been switched to vancomycin. The other patient showed transiently decreased platelet counts. Linezolid is considered generally safe and effective for children in Japan, especially for those who cannot use other anti-MRSA medications or those who require oral antibiotics for infections with multidrug-resistant Gram-positive bacteria.
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Affiliation(s)
- Masayoshi Shinjoh
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan.
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Charu V, Viboud C, Simonsen L, Sturm-Ramirez K, Shinjoh M, Chowell G, Miller M, Sugaya N. Influenza-related mortality trends in Japanese and American seniors: evidence for the indirect mortality benefits of vaccinating schoolchildren. PLoS One 2011; 6:e26282. [PMID: 22087226 PMCID: PMC3210121 DOI: 10.1371/journal.pone.0026282] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [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: 07/06/2011] [Accepted: 09/23/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The historical Japanese influenza vaccination program targeted at schoolchildren provides a unique opportunity to evaluate the indirect benefits of vaccinating high-transmitter groups to mitigate disease burden among seniors. Here we characterize the indirect mortality benefits of vaccinating schoolchildren based on data from Japan and the US. METHODS We compared age-specific influenza-related excess mortality rates in Japanese seniors aged ≥65 years during the schoolchildren vaccination program (1978-1994) and after the program was discontinued (1995-2006). Indirect vaccine benefits were adjusted for demographic changes, socioeconomics and dominant influenza subtype; US mortality data were used as a control. RESULTS We estimate that the schoolchildren vaccination program conferred a 36% adjusted mortality reduction among Japanese seniors (95%CI: 17-51%), corresponding to ∼1,000 senior deaths averted by vaccination annually (95%CI: 400-1,800). In contrast, influenza-related mortality did not change among US seniors, despite increasing vaccine coverage in this population. CONCLUSIONS The Japanese schoolchildren vaccination program was associated with substantial indirect mortality benefits in seniors.
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Affiliation(s)
- Vivek Charu
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan.
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Shinjoh M, Takahashi T. Varicella zoster exposure on paediatric wards between 2000 and 2007: safe and effective post-exposure prophylaxis with oral aciclovir. J Hosp Infect 2009; 72:163-8. [DOI: 10.1016/j.jhin.2009.01.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Accepted: 01/16/2009] [Indexed: 11/28/2022]
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Shinjoh M, Miyairi I, Hoshino K, Takahashi T, Nakayama T. Effective and safe immunizations with live-attenuated vaccines for children after living donor liver transplantation. Vaccine 2008; 26:6859-63. [PMID: 18930096 DOI: 10.1016/j.vaccine.2008.09.076] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 08/19/2008] [Accepted: 09/27/2008] [Indexed: 01/26/2023]
Abstract
Immunizations using live-attenuated vaccines are not recommended for post-liver transplant children due to its theoretical risks. However, they will encounter vaccine-preventable viral diseases upon returning to real-life situations. We performed a total of 70 immunizations with four individual live-attenuated vaccines to 18 pediatric post-living donor liver transplant (LDLT) recipients who fulfilled a clinical criteria including humoral and cell-mediated immunity. The seroconversion rates at the first dose for measles (strain AIK-C), rubella (strain TO-336), varicella (strain Oka), and mumps (strains Hoshino) were 100% (15/15), 100% (15/15), 82% (9/11), and 82% (9/11), respectively. During observed period (-5 years 11 months), a few cases with waning immunity (antibodies were once produced but the levels fell over time) were seen except after rubella immunization. Clinical diseases after seroconversion or definite serious adverse effects due to immunization were not observed. Immunizations using selected live-attenuated vaccines were safe and effective for post-LDLT children who were not severely immunosuppressed.
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Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, School of Medicine, Keio University, Shinjuku-ku, Tokyo 160-8582, Japan.
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Shinjoh M, Miyairi I, Sakurai M, Takahashi M, Ariyasu D, Nakayama T, Tokumura M, Yamashita R, Sunakawa K, Takahashi T. Cryptococcal meningitis in an immunocompetent child. Eur J Pediatr 2005; 164:596-7. [PMID: 15959803 DOI: 10.1007/s00431-005-1708-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 01/24/2005] [Accepted: 04/29/2005] [Indexed: 10/25/2022]
Affiliation(s)
- Masayoshi Shinjoh
- Department of Pediatrics, School of Medicine, Keio University, 35 Shinanomachi, 160-8582 Shinjuku-ku, Tokyo, Japan.
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Shinjoh M, Sato S, Sugaya N, Mitamura K, Takeuchi Y, Kosaki K, Takahashi T. [Effect of post-exposure prophylaxis with oseltamivir for those in contacts with influenza patients in pediatric wards]. ACTA ACUST UNITED AC 2004; 78:262-9. [PMID: 15103909 DOI: 10.11150/kansenshogakuzasshi1970.78.262] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
During the influenza season, outbreaks of influenza may occur in the pediatric wards due to spread from the patients hospitalized with influenza, or from those hospitalized during the latency period and develop influenza afterwards. Post-exposure prophylaxis with neuraminidase inhibitors has been reported to be effective in preventing outbreaks among household members and nursing home residents. However, for nosocomial spread, its effectiveness and possible adverse effects are to be determined. During the 2002/2003 influenza season, we experienced a total of 3 nosocomial outbreaks of influenza in the pediatric wards in two hospitals in the Kanto district, Japan. Since the number of contacts who developed influenza had been increasing despite the isolation precaution implemented, post-exposure prophylaxis with oseltamivir (2 mg/kg/dose, maximum 75 mg/dose, once a day for 7-10 days) was implemented with a permission from the parents to terminate the outbreaks. In the outbreaks (one with influenza A, two with influenza B), a total of 29 inpatients had contact with influenza patients: among those 29, 13 were given post-exposure prophylaxis, 16 were not. Out of 16 patients who did not receive post-exposure prophylaxis, 11 (69%) developed influenza: out of 13 with post-exposure prophylaxis, none developed influenza. Those patients who developed influenza were given oseltamivir (2 mg/kg/dose, maximum 75 mg/dose, twice a day for 5 days) and accommodated in a private room or a room with other patients with influenza of the same type. No significant adverse effects due to oseltamivir were observed among those who were enrolled in this study.
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