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Iwata S, Kobayashi O, Kurashima K, Doi Y, Kunishima H, Shinkai M, Tsushima K, Yamato M, Kano A, Hibino M, Yamatake T, Sakurai T, Ogura T. Findings from a discontinued clinical trial of favipiravir in high-risk patients with early-onset COVID-19. J Infect Chemother 2024; 30:219-227. [PMID: 37832822 DOI: 10.1016/j.jiac.2023.10.010] [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: 05/30/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION Favipiravir terminates severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication. Accordingly, early administration of favipiravir to SARS-CoV-2-infected coronavirus disease 2019 (COVID-19) patients may be expected to suppress disease progression. METHODS A randomized double-blind placebo-controlled trial was conducted to demonstrate efficacy of favipiravir in reducing disease progression in patients with mild COVID-19. The participants were unvaccinated patients with comorbidities and at risk of progression to severe disease. Patients were enrolled within 72 h of disease onset and randomized to receive either favipiravir (1800 mg/dose on Day 1 followed by 800 mg/dose) or matching placebo twice daily for 10 days. The primary endpoint was the proportion of patients requiring oxygen therapy within 28 days of randomization. RESULTS The trial was discontinued after enrolling 84 patients due to slower than anticipated enrollment caused by rapid uptake of SARS-CoV-2-vaccines and the emergence of the Omicron variant. Results from the 84 patients demonstrated no significant difference in all clinical outcomes. In post-hoc analyses, favipiravir treatment showed higher efficacy in patients within 48 h of onset. No deaths or severe adverse events were documented in the favipiravir group. Plasma concentrations of favipiravir from Day 2 onward were maintained above 40 μg/mL. CONCLUSIONS Conducting clinical trials for pathogens like SARS-CoV-2 that rapidly accumulate mutations leading to altered disease characteristics carries significant risks unless it can be done in a short period. Therefore, it would be important to prepare the comprehensive clinical trial platform that can appropriately and promptly evaluate drugs even under a pandemic.
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Affiliation(s)
- Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan; Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Osamu Kobayashi
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuyoshi Kurashima
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan
| | - Yohei Doi
- Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Departments of Microbiology and Infectious Diseases, Fujita Health University School of Medicine, Aichi, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Masaharu Shinkai
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, Tokyo, Japan
| | - Kenji Tsushima
- Department of Pulmonary Medicine, International University of Health and Welfare, School of Medicine, Chiba, Japan
| | - Masaya Yamato
- Division of General Internal Medicine and Infectious Diseases, Rinku General Medical Center, Osaka, Japan
| | - Akira Kano
- Fujimino Emergency Hospital, Saitama, Japan
| | - Makoto Hibino
- Department of Respiratory Medicine, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
| | - Takahiro Yamatake
- Development Division, FUJIFILM Toyama Chemical Co., Ltd., Tokyo, Japan
| | - Tsutomu Sakurai
- Development Division, FUJIFILM Toyama Chemical Co., Ltd., Tokyo, Japan.
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
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Tanimura K, Nakajima M, Shirakawa N, Tao K, Sugiyama M, Watanabe Y, Arakawa A, Kikuchi M, Takahashi M, Narita Y, Shiotsuka M, Kobayashi O, Iwata S, Yoshida A, Abe M, Yamagoe S, Miyazaki Y, Ogawa C. Surgical site infection caused by Rhizopus caespitosus after metastasectomy for osteosarcoma: First report of infection in humans. Pediatr Blood Cancer 2023; 70:e30049. [PMID: 36317667 DOI: 10.1002/pbc.30049] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/19/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Kazuki Tanimura
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Miho Nakajima
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Nami Shirakawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kayoko Tao
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masanaka Sugiyama
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Watanabe
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ayumu Arakawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Miyu Kikuchi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Mika Shiotsuka
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Osamu Kobayashi
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiro Abe
- Department of Fungal Infection, National Institute of Infectious Diseases, Tokyo, Japan
| | - Satoshi Yamagoe
- Department of Fungal Infection, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Fungal Infection, National Institute of Infectious Diseases, Tokyo, Japan
| | - Chitose Ogawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
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Iwata S, Hanada S, Takata M, Morozumi M, Kamei S, Ubukata K. Risk factors and pathogen characteristics associated with unfavorable outcomes among adults with pneumococcal meningitis in Japan, 2006 to 2016. J Infect Chemother 2023; 29:637-645. [PMID: 36907551 DOI: 10.1016/j.jiac.2023.03.003] [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: 12/01/2022] [Revised: 02/03/2023] [Accepted: 03/04/2023] [Indexed: 03/13/2023]
Abstract
PURPOSE In this study, we aimed to clarify the risk factors associated with unfavorable outcomes in adults with pneumococcal meningitis (PnM). METHODS Surveillance was conducted between 2006 and 2016. Adults with PnM (n = 268) were followed up for outcomes within 28 days after admission using the Glasgow Outcome Scale (GOS). After classifying the patients into the unfavorable (GOS1-4) and favorable (GOS5) outcome groups, i) the underlying diseases, ii) biomarkers at admission, and iii) serotype, genotype, and antimicrobial susceptibility for all isolates were compared between both groups. RESULTS Overall, 58.6% of patients with PnM survived,15.3% died, and 26.1% had sequelae. The number of living days in the GOS1 group was highly heterogeneous. Motor dysfunction, disturbance of consciousness, and hearing loss were the commonest sequelae. Of the underlying diseases identified in 68.9% of the PnM patients, liver and kidney diseases were significantly associated with unfavorable outcomes. Of the biomarkers, creatinine and blood urea nitrogen, followed by platelet and C-reactive protein had the most significant associations with unfavorable outcomes. There was a significant difference in the high protein concentrations in the cerebrospinal fluid between the groups. Serotypes 23F, 6C, 4, 23A, 22F, 10A, and 12F were associated with unfavorable outcomes. These serotypes were not penicillin-resistant isolates possessing three abnormal pbp genes (pbp1a, 2x, and 2b), except for 23F. The expected coverage rate of the pneumococcal conjugate vaccine (PCV) was 50.7% for PCV15 and 72.4% for PCV20. CONCLUSIONS In the introduction of PCV for adults, the risk factors for underlying diseases should be prioritized over age, and serotypes with unfavorable outcomes should be considered.
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Affiliation(s)
- Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan; Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.
| | - Shigeo Hanada
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan
| | - Misako Takata
- Department of Microbiology, Tokyo Medical University, Japan
| | - Miyuki Morozumi
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Kamei
- Center for Neuro-Infections, Ageo Central General Hospital, Saitama Pref, Japan
| | - Kimiko Ubukata
- Department of Microbiology, Tokyo Medical University, Japan; Department of General Medicine, Keio University School of Medicine, Tokyo, Japan
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Sonoyama T, Iwata S, Shinkai M, Iwata-Yoshikawa N, Shiwa-Sudo N, Hemmi T, Ainai A, Nagata N, Matsunaga N, Tada Y, Homma T, Omoto S, Yokokawa Shibata R, Igarashi K, Suzuki T, Hasegawa H, Ariyasu M. Results from a preclinical study in rodents and a Phase 1/2, randomized, double-blind, placebo-controlled, parallel-group study of COVID-19 vaccine S-268019-a in Japanese adults. Vaccine 2023; 41:1834-1847. [PMID: 36572603 PMCID: PMC9755034 DOI: 10.1016/j.vaccine.2022.12.025] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND In early 2020, developing vaccines was an urgent need for preventing COVID-19 from a contingency perspective. METHODS S-268019-a is a recombinant protein-based vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), comprising a modified recombinant spike protein antigen adjuvanted with agatolimod sodium, a Toll-like receptor-9 agonist. In the preclinical phase, it was administered intramuscularly twice at a 2-week interval in 7-week-old mice. Immunogenicity was assessed, and the mice were challenged intranasally with mouse-adapted SARS-CoV-2 at 2 and 8 weeks, respectively, after the second immunization. After confirming the preclinical effect, a Phase 1/2, randomized, parallel-group clinical study was conducted in healthy adults (aged 20-64 years). All participants received 2 intramuscular injections at various combinations of the antigen and the adjuvant (S-910823/agatolimod sodium, in μg: 12.5/250, 25/250, 50/250, 25/500, 50/500, 100/500, 10/500, 100/100, 200/1000) or placebo (saline) in an equivalent volume at a 3-week interval and were followed up until Day 50 in this interim analysis. RESULTS In the preclinical studies, S-268019-a was safe and elicited robust immunoglobulin G (IgG) and neutralizing antibody responses in mice. When challenged with SARS-CoV-2, all S-268019-a-treated mice survived and maintained weight until 10 days, whereas all placebo- or adjuvant-treated (without antigen) mice died within 6 days. In the Phase 1/2 trial, although S-268019-a was well tolerated in adult participants, was safe up to Day 50, and elicited robust anti-spike protein IgG antibodies, it did not elicit sufficient neutralizing antibody levels. CONCLUSIONS The S-268019-a vaccine was not sufficiently immunogenic in Japanese adults despite robust immunogenicity and efficacy in mice. Our results exemplify the innate challenges in translating preclinical data in animals to clinical trials, and highlight the need for continued research to overcome such barriers. (jRCT2051200092).
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Affiliation(s)
- Takuhiro Sonoyama
- Shionogi & Co., Ltd., Drug Development and Regulatory Science Division, 8F, Nissay Yodoyabashi East Bldg., 3-3-13, Imabashi, Chuo-ku, Osaka 541-0042, Japan
| | - Satoshi Iwata
- National Cancer Center Hospital, Department of Infectious Diseases, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Masaharu Shinkai
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashioi, Shinagawa-ku, Tokyo 140-8522, Japan
| | - Naoko Iwata-Yoshikawa
- Department of Pathology, National Institute of Infectious Diseases, 4-7-1, Gakuen Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Nozomi Shiwa-Sudo
- Department of Pathology, National Institute of Infectious Diseases, 4-7-1, Gakuen Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Takuya Hemmi
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Akira Ainai
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Noriyo Nagata
- Department of Pathology, National Institute of Infectious Diseases, 4-7-1, Gakuen Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Yukio Tada
- Shionogi & Co., Ltd., Drug Development and Regulatory Science Division, 8F, Nissay Yodoyabashi East Bldg., 3-3-13, Imabashi, Chuo-ku, Osaka 541-0042, Japan
| | - Tomoyuki Homma
- Shionogi & Co., Ltd., Pharmaceutical Research Division, 1-1, Futaba-cho, 3-chome, Toyonaka, Osaka 561-0825, Japan
| | - Shinya Omoto
- Shionogi & Co., Ltd., Pharmaceutical Research Division, 1-1, Futaba-cho, 3-chome, Toyonaka, Osaka 561-0825, Japan
| | - Risa Yokokawa Shibata
- Shionogi & Co., Ltd., Drug Development and Regulatory Science Division, 8F, Nissay Yodoyabashi East Bldg., 3-3-13, Imabashi, Chuo-ku, Osaka 541-0042, Japan
| | - Kenji Igarashi
- Shionogi & Co., Ltd., Drug Development and Regulatory Science Division, 8F, Nissay Yodoyabashi East Bldg., 3-3-13, Imabashi, Chuo-ku, Osaka 541-0042, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Hideki Hasegawa
- Research Center for Influenza and Respiratory Virus, National Institute of Infectious Diseases, 4-7-1, Gakuen, Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Mari Ariyasu
- Shionogi & Co., Ltd., Drug Development and Regulatory Science Division, 8F, Nissay Yodoyabashi East Bldg., 3-3-13, Imabashi, Chuo-ku, Osaka 541-0042, Japan.
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Katsuta T, Aizawa Y, Shoji K, Shimizu N, Okada K, Nakano T, Kamiya H, Amo K, Ishiwada N, Iwata S, Oshiro M, Okabe N, Korematsu S, Suga S, Tsugawa T, Nishimura N, Hishiki H, Fujioka M, Hosoya M, Mizuno Y, Miyairi I, Miyazaki C, Morishima T, Yoshikawa T, Wada T, Ouchi K, Moriuchi H, Tanaka-Taya K, Saitoh A. Acute and Postacute Clinical Characteristics of Coronavirus Disease 2019 in Children in Japan. Pediatr Infect Dis J 2023; 42:240-246. [PMID: 36730047 PMCID: PMC9935236 DOI: 10.1097/inf.0000000000003792] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND The clinical features of coronavirus disease 2019 (COVID-19) in children have been changing because of the emergence and rapid spread of variants of concern (VOC). The increase in cases infected with VOC has brought concern with persistent symptoms after COVID-19 in children. This survey aimed to analyze the clinical manifestations and persistent symptoms of pediatric COVID-19 cases in Japan. METHODS We analyzed the clinical manifestations of pediatric COVID-19 cases reported between February 2020 and April 2022 in Japan, using a dedicated database updated voluntarily by the members of the Japan Pediatric Society. Using the same database, we also analyzed persistent symptoms after COVID-19 in children who were diagnosed between February 2020 and November 2021. RESULTS A total of 5411 and 1697 pediatric COVID-19 cases were included for analyzing clinical manifestations and persistent symptoms, respectively. During the Omicron variant predominant period, the percentage of patients with seizures increased to 13.4% and 7.4% in patient groups 1-4 and 5-11 years of age, respectively, compared with the pre-Delta (1.3%, 0.4%) or Delta period (3.1%, 0.0%). Persistent and present symptoms after 28 days of COVID-19 onset were reported in 55 (3.2%). CONCLUSIONS Our survey showed that the rate of symptomatic pediatric COVID-19 cases increased gradually, especially during the Omicron variant predominant period, and a certain percentage of pediatric cases had persistent symptoms. Certain percentages of pediatric COVID-19 patients had severe complications or prolonged symptoms. Further studies are needed to follow such patients.
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Affiliation(s)
- Tomohiro Katsuta
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuta Aizawa
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kensuke Shoji
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Naoki Shimizu
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kenji Okada
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Nakano
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Hajime Kamiya
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kiyoko Amo
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatric Emergency, Osaka City General Hospital, Osaka, Japan
| | - Naruhiko Ishiwada
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Infectious Diseases, Chiba University, Medical Mycology Research Center, Chiba, Japan
| | - Satoshi Iwata
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Makoto Oshiro
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Japanese Red Cross Nagoya First Hospital, Aichi, Japan
| | - Nobuhiko Okabe
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Kawasaki City Institute for Public Health, Kanagawa, Japan
| | - Seigo Korematsu
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Saitama Medical Center, Saitama, Japan
| | - Shigeru Suga
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Infectious Disease Center and Department of Clinical Research, National Hospital Organization Mie National Hospital, Mie, Japan
| | - Takeshi Tsugawa
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Naoko Nishimura
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Konan Kosei Hospital, Aichi, Japan
| | - Haruka Hishiki
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Masashi Fujioka
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Fujioka Pediatric Clinic, Osaka, Japan
| | - Mitsuaki Hosoya
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Yumi Mizuno
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatric infectious diseases and immunology, Fukuoka Children’s Hospital, Fukuoka, Japan
| | - Isao Miyairi
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Chiaki Miyazaki
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Fukuoka-city Social Welfare Agency, Fukuoka, Japan
| | - Tsuneo Morishima
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Aichi Medical University, Aichi, Japan
| | - Tetsushi Yoshikawa
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Fujita Health University School of Medicine, Aichi, Japan
| | - Taizo Wada
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Kanazawa University, Ishikawa, Japan
| | - Kazunobu Ouchi
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Hiroyuki Moriuchi
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Kanazawa University, Ishikawa, Japan
| | - Keiko Tanaka-Taya
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akihiko Saitoh
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Kawai A, Iwata S, Shimoi T, Kobayashi E, Ogura K, Yoshida A, Okuma H, Goto Y, Morizane C, Yoshida Y, Katoh Y, Yatabe Y, Yonemori K, Nakamura K, Nishida T, Higashi T. 126P Comprehensive efforts to address multifaceted issues of rare cancers and sarcomas in Japan. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101072] [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: 04/05/2023] Open
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Fukuda A, Yoshida T, Yagishita S, Shiotsuka M, Kobayashi O, Iwata S, Umeguchi H, Yanagida M, Irino Y, Masuda K, Shinno Y, Okuma Y, Goto Y, Horinouchi H, Hamada A, Yamamoto N, Ohe Y. Real-world Data on the Incidence of Coronavirus Disease (COVID-19) in Patients With Advanced Thoracic Cancer During the Early Phase of the Pandemic in Japan. Anticancer Res 2023; 43:919-926. [PMID: 36697081 DOI: 10.21873/anticanres.16235] [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: 12/18/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND/AIM The severity and associated mortality of coronavirus disease 2019 (COVID-19) are higher in patients with thoracic cancer than in healthy populations and those with other cancer types. Here, we investigated real-world data on the incidence of COVID-19 and false-negative cases using severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse-transcription polymerase chain reaction (rRT-PCR) testing in patients with thoracic cancer. PATIENTS AND METHODS We retrospectively reviewed patients with advanced thoracic cancer at the National Cancer Center Hospital between March 2020-May 2021. Blood samples were collected and evaluated for IgM and IgG antibodies specific for nucleocapsid (N) and spike (S) protein SARS-CoV-2 before and after rRT-PCR testing. False-negative cases were assessed based on anti-SARS-CoV-2 antibody levels before and after rRT-PCR testing. RESULTS A total of 2,107 patients with thoracic cancer were identified between March 2020 and May 2021, 7 (0.3%) of whom developed COVID-19. Among the 218 patients who underwent at least one rRT-PCR test because of suspected COVID-19 symptoms or as a screening test at our institute, the most common diagnosis was non-COVID-19 pneumonia (34.4%), followed by tumor fever (30.7%). Furthermore, of the 218 patients, 120 paired serum samples before and after rRT-PCR testing were available. Seroconversion was identified in all three patients with positive SARS-CoV-2 rRT-PCR results but was only observed in 1 out of the 117 patients who tested negative; the rate of false-negative cases was low (0.9%). CONCLUSION COVID-19 incidence among patients with advanced thoracic cancer was low during the early phase of the pandemic in Japan.
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Affiliation(s)
- Akito Fukuda
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Yoshida
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan;
| | - Shigehiro Yagishita
- Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Mika Shiotsuka
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Osamu Kobayashi
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Hitomi Umeguchi
- Department of Pulmonary Disease, Saga Medical Center, Saga, Japan
| | | | - Yasuhiro Irino
- Central Research Laboratories, Sysmex Corporation, Hyogo, Japan
| | - Ken Masuda
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Shinno
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yusuke Okuma
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasushi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hidehito Horinouchi
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akinobu Hamada
- Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
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8
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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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9
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Takata M, Ubukata K, Miyazaki H, Iwata S, Nakamura S. Diversity of amino acid substitutions of penicillin-binding proteins in penicillin-non-susceptible and non-vaccine type Streptococcus pneumoniae. J Infect Chemother 2022; 28:1523-1530. [PMID: 35963598 DOI: 10.1016/j.jiac.2022.08.006] [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: 05/27/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE In Japan, the introduction of pneumococcal conjugate vaccine (PCV) in children has decreased vaccine-type (VT) pneumococcal infections caused by penicillin (PEN)-non-susceptible Streptococcus pneumoniae. PEN-non-susceptible strains have gradually emerged among non-vaccine types (NVT). In this study, we aim to investigate the pbp gene mutations and the characteristics of PEN-binding proteins (PBPs) that mediate PEN resistance in NVT strains. MATERIALS AND METHODS Pneumococcal 41 strains of NVT isolated from patients with invasive pneumococcal infection were randomly selected. Nucleotide sequences for pbp genes encoding PBP1A, PBP2X, and PBP2B were analyzed, and amino acid (AA) substitutions that contribute to β-lactam resistance were identified. In addition, the three-dimensional (3D) structure of abnormal PBPs in the resistant strain was compared with that of a reference R6 strain via homology modeling. RESULTS In PEN-non-susceptible NVT strains, Thr to Ala or Ser substitutions in the conserved AA motif (STMK) were important in PBP1A and PBP2X. In PBP2B, substitutions from Thr to Ala, adjacent to the SSN motif, and from Glu to Gly were essential. The 3D structure modeling indicated that AA substitutions are characterized by accumulation around the enzymatic active pocket in PBPs. Many AA substitutions detected throughout the PBP domains were not associated with resistance, except for AA substitutions in or adjacent to AA motifs. Clonal complexes and sequence types showed that almost all NVT cases originated in other countries and spread to Japan via repeat mutations. CONCLUSIONS NVT with diverse AA substitutions increased gradually with pressure from both antimicrobial agents and vaccines.
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Affiliation(s)
- Misako Takata
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | - Kimiko Ubukata
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan; Department of General Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Haruko Miyazaki
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Hospital, Tokyo, Japan; Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Shigeki Nakamura
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
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10
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Iwata S, Sonoyama T, Kamitani A, Shibata R, Homma T, Omoto S, Igarashi K, Ariyasu M. Phase 1/2 clinical trial of COVID-19 vaccine in Japanese participants: A report of interim findings. Vaccine 2022; 40:3721-3726. [PMID: 35606235 PMCID: PMC9122779 DOI: 10.1016/j.vaccine.2022.04.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/09/2022] [Accepted: 04/14/2022] [Indexed: 11/27/2022]
Abstract
We initiated a randomized, placebo-controlled, phase 1/2 trial to evaluate the safety and immunogenicity of the S-268019-b recombinant protein vaccine, scheduled as 2 intramuscular injections given 21 days apart, in 60 randomized healthy Japanese adults. We evaluated 2 regimens of the S-910823 antigen (5 μg [n = 24] and 10 μg [n = 24]) with an oil-in-water emulsion formulation and compared against placebo (n = 12). Reactogenicity was mild in most participants. No serious adverse events were noted. For both regimens, vaccination resulted in robust IgG and neutralizing antibody production at days 36 and 50 and predominant T-helper 1-mediated immune reaction, as evident through antigen-specific polyfunctional CD4+ T-cell responses with IFN-γ, IL-2, and IL-4 production on spike protein peptides stimulation. Based on the interim analysis, the S-268019-b vaccine is safe, produces neutralizing antibodies titer comparable with that in convalescent serum from COVID-19-recovered patients. However, further evaluation of the vaccine in a large clinical trial is warranted.
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11
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Katsuta T, Shimizu N, Okada K, Tanaka-Taya K, Nakano T, Kamiya H, Amo K, Ishiwada N, Iwata S, Oshiro M, Okabe N, Kira R, Korematsu S, Suga S, Tsugawa T, Nishimura N, Hishiki H, Fujioka M, Hosoya M, Mizuno Y, Mine M, Miyairi I, Miyazaki C, Morioka I, Morishima T, Yoshikawa T, Wada T, Azuma H, Kusuhara K, Ouchi K, Saitoh A, Moriuchi H. The clinical characteristics of pediatric coronavirus disease 2019 in 2020 in Japan. Pediatr Int 2022; 64:e14912. [PMID: 34233075 PMCID: PMC8446955 DOI: 10.1111/ped.14912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/10/2021] [Accepted: 06/14/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The COVID-19 pandemic has affected the lives of people of all ages. Most reports on pediatric cases suggest that children experience fewer and milder symptoms than do adults. This is the first nationwide study in Japan focusing on pediatric cases reported by pediatricians, including cases with no or mild symptoms. METHODS We analyzed the epidemiological and clinical characteristics and transmission patterns of 840 pediatric (<16 years old) COVID-19 cases reported between February and December 2020 in Japan, using a dedicated database which was maintained voluntarily by members of the Japan Pediatric Society. RESULTS Almost half of the patients (47.7%) were asymptomatic, while most of the others presented mild symptoms. At the time of admission or first outpatient clinic visit, 84.0% of the cases were afebrile (<37.5°C). In total, 609 cases (72.5%) were exposed to COVID-19-positive household members. We analyzed the influence of nationwide school closures that were introduced in March 2020 on COVID-19 transmission routes among children in Japan. Transmission within households occurred most frequently, with no significant difference between the periods before and after declaring nationwide school closures (70.9% and 74.5%, respectively). CONCLUSIONS COVID-19 symptoms in children are less severe than those in adults. School closure appeared to have a limited effect on transmission. Controlling household transmission from adult family members is the most important measure for prevention of COVID-19 among children.
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Affiliation(s)
- Tomohiro Katsuta
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Naoki Shimizu
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kenji Okada
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Keiko Tanaka-Taya
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takashi Nakano
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Hajime Kamiya
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kiyoko Amo
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatric emergency, Osaka City General Hospital, Osaka, Japan
| | - Naruhiko Ishiwada
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Satoshi Iwata
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Makoto Oshiro
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Japanese Red Cross Nagoya First Hospital, Aichi, Japan
| | - Nobuhiko Okabe
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Kawasaki City Institute for Public Health, Kanagawa, Japan
| | - Ryutaro Kira
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Seigo Korematsu
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Nakatsu Municipal Hospital, Oita, Japan
| | - Shigeru Suga
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Clinical Research, Infectious Disease Center, National Hospital Organization Mie National Hospital, Mie, Japan
| | - Takeshi Tsugawa
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Naoko Nishimura
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Konan Kosei Hospital, Aichi, Japan
| | - Haruka Hishiki
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Masashi Fujioka
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Fujioka Pediatric Clinic, Osaka, Japan
| | - Mitsuaki Hosoya
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Yumi Mizuno
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatric infectious diseases and immunology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Mahito Mine
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Mine Pediatric Clinic, Saitama, Japan
| | - Isao Miyairi
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan
| | - Chiaki Miyazaki
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Fukuoka-city Social Welfare Agency, Fukuoka, Japan
| | - Ichiro Morioka
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Tsuneo Morishima
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Aichi Medical University, Aichi, Japan
| | - Tetsushi Yoshikawa
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Fujita Health University School of Medicine, Aichi, Japan
| | - Taizo Wada
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Kanazawa University, Ishikawa, Japan
| | - Hiroshi Azuma
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Asahikawa Medical University, Hokkaido, Japan
| | - Koichi Kusuhara
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazunobu Ouchi
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Akihiko Saitoh
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroyuki Moriuchi
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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12
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Sugita K, Aoki K, Komori K, Nagasawa T, Ishii Y, Iwata S, Tateda K. Molecular Analysis of blaKPC-2-Harboring Plasmids: Tn 4401a Interplasmid Transposition and Tn 4401a-Carrying ColRNAI Plasmid Mobilization from Klebsiella pneumoniae to Citrobacter europaeus and Morganella morganii in a Single Patient. mSphere 2021; 6:e0085021. [PMID: 34730375 PMCID: PMC8565517 DOI: 10.1128/msphere.00850-21] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 10/21/2021] [Indexed: 11/20/2022] Open
Abstract
The spread of Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacterales is a public health concern. KPC-encoding blaKPC is predominantly spread by strains of a particular phylogenetic lineage, clonal group 258, but can also be spread by horizontal transfer of blaKPC-carrying plasmids. Here, we report the transfer of a blaKPC-2-harboring plasmid via mobilization from K. pneumoniae to Citrobacter freundii complex and Morganella morganii strains in a single patient. We performed draft whole-genome sequencing to analyze 20 carbapenemase-producing Enterobacterales strains (15 of K. pneumoniae, two of C. freundii complex, and three of M. morganii) and all K. pneumoniae strains using MiSeq and/or MinION isolated from a patient who was hospitalized in New York and Montreal before returning to Japan. All strains harbored blaKPC-2-containing Tn4401a. The 15 K. pneumoniae strains each belonged to sequence type 258 and harbored a Tn4401a-carrying multireplicon-type plasmid, IncN and IncR (IncN+R). Three of these K. pneumoniae strains also possessed a Tn4401a-carrying ColRNAI plasmid, suggesting that Tn4401a underwent interplasmid transposition. Of these three ColRNAI plasmids, two and one were identical to plasmids harbored by two Citrobacter europaeus and three M. morganii strains, respectively. The Tn4401a-carrying ColRNAI plasmids were each 23,753 bp long and incapable of conjugal transfer via their own genes alone, but they mobilized during the conjugal transfer of Tn4401a-carrying IncN+R plasmids in K. pneumoniae. Interplasmid transposition of Tn4401a from an IncN+R plasmid to a ColRNAI plasmid in K. pneumoniae and mobilization of Tn4401a-carrying ColRNAI plasmids contributed to the acquisition of blaKPC-2 in C. europaeus and M. morganii. IMPORTANCE Plasmid transfer plays an important role in the interspecies spread of carbapenemase genes, including the Klebsiella pneumoniae carbapenemase (KPC)-coding gene, blaKPC. We conducted whole-genome sequencing (WGS) analysis and transmission experiments to analyze blaKPC-2-carrying mobile genetic elements (MGEs) between the blaKPC-2-harboring K. pneumoniae, Citrobacter europaeus, and Morganella morganii strains isolated from a single patient. blaKPC-2 was contained within an MGE, Tn4401a. WGS of blaKPC-2-carrying K. pneumoniae, C. europaeus, and M. morganii strains isolated from one patient revealed that Tn4401a-carrying ColRNAI plasmids were generated by plasmid-to-plasmid transfer of Tn4401a from a multireplicon-type IncN and IncR (IncN+R) plasmid in K. pneumoniae strains. Tn4401a-carrying ColRNAI plasmids were incapable of conjugal transfer in C. europaeus and M. morganii but mobilized from K. pneumoniae to a recipient Escherichia coli strain during the conjugal transfer of Tn4401a-carrying IncN+R plasmid. Therefore, Tn4401a-carrying ColRNAI plasmids contributed to the acquisition of blaKPC-2 in C. europaeus and M. morganii.
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Affiliation(s)
- Kayoko Sugita
- Department of Microbiology and Infectious Diseases, Toho University Graduate School of Medicine, Tokyo, Japan
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo, Japan
| | - Kotaro Aoki
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Kohji Komori
- Department of Microbiology and Infectious Diseases, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Tatsuya Nagasawa
- Department of Microbiology and Infectious Diseases, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University Graduate School of Medicine, Tokyo, Japan
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University Graduate School of Medicine, Tokyo, Japan
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
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13
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Iwata S, Koyama H, Murata Y. Efficacy and safety of daptomycin in Japanese pediatric participants with complicated skin and soft tissue infections or bacteremia caused by gram-positive cocci. J Infect Chemother 2021; 28:406-412. [PMID: 34920946 DOI: 10.1016/j.jiac.2021.11.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/02/2021] [Accepted: 11/23/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Complicated skin and soft tissue infections (cSSTIs) and bacteremia caused by Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), are common causes of infection for children worldwide. Here, the safety and efficacy of daptomycin in Japanese pediatric participants are reported. METHODS This open-label, single-arm phase 2 study (NCT03643952) enrolled Japanese pediatric participants (age 1-17 years) with cSSTI or bacteremia caused by gram-positive cocci. Participants received age-adjusted doses of intravenous daptomycin for 5 to up to 14 days (cSSTI) or 5 to up to 42 days (bacteremia). The primary objective was safety and tolerability; efficacy among participants with infections caused by MRSA was a secondary objective. RESULTS A total of 18 participants (cSSTI, n = 14; bacteremia, n = 4) were enrolled across 12 study sites in Japan. The most common pathogen was S. aureus (15/18 [83.3%]), including methicillin-susceptible and -resistant isolates. Adverse events (AE) were reported in 42.9% (6/14) of participants with cSSTI and 100% (4/4) of participants with bacteremia. No deaths, serious AEs, discontinuations of study medication due to an AE, or events of clinical interest occurred in the study. In participants with infections caused by MRSA, 87.5% [7/8] achieved favorable clinical response at test of cure (TOC) visit (cSSTI, 85.7% [6/7]; bacteremia, 100% [1/1]). In this population, favorable microbiological response at TOC was achieved by 71.4% (5/7) of participants with cSSTI and 100% (1/1) of participants with bacteremia. CONCLUSIONS Daptomycin was well tolerated, exhibited a favorable safety profile, and was effective for the treatment of cSSTI or bacteremia in Japanese children.
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Affiliation(s)
- Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
| | - Hayato Koyama
- MSD K.K., Kitanomaru Square, 1-13-12 Kudankita, Chiyoda-ku, Tokyo, Japan.
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14
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Fan J, Iwata S, Tanaka Y, Kitanaga Y, Ishii A, Maiko H, Zhang X, Liu X. Kdm5a promotes B cell activation in systemic lupus erythematosus via downregulation of A20 by histone modification. Pathol Res Pract 2021:153653. [PMID: 34763954 DOI: 10.1016/j.prp.2021.153653] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 11/17/2022]
Abstract
Systemic lupus erythematosus (SLE) is a classic autoimmune connective tissue disease, which leads to multiple organ system injury. Tumor necrosis factor-induced protein 3 (TNFAIP3), generally called A20, has been documented to go together with the development of SLE. However, the role and mechanism of A20 in the progression of SLE are still unrevealed. In our study, A20 was downregulated in B cells from SLE patients and B cell responsiveness was significantly elevated in SLE patients. Overexpression of A20 restrained the proliferation and induced the apoptosis of B cells. Additionally, trimethylation of histone H3 Lysine 4 (H3K4me3) was decreased in the A20 promoter of SLE B cells. Lysine demethylase 5 A (Kdm5a) was significantly increased in B cells from SLE patients and negatively correlated with A20 expression. Further, Kdm5a knockdown increased the H3K4me3 level and A20 expression. More importantly, Kdm5a promoted the proliferation and inhibited the apoptosis of B cells in SLE via downregulation of A20. In general, Kdm5a promoted the proliferation and inhibited the apoptosis of B cells in SLE via downregulation of A20 by decreasing H3K4me3 enrichment level in the A20 promoter, suggesting a novel mechanism underlying SLE progression, and providing a promising therapeutic target for SLE. AVAILABILITY OF DATA AND MATERIALS: All data generated or analyzed during this study are included in this published article and its additional files.
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Affiliation(s)
- Jie Fan
- Department of Cardiology, Handan Central Hospital, China
| | - S Iwata
- First Department of Internal Medicine, Dean Graduate School of Medical Science University of Occupational and Environmental, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, Dean Graduate School of Medical Science University of Occupational and Environmental, Japan.
| | - Yukihiro Kitanaga
- First Department of Internal Medicine, Dean Graduate School of Medical Science University of Occupational and Environmental, Japan
| | - Akina Ishii
- First Department of Internal Medicine, Dean Graduate School of Medical Science University of Occupational and Environmental, Japan
| | - Hara Maiko
- First Department of Internal Medicine, Dean Graduate School of Medical Science University of Occupational and Environmental, Japan
| | - Xueqiang Zhang
- Department of Cardiology, Handan Central Hospital, China
| | - Xingde Liu
- Department of Cardiology, Guizhou University of Traditional Chinese Medicine, China
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15
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Shinkai M, Tsushima K, Tanaka S, Hagiwara E, Tarumoto N, Kawada I, Hirai Y, Fujiwara S, Komase Y, Saraya T, Koh H, Kagiyama N, Shimada M, Kanou D, Antoku S, Uchida Y, Tokue Y, Takamori M, Gon Y, Ie K, Yamazaki Y, Harada K, Miyao N, Naka T, Iwata M, Nakagawa A, Hiyama K, Ogawa Y, Shinoda M, Ota S, Hirouchi T, Terada J, Kawano S, Ogura T, Sakurai T, Matsumoto Y, Kunishima H, Kobayashi O, Iwata S. Efficacy and Safety of Favipiravir in Moderate COVID-19 Pneumonia Patients without Oxygen Therapy: A Randomized, Phase III Clinical Trial. Infect Dis Ther 2021; 10:2489-2509. [PMID: 34453234 PMCID: PMC8396144 DOI: 10.1007/s40121-021-00517-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [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: 05/21/2021] [Accepted: 07/27/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is an enveloped, single-stranded RNA virus. Favipiravir is an orally administrable antiviral drug whose mechanism of action is to selectively inhibit RNA-dependent RNA polymerase. A preliminary trial in COVID-19 patients reported significant improvements across a multitude of clinical parameters, but these findings have not been confirmed in an adequate well-controlled trial. We conducted a randomized, single-blind, placebo-controlled Phase III trial assessing the efficacy and safety of favipiravir in patients with moderate pneumonia not requiring oxygen therapy. Methods COVID-19 patients with moderate pneumonia (SpO2 ≥ 94%) within 10 days of onset of fever (temperature ≥ 37.5 °C) were assigned to receive either placebo or favipiravir (1800 mg twice a day on Day 1, followed by 800 mg twice a day for up to 13 days) in a ratio of 1:2. An adaptive design was used to re-estimate the sample size. The primary endpoint was a composite outcome defined as the time to improvement in temperature, oxygen saturation levels (SpO2), and findings on chest imaging, and recovery to SARS-CoV-2-negative. This endpoint was re-examined by the Central Committee under blinded conditions. Results A total of 156 patients were randomized. The median time of the primary endpoint was 11.9 days in the favipiravir group and 14.7 days in the placebo group, with a significant difference (p = 0.0136). Favipiravir-treated patients with known risk factors such as obesity or coexisting conditions provided better effects. Furthermore, patients with early-onset in the favipiravir group showed higher odds ratio. No deaths were documented. Although adverse events in the favipiravir group were predominantly transient, the incidence was significantly higher. Conclusions The results suggested favipiravir may be one of options for moderate COVID-19 pneumonia treatment. However, the risk of adverse events, including hyperuricemia, should be carefully considered. Trial registration Clinicaltrials.jp number: JapicCTI-205238. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00517-4.
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Affiliation(s)
- Masaharu Shinkai
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Kenji Tsushima
- Department of Pulmonary Medicine, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
| | - Shingo Tanaka
- Department of Otolaryngology, Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, Tokyo, 154-8532, Japan
| | - Eri Hagiwara
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan
| | - Norihito Tarumoto
- Department of Infectious Disease and Infection control, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuji Hirai
- Department of Infectious Diseases, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 193-0998, Japan
| | - Sho Fujiwara
- Department of Infectious Diseases, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama, Kanagawa, 241-0811, Japan
| | - Takeshi Saraya
- Department of Respiratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hidefumi Koh
- Division of Pulmonary Medicine, Department of Internal Medicine, Tachikawa Hospital, 4-2-22 Nishiki-cho, Tachikawa, Tokyo, 190-8531, Japan
| | - Naho Kagiyama
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, 1696 Itai, Kumagaya, Saitama, 360-0197, Japan
| | - Megumi Shimada
- Department of General Internal Medicine, Tokai University Oiso Hospital, 21-1 Gakkyo, Oiso-machi, Naka-gun, Kanagawa, 259-0198, Japan
| | - Daiki Kanou
- Department of Respiratory Internal Medicine, Yokohama Rosai Hospital, 3211 Kozukue-cho, Kohoku-ku, Yokohama, Kanagawa, 222-0036, Japan
| | - Shinichi Antoku
- Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, 2-24-18 Higashikoiwa, Edogawa-ku, Tokyo, 133-0052, Japan
| | - Yujiro Uchida
- Department of General Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-8561, Japan
| | - Yutaka Tokue
- Infection Control and Prevention Center, Gunma University Hospital, 3-39-15 Showamachi, Maebashi, Gunma, 371-8511, Japan
| | - Mikio Takamori
- Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8524, Japan
| | - Yasuhiro Gon
- Department of Respiratory Medicine, Nihon University Itabashi Hospital, 30-1 Oyaguchikami-cho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Kenya Ie
- Department of General Internal Medicine, Kawasaki Municipal Tama Hospital, 1-30-37 Shukugawara, Tama-ku, Kawasaki, Kanagawa, 214-8525, Japan
| | - Yoshitaka Yamazaki
- Department of Respiratory and Infectious Diseases, Nagano Prefectural Shinshu Medical Center, 1332 Suzaka, Suzaka, Nagano, 382-8577, Japan
| | - Kazumasa Harada
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Naoki Miyao
- Department of Internal Medicine, Nippon Koukan Hospital, 1-2-1 Kokandori, Kawasaki-ku, Kawasaki, Kanagawa, 210-0852, Japan
| | - Takashi Naka
- Department of Neurology, Higashiosaka City Medical Center, 3-4-5 Nishiiwata, Higashiosaka, Osaka, 578-8588, Japan
| | - Mitsunaga Iwata
- Department of Emergency and General Internal Medicine, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Atsushi Nakagawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Kazutoshi Hiyama
- Department of Infectious Diseases, National Hospital Organization Fukuokahigashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan
| | - Yoshihiko Ogawa
- Department of Infectious Diseases, Sakai City Medical Center, 1-1-1 Ebarajicho, Nishi-ku, Sakai, Osaka, 593-8304, Japan
| | - Masahiro Shinoda
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Shinichiro Ota
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Takatomo Hirouchi
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22 Higashioi, Shinagawa-ku, Tokyo, 140-8522, Japan
| | - Jiro Terada
- Department of Pulmonary Medicine, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
| | - Shuichi Kawano
- Department of Internal Medicine, Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, Tokyo, 154-8532, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomiokahigashi, Kanazawa-ku, Yokohama, Kanagawa, 236-0051, Japan
| | - Tsutomu Sakurai
- Scientific Information Department, FujiFilm Toyama Chemical Co., Ltd., 3-4-8 Hatchobori, Chuo-ku, Tokyo, 104-0032, Japan
| | - Yoshihiko Matsumoto
- Scientific Information Department, FujiFilm Toyama Chemical Co., Ltd., 3-4-8 Hatchobori, Chuo-ku, Tokyo, 104-0032, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, School of Medicine, St. Marianna University, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Osamu Kobayashi
- Department of Infectious Diseases, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, 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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16
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Yazaki S, Yoshida T, Kojima Y, Yagishita S, Nakahama H, Okinaka K, Matsushita H, Shiotsuka M, Kobayashi O, Iwata S, Narita Y, Ohba A, Takahashi M, Iwasa S, Kobayashi K, Ohe Y, Yoshida T, Hamada A, Doi T, Yamamoto N. Difference in SARS-CoV-2 Antibody Status Between Patients With Cancer and Health Care Workers During the COVID-19 Pandemic in Japan. JAMA Oncol 2021; 7:1141-1148. [PMID: 34047762 DOI: 10.1001/jamaoncol.2021.2159] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Patients with cancer and health care workers (HCWs) are at high risk of SARS-CoV-2 infection. Assessing the antibody status of patients with cancer and HCWs can help understand the spread of COVID-19 in cancer care. Objective To evaluate serum SARS-CoV-2 antibody status in patients with cancer and HCWs during the COVID-19 pandemic in Japan. Design, Setting, and Participants Participants were enrolled for this prospective cross-sectional study between August 3 and October 30, 2020, from 2 comprehensive cancer centers in the epidemic area around Tokyo, Japan. Patients with cancer aged 16 years or older and employees were enrolled. Participants with suspected COVID-19 infection at the time of enrollment were excluded. Exposures Cancer of any type and cancer treatment, including chemotherapy, surgery, immune checkpoint inhibitors, radiotherapy, and targeted molecular therapy. Main Outcomes and Measures Seroprevalence and antibody levels in patients with cancer and HCWs. Seropositivity was defined as positivity to nucleocapsid IgG (N-IgG) and/or spike IgG (S-IgG). Serum levels of SARS-CoV-2 IgM and IgG antibodies against the nucleocapsid and spike proteins were measured by chemiluminescent enzyme immunoassay. Results A total of 500 patients with cancer (median age, 62.5 years [range, 21-88 years]; 265 men [55.4%]) and 1190 HCWs (median age, 40 years [range, 20-70 years]; 382 men [25.4%]) were enrolled. In patients with cancer, 489 (97.8%) had solid tumors, and 355 (71.0%) had received anticancer treatment within 1 month. Among HCWs, 385 (32.3%) were nurses or assistant nurses, 266 (22.4%) were administrative officers, 197 (16.6%) were researchers, 179 (15.0%) were physicians, 113 (9.5%) were technicians, and 50 (4.2%) were pharmacists. The seroprevalence was 1.0% (95% CI, 0.33%-2.32%) in patients and 0.67% (95% CI, 0.29%-1.32%) in HCWs (P = .48). However, the N-IgG and S-IgG antibody levels were significantly lower in patients than in HCWs (N-IgG: β, -0.38; 95% CI, -0.55 to -0.21; P < .001; and S-IgG: β, -0.39; 95% CI, -0.54 to -0.23; P < .001). Additionally, among patients, N-IgG levels were significantly lower in those who received chemotherapy than in those who did not (median N-IgG levels, 0.1 [interquartile range (IQR), 0-0.3] vs 0.1 [IQR, 0-0.4], P = .04). In contrast, N-IgG and S-IgG levels were significantly higher in patients who received immune checkpoint inhibitors than in those who did not (median N-IgG levels: 0.2 [IQR, 0.1-0.5] vs 0.1 [IQR, 0-0.3], P = .02; S-IgG levels: 0.15 [IQR, 0-0.3] vs 0.1[IQR, 0-0.2], P = .02). Conclusions and Relevance In this cross-sectional study of Japanese patients with cancer and HCWs, the seroprevalence of SARS-CoV-2 antibodies did not differ between the 2 groups; however, findings suggest that comorbid cancer and treatment with systemic therapy, including chemotherapy and immune checkpoint inhibitors, may influence the immune response to SARS-CoV-2.
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Affiliation(s)
- Shu Yazaki
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.,Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Yoshida
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.,Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.,Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Shigehiro Yagishita
- Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Hiroko Nakahama
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Keiji Okinaka
- Department of General Internal Medicine, National Cancer Center Hospital East, Chiba, Japan
| | - Hiromichi Matsushita
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Mika Shiotsuka
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Osamu Kobayashi
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiro Ohba
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Satoru Iwasa
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan.,Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kenya Kobayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Akinobu Hamada
- Division of Molecular Pharmacology, National Cancer Center Research Institute, Tokyo, Japan
| | - Toshihiko Doi
- Department of Experimental Therapeutics, National Cancer Center Hospital East, Chiba, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
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17
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Sobue T, Fukuda H, Matsumoto T, Lee B, Ito S, Iwata S. The background occurrence of selected clinical conditions prior to the start of an extensive national vaccination program in Japan. PLoS One 2021; 16:e0256379. [PMID: 34437567 PMCID: PMC8389412 DOI: 10.1371/journal.pone.0256379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/04/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic caused by SARS-CoV-2 has now affected tens of millions of people globally. It is the hope that vaccines against SARS-CoV-2 will deliver a comprehensive solution to this global pandemic; however, this will require extensive national vaccination programs. Ultimately, clinical conditions and even sudden unexplained death will occur around the time of vaccination, thus a distinction needs to be made between events that are causally related to the vaccine or temporally related to vaccination. This study aimed to estimate the background occurrence of 43 clinical conditions in the Japanese population. METHODS A retrospective cohort study was conducted from 2013 to 2019 using data from two large healthcare claims databases (MDV and JMDC) in Japan. The estimated number of new cases and incidence were calculated based on the actual number of new cases identified in the databases. The PubMed and Ichushi-web databases, as well as grey literature such as guidelines and government statistics, were also searched to identify any publications related to incidence of these conditions in Japan. RESULTS AND CONCLUSION The estimates of the number of total cases and incidence were similar for the MDV and JMDC databases for some diseases. In addition, some estimates were similar to those in the scientific literature. For example, from the MDV and JMDC databases, estimates of incidence of confirmed Bell's palsy in 2019 were 41.7 and 47.9 cases per 100,000 population per year, respectively. These estimates were of the same order from the scientific publication. Determining whether clinical conditions occurring around the time of vaccination are causally or only temporally related to vaccination will be critical for public health decision makers as well as for the general public. Comparison of background occurrence at the population level may provide some additional objective evidence for the evaluation of temporality or causality.
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Affiliation(s)
- Tomotaka Sobue
- Division of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Haruhisa Fukuda
- Department of Health Care Administration and Management, Kyushu University, Fukuoka, Japan
| | - Tetsuya Matsumoto
- Department of Infectious Diseases, International University of Health and Welfare, Narita, Japan
| | - Bennett Lee
- Vaccine Medical Affairs, Pfizer Japan Inc., Tokyo, Japan
| | - Shuhei Ito
- Vaccine Medical Affairs, Pfizer Japan Inc., Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
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18
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Shibata M, Morozumi M, Maeda N, Komiyama O, Shiro H, Iwata S, Ubukata K. Relationship between intrapartum antibiotic prophylaxis and group B streptococcal colonization dynamics in Japanese mother-neonate pairs. J Infect Chemother 2021; 27:977-983. [PMID: 33610482 DOI: 10.1016/j.jiac.2021.02.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/20/2021] [Accepted: 02/08/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION In Japan, universal screening for group B streptococcal (GBS) colonization in pregnant women and intrapartum antibiotic prophylaxis (IAP) are recommended to prevent neonatal GBS infection. However, the dynamics of GBS colonization in Japanese mother/neonate pairs have not been adequately studied. METHODS A prospective cohort study was conducted from July 2018 to March 2019. Rectovaginal samples were collected from pregnant women (33-37 gestation weeks) once. In neonates, nasopharyngeal and rectal samples were collected at three time points: after birth, 1 week after birth, and 1 month after birth. All samples were analyzed for GBS using real-time PCR testing and culture methods. Capsular typing was performed for all GBS isolates and GBS-positive samples using real-time PCR testing. RESULTS The overall maternal and neonatal GBS-positivity rates were 22.7% (57/251) and 8.8% (22/251), respectively. IAP for GBS-positive mothers (96.5%) was highly administered. Eleven (19.3%) neonates born to GBS-positive mothers were GBS-positive, which was significantly higher than the 11 (5.7%) neonates born to GBS-negative mothers. The rate of GBS-positivity in neonates increased with an increased number of GBS colonies in mothers. More neonates were GBS-positive 1 month after birth than 1 week after birth, and there was a higher rate of GBS-positive rectal swabs than nasopharyngeal swabs. Capsular types of GBS that were isolated from each mother and neonate pair were the same, namely, Ib, III, V, and VI. CONCLUSIONS These findings indicate that the efficacy of IAP in preventing GBS transmission to neonates might be limited to within a few weeks after birth.
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Affiliation(s)
- Meiwa Shibata
- Department of Pediatrics, Yokohama Rosai Hospital, Japan; Department of Infectious Diseases, Keio University School of Medicine, Japan
| | - Miyuki Morozumi
- Department of Infectious Diseases, Keio University School of Medicine, Japan
| | - Naonori Maeda
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, Japan
| | - Osamu Komiyama
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, Japan
| | - Hiroyuki Shiro
- Department of Pediatrics, Yokohama Rosai Hospital, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, Keio University School of Medicine, Japan; Department of Infectious Diseases, National Cancer Center Hospital, Japan
| | - Kimiko Ubukata
- Department of Infectious Diseases, Keio University School of Medicine, Japan; Department of General Medicine, Keio University School of Medicine, Japan.
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19
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Morozumi M, Tajima T, Sakuma M, Shouji M, Meguro H, Saito K, Iwata S, Ubukata K. Sequence Type Changes Associated with Decreasing Macrolide-Resistant Mycoplasma pneumoniae, Japan. Emerg Infect Dis 2021; 26:2210-2213. [PMID: 32818419 PMCID: PMC7454074 DOI: 10.3201/eid2609.191575] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We compared sequence types (STs) of Mycoplasma pneumoniae isolates from Japan during 2002–2019. ST3 and ST14 dominated during 2002–2016, and ST7 and ST33 dominated during 2018–2019. These STs were associated with a decrease in macrolide-resistant strains after an epidemic of infection with M. pneumoniae during 2011–2012.
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20
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Hanada S, Takata M, Morozumi M, Iwata S, Fujishima S, Ubukata K. Multiple comorbidities increase the risk of death from invasive pneumococcal disease under the age of 65 years. J Infect Chemother 2021; 27:1311-1318. [PMID: 33962862 DOI: 10.1016/j.jiac.2021.04.018] [Citation(s) in RCA: 7] [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: 02/16/2021] [Revised: 03/22/2021] [Accepted: 04/21/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Risk factors for death from invasive pneumococcal disease (IPD) have not been clearly established in patients aged under 65 years. We aimed to evaluate contributions of host and bacterial factors to the risk of death from IPD in patients aged under 65 years in Japan. METHODS In this prospective, observational, multicenter cohort study, patients with IPD (n = 581) aged 6-64 years were enrolled between 2010 and 2017. We investigated the role of host and bacterial factors in 28-day mortality. RESULTS The mortality rate increased from 3.4% to 6.2% in patients aged 6-44 years to 15.5%-19.5% in those aged 45-64 years. Multivariable analysis identified the following risk factors for mortality: age 45-64 years (hazard ratio [HR], 3.4; 95% confidence interval [CI], 1.6-6.8, p = 0.001), bacteremia with unknown focus (HR, 2.0; 95% CI, 1.1-3.7, p = 0.024), meningitis (HR, 2.1; 95% CI, 1.1-4.0, p = 0.019), underlying multiple non-immunocompromising conditions (HR, 2.6; 95% CI, 1.1-7.4, p = 0.023), and immunocompromising conditions related to malignancy (HR, 2.4; 95% CI, 1.0-5.2, p = 0.039). Pneumococcal serotype was not associated with poor outcomes. CONCLUSIONS Host factors, including age of 45-64 years and underlying multiple non-immunocompromising conditions, are important for the prognosis of IPD. Our results will contribute to the development of targeted pneumococcal vaccination strategies in Japan.
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Affiliation(s)
- Shigeo Hanada
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Japan; Okinaka Memorial Institute for Medical Research, Japan
| | - Misako Takata
- Department of Infectious Diseases, Keio University School of Medicine, Japan; Department of Microbiology, Tokyo Medical University, Japan
| | - Miyuki Morozumi
- Department of Infectious Diseases, Keio University School of Medicine, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, Keio University School of Medicine, Japan; Department of Infectious Diseases, National Cancer Center Hospital, Japan
| | - Seitaro Fujishima
- Center for General Medicine Education, Keio University School of Medicine, Japan
| | - Kimiko Ubukata
- Department of Infectious Diseases, Keio University School of Medicine, Japan; Department of Microbiology, Tokyo Medical University, Japan; Center for General Medicine Education, Keio University School of Medicine, Japan.
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21
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Adachi Y, Yamazoe-Ishiguri Y, Iwata S, Murase A, Kihara R, Watamoto K. Two Cases of Autoimmune Neutropenia Complicated with Other Lineages of Autoimmune Cytopenia, Successfully Treated with Prednisolone. Intern Med 2021; 60:1271-1277. [PMID: 33162482 PMCID: PMC8112969 DOI: 10.2169/internalmedicine.6032-20] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Though adult-onset primary autoimmune pancytopenia (AIP) rarely follows a self-limited course, a standard treatment strategy has not yet been established. We herein report two cases, each involving primary autoimmune neutropenia complicated with autoimmune thrombocytopenia or Evans syndrome. They were refractory to granulocyte-colony stimulating factor, but all lineages of cytopenia promptly recovered with prednisolone (PSL). In case 1, PSL was tapered and discontinued six months after its initiation without AIP relapse. In case 2, PSL has been tapered for five months without relapse. To establish an optimal treatment strategy for AIP, it is necessary to accumulate more cases.
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Affiliation(s)
| | | | - Satoshi Iwata
- Department of Hematology, Komaki City Hospital, Japan
| | | | - Rika Kihara
- Department of Hematology, Komaki City Hospital, Japan
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22
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Ito A, Kobayashi K, Shiotsuka M, Sato T, Omura G, Matsumoto Y, Ikeda A, Sakai A, Eguchi K, Takano T, Matsumoto F, Kobayashi O, Iwata S, Yoshimoto S. Uniform infection screening allowed safe head and neck surgery during the coronavirus disease 2019 pandemic in Japan. Jpn J Clin Oncol 2021; 51:400-407. [PMID: 33048119 PMCID: PMC7665677 DOI: 10.1093/jjco/hyaa195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 09/27/2020] [Indexed: 01/08/2023] Open
Abstract
Background The purpose of this study was to determine whether a uniform infection screening protocol could be used to safely perform head and neck cancer surgery during the coronavirus disease 2019 pandemic and clarify how surgical treatment changed compared with the pre-pandemic period. Materials and methods During the unprecedented coronavirus disease 2019 pandemic in Tokyo, we continued providing head and neck cancer care, guided by our own uniform screening protocol. In this study, medical records of 208 patients with head and neck malignancy, who underwent surgical treatment at our hospital during the first and second wave of pandemic for each 2-month period (first wave: 30 March 2020–30 May 2020, second wave: 14 July 2020–14 September 2020) and the 2-month pre-pandemic period (30 October 2019–30 December 2020), were analysed. Results A total of 133 patients were admitted for surgical treatment and all, except six patients with emergency tracheostomy, were screened according to the protocol. As a result, all 127 patients received surgical treatment as planned, and all 1247 medical staff members involved in the surgeries were uninfected by severe acute respiratory syndrome coronavirus 2. During the first wave of pandemic, 20% reduction of head and neck surgery was requited; however, restrictions of surgery were not necessary during the second wave. Surgical procedure, length of hospitalization, postoperative complications and number of medical staff were unchanged compared with pre-pandemic period. Conclusion Our data indicate that continuation of head and neck anticancer surgical treatment in an epidemic area during the coronavirus disease 2019 pandemic were safe and feasible, if adequate and strict preventive measures are vigorously and successfully carried out.
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Affiliation(s)
- Akiko Ito
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Kenya Kobayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Mika Shiotsuka
- Department of Infection Disease, National Cancer Center Hospital, Tokyo
| | - Tetsufumi Sato
- Department of Anesthesia and Intensive care, National Cancer Center Hospital, Tokyo, Japan
| | - Go Omura
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | | | - Atsuo Ikeda
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Azusa Sakai
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Kohtaro Eguchi
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Tomonari Takano
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Fumihiko Matsumoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
| | - Osamu Kobayashi
- Department of Infection Disease, National Cancer Center Hospital, Tokyo
| | - Satoshi Iwata
- Department of Infection Disease, National Cancer Center Hospital, Tokyo
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo
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23
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Gatellier L, Shankar A, Dewi LKM, Hussain QM, Dendup Wangdi T, Sukumaran DB, Sari NK, Tavakkoli Shiraji S, Biglari M, Tahmasebi M, Iwata S, Suzuki T, Myung SK, Chun JY, Han JS, Lau FN, Yusak S, Bayarsaikhan L, Mu KT, Pradhananga KK, Yusuf A, Lin CH, Chiang RCJ, Sangrajran S, Nguyen QT, Huong GN, Soe AN, Sharma DN, Sengar M, Pramesh CS, Matsuda T, Jarrahi AM, Hwang W. The Impact of COVID-19 on Cancer Care in the Post Pandemic World: Five Major Lessons Learnt from Challenges and Countermeasures of Major Asian Cancer Centres. Asian Pac J Cancer Prev 2021; 22:681-690. [PMID: 33773529 PMCID: PMC8286686 DOI: 10.31557/apjcp.2021.22.3.681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: The COVID-19 pandemic has dramatically affected healthcare services around Asia. The Asian National Cancer Centres Alliance and the Asia-Pacific Organisation for Cancer Prevention collaborated to assess the mid- and long- term impact of COVID-19 to cancer care in Asia. Methods: The two entities organised a combined symposium and post-meeting interactions among representatives of major cancer centres from seventeen Asian countries to outlining major challenges and countermeasures. Results: Participating stakeholders distilled five big questions. 1) “Will there be an explosion of late-stage cancers after the pandemic?” To address and recover from perceived delayed prevention, screening, treatment and care challenges, collaboration of key stakeholders in the region and alignment in cancer care management, policy intervention and cancer registry initiatives would be of essential value. 2) “Operations and Finance” The pandemic has resulted in significant material and financial casualties. Flagged acute challenges (shortages of supplies, imposition of lockdown) as well as longer-standing reduction of financial revenue, manpower, international collaboration, and training should also be addressed. 3) “Will telemedicine and technological innovations revolutionize cancer care?” Deploying and implementing telemedicine such as teleconsultation and virtual tumour boards were considered invaluable. These innovations could become a new regular practice, leading to expansion of tele-collaboration through collaboration of institutions in the region. 4) “Will virtual conferences continue after the pandemic?” Virtual conferences during the pandemic have opened new doors for knowledge sharing, especially for representatives of low- and middle-income countries in the region, while saving time and costs of travel. 5) “How do we prepare for the next pandemic or international emergency?” Roadmaps for action to improve access to appropriate patient care and research were identified and scrutinised. Conclusion: Through addressing these five big questions, focused collaboration among members and with international organisations such as City Cancer Challenge will allow enhanced preparedness for future international emergencies.
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Affiliation(s)
| | - Abhishek Shankar
- Lady Hardinge Medical College & Associated Hospitals, Delhi, India
| | - Luh K Mela Dewi
- Dharmais Hospital - National Cancer Center, Jakarta, Indonesia
| | | | | | | | | | - Sahar Tavakkoli Shiraji
- Hematology, Oncology and Bone Marrow transplantation Research Center, Shariati Hospital, Tehran University of Medical Science,Tehran, Iran
| | - Mohammad Biglari
- Hematology, Oncology and Bone Marrow transplantation Research Center, Shariati Hospital, Tehran University of Medical Science,Tehran, Iran
| | - Mamak Tahmasebi
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Seung-Kwon Myung
- National Cancer Center of Korea, Goyang-si Gyeonggi-do, Republic of Korea
| | - June Young Chun
- National Cancer Center of Korea, Goyang-si Gyeonggi-do, Republic of Korea
| | - Jong Soo Han
- National Cancer Center of Korea, Goyang-si Gyeonggi-do, Republic of Korea
| | - Fen Nee Lau
- National Cancer Institute, Putrajaya, Malaysia
| | | | | | - Khin Thin Mu
- Myanmar Yangon General Hospital, Yangon, Myanmar
| | | | - Aasim Yusuf
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | - Ching-Hung Lin
- National Taiwan University Cancer Center Hospital, Taipei City, Taiwan
| | - Ruru Chun-Ju Chiang
- Taiwan Cancer Registry, and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | | | | | | | - D N Sharma
- Dr BR Ambedkar Institute Rotary Cancer Hospital & National Cancer Institute, All India Institute of Medical Sciences, Delhi, India
| | - Manju Sengar
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - C S Pramesh
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Oishi T, Muratani T, Tanaka T, Sato M, Kohdera U, Ouchi K, Iwata S, Matsumoto T, Nakahama C. Study of normal flora in the pharynx of healthy children. Jpn J Infect Dis 2021; 74:450-457. [PMID: 33642434 DOI: 10.7883/yoken.jjid.2020.824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To improve our current understanding of normal flora in children, we investigated bacterial isolates from pharynx and nasopharynx of 173 and 233 healthy children, respectively. The bacterial isolation rates were compared among three age groups: infants (<1 year), toddlers (1-5 years), and school-age children (6-15 years). Gram-positive cocci (GPC) were the predominant bacteria in the pharynx (Streptococcus mitis/oralis, 87.3%; Streptococcus salivarius, 54.3%; Rothia mucilaginosa, 41.6%; Staphylococcus aureus, 39.3%). Among infants, Streptococcus salivarius and Neisseria subflava, which are related to the development of teeth, were significantly lower than in the other age groups (p<0.0001, S. salivarius; p<0.01, N. subflava). Gram-negative rods (GNR) predominated the nasopharynx (Moraxella catarrhalis, 32.1%; and Moraxella nonliquefaciens, 28.3%) except for Corynebacterium pseudodiphtheriticum (44.2%) of gram-positive rods. Among toddlers, Moraxella catarrhalis and Streptococcus pneumoniae, which are the most common pathogens in acute otitis media, were significantly higher than in the infant group (p<0.05 for both). Among bacterial species implicated in pediatric respiratory infection, Streptococcus pyogenes was isolated in 3.5% of pharyngeal samples. S. pneumoniae and Haemophilus influenzae were isolated in 22.3% and 17.2% of nasopharyngeal samples, respectively. In conclusion, normal flora of the respiratory tract differs not only by sampling site but also by age group.
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Affiliation(s)
| | | | | | | | | | | | - Satoshi Iwata
- Department of Infectious Diseases National Cancer Center Hospital, Japan.,Center for Infectious Disease and Infection Control, Keio University Hospital, Japan
| | - Tetsuro Matsumoto
- Hospital of the University of Occupational and Environmental Health, Japan
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25
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Baba K, Yoshida T, Shiotsuka M, Kobayashi O, Iwata S, Ohe Y. Rapid development of pulmonary Mycobacterium avium infection during chemoradiotherapy followed by durvalumab treatment in a locally advanced NSCLC patient. Lung Cancer 2021; 153:182-183. [PMID: 33546908 DOI: 10.1016/j.lungcan.2021.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 12/30/2022]
Affiliation(s)
- Keisuke Baba
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Yoshida
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
| | - Mika Shiotsuka
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Osamu Kobayashi
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
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26
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Iwata S, Takata M, Morozumi M, Miyairi I, Matsubara K, Ubukata K. Drastic reduction in pneumococcal meningitis in children owing to the introduction of pneumococcal conjugate vaccines: Longitudinal analysis from 2002 to 2016 in Japan. J Infect Chemother 2020; 27:604-612. [PMID: 33303361 DOI: 10.1016/j.jiac.2020.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/17/2020] [Revised: 10/22/2020] [Accepted: 11/13/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION The characteristics of pneumococcal isolates and their associations with outcomes in pediatric meningitis are unclear. This study aimed to clarify serotypes and resistance genotypes of Streptococcus pneumoniae from children with meningitis and evaluate the patient prognoses and backgrounds. METHODS Large-scale surveillance was conducted from 2002 to 2016 through periods I-V. Serotypes and penicillin (PEN) resistance genotypes were analyzed for pneumococcal isolates (n = 459) and cerebrospinal fluid (CSF) samples (n = 25). Furthermore, underlying diseases (n = 251), prognoses (n = 202), and laboratory data were evaluated. RESULTS The number of meningitis cases decreased drastically after the introduction of 7-valent pneumococcal conjugate vaccine (PCV7) to -53.6% and after switching to PCV13 to -70.2%. In particular, this reduction was apparent at ≤3 years of age. The proportion of the PCV7 serotype decreased sharply from 70.1% before introduction to 2.6% during period V; however, the non-vaccine type increased from 17.5% to 87.2%. The PEN resistance rate (gPRSP) was decreased from approximately 49% to 12.2% during period V. Among cases revealed prognosis, sequelae and mortality rates were 16.3% and 5.4%, respectively. The rate of the patients with underlying diseases was 26.3% and relatively high in ≥6 years. Laboratory data associated with a poor prognosis were low white blood cell count (<12.7 × 103/μL), low platelet count (<28.1 × 104/μL), low CSF-glucose (<36 mg/dL), and high CSF-protein (≥142 mg/dL). CONCLUSIONS Changes in serotype prevalence warrant continuous monitoring to observe future trends of pneumococcal meningitis, and further developments in multivalent conjugate vaccines are required.
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Affiliation(s)
- Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan; Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.
| | - Misako Takata
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Miyuki Morozumi
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Isao Miyairi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Keita Matsubara
- Department of Pediatrics, Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan
| | - Kimiko Ubukata
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan; Department of General Medicine, Keio University School of Medicine, Japan
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Ishiwada N, Fujimaki K, Matsumoto T, Kiyota H, Tateda K, Sato J, Hanaki H, Takayanagi R, Yamaguchi Y, Hoshino T, Kuroki H, Iwata S, Tajima T, Horikoshi Y, Shiro H, Bamba M, Kawamura N, Ouchi K, Matsubara K, Okada T, Furuno K, Tsumura N. Nationwide surveillance of bacterial pathogens isolated from children conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2017: General overview of pathogenic antimicrobial susceptibility. J Infect Chemother 2020; 27:139-150. [PMID: 33277177 DOI: 10.1016/j.jiac.2020.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/14/2020] [Accepted: 11/13/2020] [Indexed: 11/17/2022]
Abstract
A nationwide surveillance of the antimicrobial susceptibility of pediatric patients to bacterial pathogens was conducted by Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in Japan in 2017. The isolates were collected from 18 medical facilities between March 2017 and May 2018 by the three societies. Antimicrobial susceptibility testing was conducted at the central laboratory (Infection Control Research Center, Kitasato University, Tokyo) according to the methods recommended by the Clinical Laboratory Standards Institute. Susceptibility testing was evaluated in 926 strains (331 Streptococcus pneumoniae, 360 Haemophilus influenzae, 216 Moraxella catarrhalis, 5 Streptococcus agalactiae, and 14 Escherichia coli). The ratio of penicillin-resistant S. pneumoniae was 0% based on CLSI M100-ED29 criteria. However, three meropenem or tosufloxacin resistant S. pneumoniae isolates were obtained. Among H. influenzae, 13.1% of them were found to be β-lactamase-producing ampicillin resistant strains, while 20.8% were β-lactamase non-producing ampicillin-resistant strains. No capsular type b strains were detected. In M. catarrhalis, 99.5% of the isolates were β-lactamase-producing strains. All S. agalactiae and E. coli strains were isolated from sterile body sites (blood or cerebrospinal fluid). The ratio of penicillin-resistant S. agalactiae was 0%, while that of extended spectrum β-lactamase-producing E. coli was 14.3%.
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Affiliation(s)
- Naruhiko Ishiwada
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan.
| | - Kazuo Fujimaki
- The Surveillance Committee of JSC, JAID, and JSCM, Tokyo, Japan; Fujifilm Toyama Chemical Co., Ltd, Japan
| | | | - Hiroshi Kiyota
- The Surveillance Committee of JSC, JAID, and JSCM, Tokyo, Japan
| | - Kazuhiro Tateda
- The Surveillance Committee of JSC, JAID, and JSCM, Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of JSC, JAID, and JSCM, Tokyo, Japan
| | - Hideaki Hanaki
- Infection Control Research Center, The Omura Satoshi Memorial Institution, Kitasato University, Tokyo, Japan
| | - Reiko Takayanagi
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Tohoku Rosai Hospital, Miyagi, Japan
| | - Yoshio Yamaguchi
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Infection and Allergy, Tochigi Medical Center, Tochigi, Japan
| | - Tadashi Hoshino
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Division of Infections Diseases, Chiba Children's Hospital, Chiba, Japan
| | - Haruo Kuroki
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Sotobo Children's Clinic, Chiba, Japan
| | - Satoshi Iwata
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Infection Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Tajima
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Hakujikai Memorial Hospital, Tokyo, Japan
| | - Yuho Horikoshi
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Division of Infections Diseases, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Hiroyuki Shiro
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Masahiro Bamba
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Naohisa Kawamura
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Osaka Rosai Hospital, Osaka, Japan
| | - Kazunobu Ouchi
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Kawasaki Medical School Hospital, Okayama, Japan
| | - Keita Matsubara
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan
| | - Takafumi Okada
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Shikoku Medical Center for Children and Adults, Kagawa, Japan
| | - Kenji Furuno
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of General Pediatrics and Interdisciplinary Medicine, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Naoki Tsumura
- Pediatric Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID), The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Pediatrics, Kurume University Hospital, Fukuoka, Japan
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Saitoh A, Saitoh A, Katsuta T, Mine M, Kamiya H, Miyairi I, Ishiwada N, Oshiro M, Kira R, Shimizu N, Suga S, Tsugawa T, Fujioka M, Miyazaki C, Morioka I, Korematsu S, Nakano T, Tanaka-Taya K, Yoshikawa T, Iwata S, Kusuhara K, Azuma H, Moriuchi H, Okabe N, Hosoya M, Tsutsumi H, Okada K. Effect of a vaccine information statement (VIS) on immunization status and parental knowledge, attitudes, and beliefs regarding infant immunization in Japan. Vaccine 2020; 38:8049-8054. [PMID: 33139133 DOI: 10.1016/j.vaccine.2020.10.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Because of the overabundance of vaccination information on the internet, in the media, and on social media, providing clear and correct information on immunization is critical for parental decision-making. In 2018, the Japan Pediatric Society created and distributed a Vaccine Information Statement (VIS) to provide appropriate immunization information to caregivers. The objectives of the present study were to evaluate the effect of the VIS on immunization rates, adherence to schedule, and parental understanding of immunization in Japan. METHODS This cross-sectional study was conducted at 18 centers in 2 prefectures in Japan. Caregivers were assigned to an intervention group, which received the VIS and a questionnaire when their child reached the age of 1 month, and a control group, which received only the questionnaire. Using the self-reported questionnaires, we evaluated vaccination rates and schedule adherence at age 2 months, and parental knowledge, attitudes, and beliefs regarding immunization. Three months later, the questionnaires were returned, and the findings were compared between the 2 groups. RESULTS We contacted 422 and 428 persons in the intervention and control groups, respectively, and 111/422 (26.3%) and 119/428 (27.8%) returned the surveys. Vaccination rates and adherence rates for the first dose of 4 recommended vaccines did not differ significantly (P > 0.25); however, there were some positive effects on items related to vaccine knowledge (P = 0.03), perceived benefits (P = 0.02), perceived barriers (P < 0.001), and perceived behavioral control (P = 0.01). CONCLUSION The VIS improved parent comprehension of infant immunization. Future studies should examine if the effects of such an intervention persist and affect vaccine uptake throughout childhood.
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Affiliation(s)
- Aya Saitoh
- Department of Nursing, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Akihiko Saitoh
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomohiro Katsuta
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Mahito Mine
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Mine Pediatric Clinic, Saitama, Japan
| | - Hajime Kamiya
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Isao Miyairi
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan
| | - Naruhiko Ishiwada
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Makoto Oshiro
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Neonatology, Japanese Red Cross Nagoya Daiichi Hospital, Aichi, Japan
| | - Ryutaro Kira
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Naoki Shimizu
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Shigeru Suga
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Infectious Disease Center and Department of Clinical Research, National Hospital Organization Mie Hospital, Mie, Japan
| | - Takeshi Tsugawa
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Masashi Fujioka
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Fujioka Pediatrics, Osaka, Japan
| | - Chiaki Miyazaki
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Fukuoka Welfare Center for the Disabled, Fukuoka, Japan
| | - Ichiro Morioka
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Seigo Korematsu
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, University Faculty of Medicine, Oita, Japan
| | - Takashi Nakano
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Keiko Tanaka-Taya
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tetsushi Yoshikawa
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, Fujita Health University School of Medicine, Aichi, Japan
| | - Satoshi Iwata
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Kusuhara
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Hiroshi Azuma
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, Asahikawa Medical University, Hokkaido, Japan
| | - Hiroyuki Moriuchi
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, Nagasaki University, Nagasaki, Japan
| | - Nobuhiko Okabe
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Kawasaki City Institute for Public Health, Kanagawa, Japan
| | - Mitsuaki Hosoya
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Hiroyuki Tsutsumi
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Department of Pediatrics, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Kenji Okada
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan; Division of Basic Nursing, Fukuoka Nursing College, Fukuoka, Japan
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Hosoba R, Makita S, Shiotsuka M, Kobayashi O, Nakano K, Muroya M, Okada N, Suzuki M, Ida H, Fukuhara S, Munakata W, Suzuki T, Maruyama D, Maeshima AM, Matsushita H, Yamamoto N, Ohe Y, Iwata S, Izutsu K. COVID-19 pneumonia in a patient with adult T-cell leukemia-lymphoma. J Clin Exp Hematop 2020; 60:174-178. [PMID: 32879154 PMCID: PMC7810254 DOI: 10.3960/jslrt.20030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Indexed: 12/25/2022] Open
Abstract
Although some patients with COVID-19 develop only mild symptoms, fatal complications have been observed among those with comorbidities. As patients with cancer are immunocompromised, they are thought to have a high risk of severe illness associated with COVID-19. We report a COVID-19 patient with adult T-cell leukemia-lymphoma (ATL) who was treated using favipiravir. A 69-year-old woman with lymphoma-type ATL was treated using cyclophosphamide, doxorubicin, vincristine, prednisolone and mogamulizumab (M-CHOP) with substantial efficacy. However, in cycle 4 of M-CHOP therapy, she developed fever with mild cough. The patient was admitted to the hospital and CT revealed bilateral ground-glass opacities. SARS-CoV-2 was detected by RT-PCR and the patient was diagnosed with COVID-19. Considering severe immunosuppression caused by ATL, we initiated favipiravir therapy. Subsequently, the fever improved without antipyretics and her C-reactive protein level decreased rapidly. SARS-CoV-2 PCR tests were negative on days 17 and 18 of favipiravir therapy, and the patient was discharged without residual disease on the final CT. This is the first documented case of COVID-19 in a patient with ATL. Although severe immunosuppression caused by ATL was present, severe COVID-19 pneumonia did not develop. The immunosuppressed condition caused by hematological malignancy may not always be a risk factor for severe illness associated with COVID-19. Further accumulation of data regarding COVID-19 in patients with hematological malignancies is warranted to clarify the risk factors for severe illness, the best-in-class antiviral agent, and the optimal treatment strategy in this population.
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Affiliation(s)
- Rika Hosoba
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Shinichi Makita
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Mika Shiotsuka
- Office of Infection Control and Prevention, National Cancer Center Hospital, Tokyo, Japan
| | - Osamu Kobayashi
- Office of Infection Control and Prevention, National Cancer Center Hospital, Tokyo, Japan
| | - Kiyoko Nakano
- Office of Infection Control and Prevention, National Cancer Center Hospital, Tokyo, Japan
| | - Mimiko Muroya
- Office of Infection Control and Prevention, National Cancer Center Hospital, Tokyo, Japan
| | - Naoko Okada
- Nursing Office, Ward 11B, National Cancer Center Hospital, Tokyo, Japan
| | - Makiko Suzuki
- Nursing Office, Ward 18, National Cancer Center Hospital, Tokyo, Japan
| | - Hanae Ida
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Suguru Fukuhara
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Wataru Munakata
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Dai Maruyama
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Hiromichi Matsushita
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- The COVID-19 Treatment Team, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Iwata
- Office of Infection Control and Prevention, National Cancer Center Hospital, Tokyo, Japan
| | - Koji Izutsu
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
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Frezza A, Ravi V, Lo Vullo S, Tolomeo F, Wei-Wu Chen T, Teterycz P, Baldi G, Italiano A, Penel N, Brunello A, Duffaud F, Hindi N, Iwata S, Smrke A, Fedenko A, Gelderblom H, Van Der Graaf W, Vozy A, Vincenzi B, Stacchiotti S. 1627MO Systemic therapies in advanced epithelioid haemangioendothelioma (EHE): A retrospective international series from the World Sarcoma Network. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Dewi LKM, Gatellier L, Sabapathy K, Pramesh CS, Dai M, Huong TT, Gultekin M, Nansalmaa E, Htwe KK, Yusuf A, Tahmasebi M, Pradhananga KK, Park JB, Hanapiah SM, Sangrajran S, Baral RP, Jayusman AM, Iwata S, Wei Kwek J, Sengar M, Chinnaswamy G, He J, Tian G, Huyen PT, Thuan TV, Luvsanjodorj B, Myint YY, Young Chun J, Han JS, Hwang WYK, Sari NK, Matsuda T. An Asian Perspective of the Management of COVID-19: the Asian National Cancer Centers Alliance Led Regional Comparison. Asian Pac J Cancer Care 2020. [DOI: 10.31557/apjcc.2020.5.s1.27-42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To describe how the Asian National Cancer Centers Alliance (ANCCA) members preserve high standards of care for cancer patients while battling the COVID-19 pandemic and to propose new strategies in the Asian Cancer Centers’ preparedness to future pandemics. Methods: A 41-question-based survey was developed using an online survey tool and conducted among 15 major Asian National Cancer Centers, including 13 ANCCA members. Direct interviews of several specialists were conducted subsequently to obtain additional answers to key questions that emerged during the survey analysis. Result: Institution/country-specific results provided a strong insight on the diverse ways of managing the pandemic around Asia, while maintaining well-balanced cancer care. Pragmatic strategies were put in place in each NCC hospital, including zoning and intensive triage depending on the pandemic impact. Distancing strategies and telemedicine were implemented in different capacity depending on the national healthcare system. In addition, there was a diverse impact on the manpower and financial aspect of cancer care across surveyed NCCs relating to magnitude of the pandemic impact on the country. Conclusion: The priorities nevertheless remain on maintaining cancer care delivery while protecting both patients and health care workers from the risk of COVID-19 infection. The role of a think-tank such as ANCCA to help share experiences in a timely manner can enhance preparedness in future pandemic scenarios.
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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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Hao H, Nakayamada S, Kaoru Y, Ohkubo N, Iwata S, Tanaka Y. THU0231 IL-2 DRIVES THE CONVERSION OF T FOLLICULAR HELPER TO T FOLLICULAR REGULATORY CELLS THROUGH EPIGENETIC MODIFICATION IN SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic lupus erythematosus (SLE) is a complex polygenic autoimmune disease characterized by immune-system aberrations. Among several types of immune cells, T follicular helper (Tfh) cells promote autoantibody production, whereas T follicular regulatory (Tfr) cells suppress Tfh-mediated antibody responses.(1)Objectives:To identify the characteristics of Tfr cells and to elucidate the mechanisms of conversion of Tfh cells to Tfr cells, we probed the phenotype of T helper cells in patients with SLE and underlying epigenetic modifications by cytokine-induced signal transducer and activators of transcription (STAT) family factors.Methods:Peripheral blood mononuclear cells from SLE patients (n=44) and healthy donors (HD; n=26) were analyzed by flow cytometry. Memory Tfh cells were sorted and cultured under stimulation with T cell receptor and various cytokines. Expression of characteristic markers and phosphorylation of STATs (p-STATs) were analyzed by flow cytometry and quantitation PCR. Histone modifications were evaluated by chromatin immunoprecipitation.Results:The proportion of CXCR5+FoxP3+Tfr cells in CD4+T cells tended to increase (2.1% vs 1.7%, p=0.17); however, that of CD4+CD45RA-FoxP3hiactivated Tfr cells in Tfr cells was decreased (4.8% vs 7.1%, p<0.05), while CD4+CD45RA-FoxP3lownon-suppressive Tfr cells was increased (50.1% vs 38.2%, p<0.01) in SLE compared to HD. The percentage of PD-1hiactivated Tfh cells was significantly higher in SLE compared to HD (15.7% vs 5.9%, p<0.01). Furthermore, active patients had a higher ratio of activated Tfh/Tfr cells compared to inactive patients. In vitro study showed that IL-2, but not other cytokines such as TGF-β1, IL-12, IL-27, and IL-35, induced the conversion of memory Tfh cells to functional Tfr cells characterized by CXCR5+Bcl6+Foxp3hipSTAT3+pSTAT5+cells. The loci ofFOXP3at STAT binding sites were marked by bivalent histone modifications. After IL-2 stimulation, STAT5 directly bound on FOXP3 gene loci accompanied by suppressing H3K27me3. Finally, we found that serum level of IL-2 was decreased in SLE and that stimulation with IL-2 suppressed the generation of CD38+CD27+B cells by ex vivo coculture assay using Tfh cells and B cells isolated from human blood.Conclusion:Our findings indicated that the regulatory function of Tfr cells is impaired due to the low ability of IL-2 production and that IL-2 restores the function of Tfr cells through conversion of Tfh cells to Tfr cells in SLE. Thus, the reinstatement of the balance between Tfh and Tfr cells will provide important therapeutic approaches for SLE.References:[1]Deng J, Wei Y, Fonseca VR, et al. T follicular helper cells and T follicular regulatory cells in rheumatic diseases. Nat Rev Rheumatol. 2019; 15 (8): 475-90.Disclosure of Interests: :He Hao: None declared, Shingo Nakayamada Grant/research support from: Mitsubishi-Tanabe, Takeda, Novartis and MSD, Speakers bureau: Bristol-Myers, Sanofi, Abbvie, Eisai, Eli Lilly, Chugai, Asahi-kasei and Pfizer, Yamagata Kaoru: None declared, Naoaki Ohkubo: None declared, Shigeru Iwata: None declared, Yoshiya Tanaka Grant/research support from: Asahi-kasei, Astellas, Mitsubishi-Tanabe, Chugai, Takeda, Sanofi, Bristol-Myers, UCB, Daiichi-Sankyo, Eisai, Pfizer, and Ono, Consultant of: Abbvie, Astellas, Bristol-Myers Squibb, Eli Lilly, Pfizer, Speakers bureau: Daiichi-Sankyo, Astellas, Chugai, Eli Lilly, Pfizer, AbbVie, YL Biologics, Bristol-Myers, Takeda, Mitsubishi-Tanabe, Novartis, Eisai, Janssen, Sanofi, UCB, and Teijin
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Miyazaki Y, Nakano K, Nakayamada S, Kubo S, Iwata S, Hanami K, Fukuyo S, Miyagawa I, Yamaguchi A, Kawabe A, Kazuyoshi S, Tanaka Y. FRI0102 SERUM TNFΑ LEVELS AT 24 HOURS AFTER FIRST ADMINISTRATION OF CERTOLIZUMAB PEGOL PREDICT EFFECTIVENESS AT WEEK 12 IN PATIENTS WITH RHEUMATOID ARTHRITIS FROM TSUBAME STUDY (UMIN ID:0002381). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:To increase the remission rate of rheumatoid arthritis (RA), it is necessary to determine the efficacy of the tumor necrosis factor (TNF) inhibitor as early as possible. Moreover, the response to certolizumab pegol (CZP) at 12 weeks has been reported to predict its long-term efficacy.Objectives:As part of a prospective single-center observational study (TSUBAME study), we prospectively enrolled patients to be treated with CZP in our institution to evaluate its effectiveness and safety starting at 24 hours after the first dose in clinical settings, while recording blood CZP concentrations and biomarkers over time to examine their correlation with clinical effects.Methods:One hundred patients with RA and inadequate response to MTX who received CZP were enrolled in the TSUBAME study. The changes in serum TNFα, IL-6, and CZP levels at 24 hours after first administration of CZP were measured, and the correlation between serum biomarkers and clinical response was determined.Results:At 24 hours after CZP initiation, significant improvement was observed in the disease activity (baseline and 24 h: 5.4 ± 1.3, 5.0 ± 1.3, respectively, p < 0.01), which was maintained until week 12. (baseline and 12 w: 5.4 ± 1.3, 3.3 ± 1.4, respectively, p < 0.01). Serum TNFα and IL-6 levels significantly decreased at 24 hours after first administration of CZP compared to baseline. No correlation was found between TNFα and IL-6 levels at baseline and the clinical response. According to univariate analysis, low serum TNFα and IL-6 levels and high CZP levels at 24 hours were associated with DAS28 (ESR) remission at 12 weeks. According to multivariate analysis, low serum TNFα levels at 24 hours were significantly associated with DAS28 (ESR) remission at 12 weeks (OR 0.05, 95%CI 0.01, 0.75, p = 0.03). Based on these findings, an ROC curve was created using remission according to the DAS28 (ESR) at week 12 as a dependent variable and TNFα concentration at 24 hours as an independent variable, resulting in a cut-off value of 0.76 pg/ml. From this result, the TNFα concentration at 24 hours was divided into 2 groups according to this cut-off, and the rates of remission according to the DAS28 (ESR) at week 12 were compared. In the group with TNFα concentration at 24 hours below the cut-off value, the rate of remission according to the DAS28 (ESR) at week 12 was significantly higher than in the group with TNFα concentration at 24 hours above the cut-off value (below the cut-off: above the cut-off = 56.3%: 21.6%, p < 0.001). Between the group that achieved remission according to the DAS28(ESR) and the group that did not achieve remission at week 12, there was almost no difference in the distribution of TNFα concentrations at baseline; however, the distribution of TNFα concentrations at 24 hours was lower in the group that achieved remission.Conclusion:CZP was effective where serum TNFα was strongly neutralized within 24 hours. These results suggest that low serum TNFα levels at 24 hours after first administration of CZP may predict the effectiveness of CZP. To increase the remission rate in RA, it is necessary to determine the effectiveness of the molecular targeted drugs used at an early point, in addition to how rapid the onset of action is. CZP is extremely fast-acting, and its effectiveness can be predicted as early as 24 hours after the first dose, suggesting that it may be possible to determine the effectiveness early.Acknowledgments:The authors thank Ms. M. Hirahara for providing excellent technical assistance.Disclosure of Interests:Yusuke Miyazaki Grant/research support from: Astellas Pharma Inc and UCB S.A., Kazuhisa Nakano: None declared, Shingo Nakayamada Grant/research support from: Mitsubishi-Tanabe, Takeda, Novartis and MSD, Speakers bureau: Bristol-Myers, Sanofi, Abbvie, Eisai, Eli Lilly, Chugai, Asahi-kasei and Pfizer, Satoshi Kubo: None declared, Shigeru Iwata: None declared, Kentaro Hanami: None declared, Shunsuke Fukuyo: None declared, Ippei Miyagawa: None declared, Ayako Yamaguchi: None declared, Akio Kawabe: None declared, SAITO KAZUYOSHI: None declared, Yoshiya Tanaka Grant/research support from: Asahi-kasei, Astellas, Mitsubishi-Tanabe, Chugai, Takeda, Sanofi, Bristol-Myers, UCB, Daiichi-Sankyo, Eisai, Pfizer, and Ono, Consultant of: Abbvie, Astellas, Bristol-Myers Squibb, Eli Lilly, Pfizer, Speakers bureau: Daiichi-Sankyo, Astellas, Chugai, Eli Lilly, Pfizer, AbbVie, YL Biologics, Bristol-Myers, Takeda, Mitsubishi-Tanabe, Novartis, Eisai, Janssen, Sanofi, UCB, and Teijin
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Suzuki J, Kobayashi S, Yoshida N, Azuma Y, Kobayashi-Ogata N, Kartikasari DP, Yanagawa Y, Iwata S. Phylogenetic position of Nyctotherus teleacus isolated from a tortoise (Astrochelys radiata) and its electron microscopic features. J Vet Med Sci 2020; 82:699-703. [PMID: 32336700 PMCID: PMC7324835 DOI: 10.1292/jvms.20-0004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Indexed: 11/29/2022] Open
Abstract
A commensal ciliate was isolated from the stool of a tortoise (Astrochelys
radiata). The ciliate was classified as Nyctotherus teleacus,
according to its basic morphological features. Electron microscopic observations using
cultured N. teleacus (NictoT1 strain) revealed many spherical
hydrogenosomes and methanogen-suspected bacteria, together with a characteristic
triangular macronucleus containing many spherical chromosomes in the cytoplasm of NictoT1.
The results of phylogenetic analysis showed that NictoT1 was included in the cluster of
Nyctotheroides spp. (family Nyctotheridae).
Nyctotheroides spp. commonly infest amphibians, which are taxonomically
closely related to reptiles, including the tortoises evaluated in the present study.
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Affiliation(s)
- Jun Suzuki
- Division of Food Microbiology, Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunin-cho, Shinjuku-ku, Tokyo 169-0073, Japan
| | - Seiki Kobayashi
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Naoko Yoshida
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yoshiyuki Azuma
- Laboratory of Animal and Human Nutritional Physiology, Kitasato University School of Veterinary Medicine, 35-1 Higashi, 23-bancho, Towada-shi, Aomori 034-8628, Japan
| | - Namiko Kobayashi-Ogata
- Center for Advanced Marine Core Research, Kochi University, 200 Mononobe Otsu, Nangoku-shi, Kochi 783-8502, Japan
| | - Dwi Peni Kartikasari
- Department of Parasitology, Faculty of Medicine, Universitas Airlangga, Kampus A UNAIR, Jl. Prof. Moestopo 47 Surabaya, 60132, Indonesia
| | - Yasuaki Yanagawa
- AIDS Clinical Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Ubukata K, Wajima T, Morozumi M, Sakuma M, Tajima T, Matsubara K, Itahashi K, Iwata S. Changes in epidemiologic characteristics and antimicrobial resistance of Streptococcus pyogenes isolated over 10 years from Japanese children with pharyngotonsillitis. J Med Microbiol 2020; 69:443-450. [PMID: 32011228 DOI: 10.1099/jmm.0.001158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Pharyngotonsillitis caused by Streptococcus pyogenes (group A streptococci, or GAS) is among the most common infections treated with antibiotics in pediatric patients.Aim. This study aimed to analyse changes in molecular epidemiology and antibiotic susceptibility among GAS isolates in three study periods spanning 10 years.Methodology. GAS isolated from paediatric patients with pharyngotonsillitis during Period I (mid-2007 to 2008, n=235), Period II (2012, n=210), and Period III (2018, n=189) were analysed for emm type, multilocus sequence type (MLST), antibiotic susceptibility, and macrolide (ML)- and quinolone (QL)-resistance genes.Results. Over 20 % of isolates represented emm1 and emm12 types, remaining common in all three periods. Among other emm types, emm4 was common in Period I, emm28 and emm89 in Period II, and emm3 and emm89 in Period III. All isolates remained highly susceptible to penicillins and cephalosporins. Isolates possessing mefA, ermA, or ermB genes mediating ML resistance increased from 34.9 % in Period I to 60.9 % in Period II, but fell to 27.5 % in Period III. QL-resistant isolates with amino acid substitutions affecting ParC and/or GyrA gradually increased from 11.5 to 14.3 %. Specific sequence types identified by MLST and emm typing were associated closely with ML or QL resistance.Conclusion. Our findings indicate that even in ambulatory care, antibiotic choice for these infections should be based on rapid identification and characterization of causative pathogens.
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Affiliation(s)
- Kimiko Ubukata
- Department of Infectious Diseases, Keio University, School of Medicine, Tokyo, Japan
| | - Takeaki Wajima
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Miyuki Morozumi
- Department of Infectious Diseases, Keio University, School of Medicine, Tokyo, Japan
| | - Megumi Sakuma
- Department of Infectious Diseases, Keio University, School of Medicine, Tokyo, Japan
| | - Takeshi Tajima
- Department of Pediatrics, Hakujikai Memorial Hospital, Tokyo, Japan
| | - Keita Matsubara
- Department of Pediatrics, Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan
| | - Koju Itahashi
- Pharmaceutical R&D Division, Meiji Seika Pharma, Tokyo, Japan
| | - Satoshi Iwata
- Departments of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan.,Department of Infectious Diseases, Keio University, School of Medicine, Tokyo, Japan
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Tamaoka S, Shindo J, Tsuchihashi T, Bamba M, Iwata S. A 9-year-old boy with a sinus-related epidural abscess caused by Listeria monocytogenes. Pediatr Int 2020; 62:502-503. [PMID: 32307827 DOI: 10.1111/ped.14111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/29/2019] [Revised: 10/26/2019] [Accepted: 12/12/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Satoshi Tamaoka
- Departments of, Department of, Pediatrics, Keio University School of Medicine, Tokyo, Japan.,Department of Pediatrics, Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Jyunya Shindo
- Department of Pediatrics, Kawasaki Municipal Hospital, Kanagawa, Japan
| | | | - Masahiro Bamba
- Department of Pediatrics, Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Satoshi Iwata
- Department of, Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
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Yamazawa E, Ohno M, Satomi K, Yoshida A, Miyakita Y, Takahashi M, Satomi N, Asanome T, Maeshima A, Shiotsuka M, Iwata S, Yamasaki H, Morishima Y, Sugiyama H, Narita Y. First case of human neurocoenurosis caused by Taenia serialis: A case report. Int J Infect Dis 2020; 92:171-174. [PMID: 31927059 DOI: 10.1016/j.ijid.2020.01.004] [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: 12/06/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 10/25/2022] Open
Abstract
Human coenurosis is caused by the larval stages of Taenia species, mainly Taenia multiceps and Taenia serialis. T. multiceps has been reported to cause human central nervous system (CNS) infections, but no CNS case caused by T. serialis has been reported. The authors report the first case of human neurocoenurosis caused by T. serialis, which was confirmed by mitochondrial DNA analysis. A 38-year-old man presented with visual disturbance and headache, and subsequent magnetic resonance imaging (MRI) revealed a ring-enhancing cystic lesion in the left occipital lobe. Biopsy was performed, and the resultant histopathological diagnosis was that of low-grade B-cell lymphoma. Chemotherapy was initiated, but a subsequent MRI showed increased ring enhancement. Due to the unexpected clinical course, a surgical resection of the lesion was performed. The lesion was completely removed. Pathological examination showed multiple scolices with hooklets, suckers, and numerous calcareous corpuscles. Therefore, the diagnosis of neurocysticercosis was made. However, mitochondrial DNA analysis showed that the disease was definitively coenurosis caused by T. serialis. Albendazole was administered, with no evidence of recurrence at 12 months following the operation. In this study, we demonstrate that T. serialis can cause CNS infection and that genetic analysis is recommended to establish a definitive diagnosis.
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Affiliation(s)
- Erika Yamazawa
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Makoto Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
| | - Kaishi Satomi
- Department of Diagnostic Pathology, National Cancer Center Hospital, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Yasuji Miyakita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Natsuko Satomi
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Taku Asanome
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Akiko Maeshima
- Department of Diagnostic Pathology, National Cancer Center Hospital, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Mika Shiotsuka
- Department of Infectious Diseases, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Hiroshi Yamasaki
- Department of Parasitology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Yasuyuki Morishima
- Department of Parasitology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Hiromu Sugiyama
- Department of Parasitology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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Okai T, Mizutani K, Yamaguchi T, Ogawa M, Kajio K, Ito A, Iwata S, Takahashi Y, Izumiya Y, Murakami T, Shibata T, Yoshiyama M. P107 Predictors of increased d-dimer level at follow-up period after transcatheter aortic valve implantation.Is oral anticoagulation therapy better? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Recently, there are some reports that hypo-attenuated leaflet thickening (HALT) following transcatheter aortic valve implantation (TAVI) is incidentally detected by multi-slice computed tomography. It is believed that valve thrombosis causes HALT, because oral anticoagulation therapy (OAC) is effective for HALT regression. Furthermore, it is reported that d-dimer level increases in patients with HALT, and might be a key biomarker to detect HALT.
Purpose
We sought to investigate the predictors related to increased d-dimer level at 6 months after follow-up TAVI.
Methods
We enrolled 124 consecutive patients who underwent successful TAVI between 2016 and 2018. Study patients were classified into two groups according to antithrombotic therapy resume (OAC therapy or anti-platelet therapy).We set the primary endpoint as the d-dimer levels at 6 months after TAVI. To evaluate the risks of the primary endpoint, we employed a multivariable linear regression model, setting the primary endpoint as an objective variable and patient and clinical backgrounds as explanatory variables. Furthermore, we set the secondary endpoint as one-year bleeding event.
Results
The median age of patients was 83 years old (quartile 80-87). Patients who had taken OAC at 6 months follow-up after TAVI were 29.8%. The median d-dimer level at 6 months after TAVI was 1.3 (1.0-2.2) µg/ml, and OAC group had statistically lower d-dimer level at 6 months follow-up than those in non-OAC group (p = 0.020). Uni-variable liner regression model demonstrated that increased d-dimer level at follow-up had significant relationship with large effective orifice area (EOA) (p = 0.002) and low left ventricular ejection fraction (LVEF) (p = 0.048) after TAVI. Furthermore, large EOA (p = 0.003) and OAC therapy (p = 0.027) were independently associated with increased d-dimer level in multivariate analysis. Kaplan-Meier estimates revealed that there were no significant difference regarding one-year bleeding event between OAC group and non-OAC group (long-rank p = 0.167).
Conclusions
This study suggests that large EOA after TAVI is associated with increased d-dimer levels at 6 months after TAVI, and OAC therapy might have a potential to decrease d-dimer level after TAVI without increase of bleeding events.
Abstract P107 Figure: One-year bleeding event
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Affiliation(s)
- T Okai
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - K Mizutani
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - T Yamaguchi
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - M Ogawa
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - K Kajio
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - A Ito
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - S Iwata
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - Y Takahashi
- Osaka City University Graduate School of Medicine, Cardiovascular Surgery, Osaka, Japan
| | - Y Izumiya
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - T Murakami
- Osaka City University Graduate School of Medicine, Cardiovascular Surgery, Osaka, Japan
| | - T Shibata
- Osaka City University Graduate School of Medicine, Cardiovascular Surgery, Osaka, Japan
| | - M Yoshiyama
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
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Matsuoka YJ, Okubo R, Shimizu Y, Tsuji K, Narisawa T, Sasaki J, Sasai H, Akashi-Tanaka S, Hamaguchi T, Iwasa T, Iwata S, Kato T, Kurotani K, Maruyama D, Mori A, Ogawa A, Sakurai N, Shimazu T, Shimizu C, Tabuchi T, Takahashi M, Takano T, Tatematsu N, Uchitomi Y, Watanabe C, Fukui T. Developing the structure of Japan's cancer survivorship guidelines using an expert panel and modified Delphi method. J Cancer Surviv 2019; 14:273-283. [PMID: 31811478 DOI: 10.1007/s11764-019-00840-3] [Citation(s) in RCA: 5] [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: 09/18/2019] [Accepted: 11/23/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To develop consensus-based components used in the first evidence-based cancer survivorship guidelines in Japan. METHODS Purposive sampling was used to recruit a panel of experts in oncology clinical practice, nursing, health science, epidemiology, and patient advocacy. The panel engaged in a modified Delphi process to (1) generate consensus related to the definition of survivorship, (2) determine the aim and target users of the guideline, and (3) identify clinical issues for inclusion. A Web-based survey and panel meeting were conducted to obtain the panelists' feedback on the initial draft proposed by the secretariat. Multiple online votes were then completed until all elements of the proposed guidelines reached an approval rate of 80% or higher. Following each round, iterative refinements were made based on all panelists' feedback. RESULTS Twenty-two experts were enrolled in the panel and participated in four rounds of online voting and two face-to-face meetings. Ultimately, the panel reached consensus on the definition of survivorship, the aim of the guidelines, and target users. Moreover, 11 of the original 17 clinical issues were retained. Finally, the panel selected two priority areas to implement immediately. CONCLUSION The panel's consensus on the definition of survivorship, aim and target users of the guideline, and 11 clinical issues will serve as a compass for the development of comprehensive cancer survivorship guidelines in Japan. IMPLICATIONS FOR CANCER SURVIVORS A culturally sensitive consensus approach was developed to improve the long term health and well- being of cancer survivors in Japan.
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Affiliation(s)
- Yutaka J Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045, Japan.
| | - Ryo Okubo
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045, Japan
| | - Yoichi Shimizu
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045, Japan
- Department of Nursing, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Katsunori Tsuji
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045, Japan
| | - Tomomi Narisawa
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045, Japan
| | - Jiichiro Sasaki
- Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Hiroyuki Sasai
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo, 153-8902, Japan
| | - Sadako Akashi-Tanaka
- Department of Breast Surgery Oncology, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Tetsuya Hamaguchi
- Department of Gastroenterological Oncology, Comprehensive Cancer Center, Saitama Medical University, 1397-1, Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Takeshi Iwasa
- Department of General Internal Medicine, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo, 104-0045, Japan
| | - Satoshi Iwata
- Department of Infectious Disease, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Tomoyasu Kato
- Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kayo Kurotani
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - Dai Maruyama
- Department of Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Ayako Mori
- Department of Nursing, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Asao Ogawa
- Department of Psycho-Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, 277-8577, Japan
| | - Naomi Sakurai
- Cancer Solutions Co., Ltd., 2-9-401 Kandanishikicho Chiyoda-ku, Tokyo, 101-0054, Japan
| | - Taichi Shimazu
- Division of Prevention, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Chikako Shimizu
- Department of Breast and Medical Oncology, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Takahiro Tabuchi
- Osaka International Cancer Institute, Cancer Control Center, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Miyako Takahashi
- Division of Cancer Survivorship Research, Center for Cancer Control and Information Services, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Toshimi Takano
- Department of Medical Oncology, Toranomon Hospital, 2-2-2 Toranomon, Tokyo, 105-8470, Japan
| | - Noriatsu Tatematsu
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Chie Watanabe
- Department of Nursing, Faculty of Human Sciences, Sophia University, 7-1 Kioi-cho Chiyoda-ku, Tokyo, 102-8554, Japan
| | - Tsuguya Fukui
- St. Luke's International Hospital, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
- St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
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Yoshida N, Kobayashi S, Suzuki J, Azuma Y, Kobayashi-Ogata N, Kartikasari DP, Yanagawa Y, Iwata S. Growth-promoting effects of the hydrogen-sulfide compounds produced by Desulfovibrio desulfuricans subsp. desulfuricans co-cultured with Escherichia coli (DH5α) on the growth of Entamoeba and Endolimax species isolates from swine. Biosci Trends 2019; 13:402-410. [PMID: 31597818 DOI: 10.5582/bst.2019.01233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Certain Desulfovibrio sp. (anaerobic sulfate-reducing bacteria) are indigenous to swine cecum and colon, which are also common habitats for parasitic amoebae such as Entamoeba polecki and Entamoeba suis. In this study, we evaluated the growth-promoting effects of D. desulfuricans co-cultured with Escherichia coli (DH5α) and its products [e.g., hydrogen sulfide (H2S) and certain iron-sulfide (FeS) compounds] using Robinson's medium, on the 4 amoeba isolates from swine-Entamoeba polecki subtype (ST)-1, E. polecki ST-3, Entamoeba suis, and Endolimax sp., and, consequently, a continuous culture system for these amoebae was established. However, this novel culture system was required to regulate the excess H2S dissolved in the medium by increasing air space as amoeba isolates thrive only in large air spaces (30-40%). The effects of air space and H2S and FeS compounds on the growth of E. polecki ST-1 (TDP-5) were determined. E. polecki ST-1 (TDP-5) thrived well in culture bottles with an air space of 30-40% (aerobic) (H2S: ~250-400 μmoles/L), but did not grow at all in an air space < 5% (microaerobic) ( H2S:~800 μmoles/L) and in anaerobic vessels (H2S: 20-30 μmoles/L). In both H2S-depleted and FeS compound-depleted conditions, the amoebae sp. could not thrive either. It was hypothesized that an appropriate concentration of H2S and FeS compounds might function as important physiologically active components of electron carriers such as FeS and ferredoxin.
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Affiliation(s)
- Naoko Yoshida
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Seiki Kobayashi
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Jun Suzuki
- Division of Food Microbiology, Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Yoshiyuki Azuma
- Laboratory of Animal and Human Nutritional Physiology, Kitasato University School of Veterinary Medicine, Towada, Aomori, Japan
| | | | - Dwi Peni Kartikasari
- Department of Parasitology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Yasuaki Yanagawa
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
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Kubota H, Uwamino Y, Matsui M, Sekizuka T, Suzuki Y, Okuno R, Uchitani Y, Ariyoshi T, Aoki W, Suzuki S, Kuroda M, Shinkai T, Yokoyama K, Sadamasu K, Funakoshi T, Murata M, Hasegawa N, Iwata S. FRI-4 carbapenemase-producing Enterobacter cloacae complex isolated in Tokyo, Japan. J Antimicrob Chemother 2019; 73:2969-2972. [PMID: 30060114 DOI: 10.1093/jac/dky291] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/25/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives A carbapenem-resistant Enterobacter cloacae complex isolated in Tokyo, Japan, produced a carbapenemase that was detected by a Carba NP test and a modified carbapenem inactivation method, but none of the 'Big Five' carbapenemase genes was detected by PCR. This study aimed to identify the carbapenemase. Methods Carbapenemase genes were screened by WGS. Next, we generated a recombinant plasmid in which the carbapenemase gene was inserted. We also extracted the carbapenemase gene-carrying plasmid from the E. cloacae complex. The effects of both plasmids on the antibiotic susceptibility of Escherichia coli were then tested. The carbapenemase gene-carrying plasmid in the E. cloacae complex was completely sequenced. Results A novel carbapenemase gene, blaFRI-4, encoded an amino acid sequence that was 93.2% identical to French imipenemase (FRI-1). E. coli transformed with blaFRI-4 showed reduced carbapenem susceptibility. A complete sequence of the blaFRI-4-carrying 98 508 bp IncFII/IncR plasmid (pTMTA61661) showed that blaFRI-4 and the surrounding region (18.7 kb) were duplicated. Conclusions The FRI-4-producing E. cloacae complex was isolated in Japan, whereas all other FRI variants have been found in Europe, suggesting that the spread of FRI carbapenemases is global.
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Affiliation(s)
- Hiroaki Kubota
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunincho, Shinjuku-ku, Tokyo, Japan
| | - Yoshifumi Uwamino
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.,Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Mari Matsui
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho, Higashimurayama-shi, Tokyo, Japan
| | - Tsuyoshi Sekizuka
- Pathogen Genomics Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Yasunori Suzuki
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunincho, Shinjuku-ku, Tokyo, Japan
| | - Rumi Okuno
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunincho, Shinjuku-ku, Tokyo, Japan
| | - Yumi Uchitani
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunincho, Shinjuku-ku, Tokyo, Japan
| | - Tsukasa Ariyoshi
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunincho, Shinjuku-ku, Tokyo, Japan
| | - Wataru Aoki
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Satowa Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho, Higashimurayama-shi, Tokyo, Japan
| | - Makoto Kuroda
- Pathogen Genomics Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Takayuki Shinkai
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunincho, Shinjuku-ku, Tokyo, Japan
| | - Keiko Yokoyama
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunincho, Shinjuku-ku, Tokyo, Japan
| | - Kenji Sadamasu
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunincho, Shinjuku-ku, Tokyo, Japan
| | - Takeru Funakoshi
- Department of Dermatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Mitsuru Murata
- Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Naoki Hasegawa
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Satoshi Iwata
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
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Ogawa M, Mizutani K, Okai T, Kajio K, Ito A, Iwata S, Takahashi Y, Murakami T, Shibata T, Yoshiyama M. P3693Self-expandable transcatheter aortic valve implantation is associated with frequent periprocedural stroke detected by diffusion-weighted magnetic resonance imaging -Insight from propensity score match. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Little evidence is available regarding the risk of peri-procedural stroke detected by diffusion-weighted magnetic resonance imaging (DW-MRI) after transcatheter aortic valve implantation (TAVI). Our purpose was to evaluate stroke risk after TAVI using DW-MRI by enrolling consecutive patients who underwent transfemoral TAVI and post-procedural DW-MRI.
Methods
We prospectively enrolled 113 consecutive patients who underwent transfemoral TAVI and post-procedural DW-MRI. We used balloon-expandable valves as first-line therapy and selected self-expandable valves only for patients with narrow sinotubular junctions or annuli. We set the primary endpoint as the number of high intensity areas (HIA) detected by DW-MRI regardless of the size of the area. To evaluate the risks of the primary endpoint, we employed a multivariable linear regression model, setting the primary endpoint as an objective variable and patient and clinical backgrounds as explanatory variables. In addition, the relationship between valve type and the number of HIAs on DW-MRI was also confirmed by the propensity score matching analysis to evaluate the robustness of the result, using a multivariable linear regression model with the protocol described in the previous manuscript. Shortly, the propensity score was calculated with a logistic regression model by setting the treatment as the response variable and baseline characteristics and procedural information that were significantly different between 2 groups (balloon expandable and self-expandable) as explanatory variables, which included age, estimated glomerular filtration rate, oversizing rate, and BAV before THV deployment.
Results
Median patient age was 84 years, and 36.3% were men. Ninety-three patients underwent balloon-expandable TAVI and 20 underwent self-expandable TAVI. Symptomatic stroke occurred in 6 (5.3%) whereas asymptomatic stroke occurred in 59 (52.2%) patients. The incidence of symptomatic and total stroke was higher in patients who underwent self-expandable TAVI than those who underwent balloon-expandable TAVI (30.0% vs 0.0%, p<0.001 and 90.0% vs 50.5%, p=0.001, respectively). A multivariable linear regression model demonstrated an increased primary endpoint when self-expandable TAVI was performed (p<0.001). The other covariates had no significant relationship to the primary endpoint. Akaike information criterion-based stepwise statistical model selection revealed that valve type was the only explanatory variable for the best predictive model. This result was also confirmed with the propensity score matching analysis (estimate, 2.359; 95% CI, 0.426–4.292; p=0.019) after adjustments of propensity score, in which 28 patients were matched (n=14 in each group).
Conclusions
Self-expandable valves were associated with increased numbers of HIA on DW-MRI after TAVI in patients with severe aortic stenosis.
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Affiliation(s)
- M Ogawa
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Mizutani
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Okai
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Kajio
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Ito
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Iwata
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Takahashi
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Murakami
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Shibata
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Yoshiyama
- Osaka City University Graduate School of Medicine, Osaka, Japan
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Hatano R, Itoh T, Otsuka H, Okamoto S, Komiya E, Iwata S, Aune TM, Dang NH, Kuwahara-Arai K, Ohnuma K, Morimoto C. Characterization of novel anti-IL-26 neutralizing monoclonal antibodies for the treatment of inflammatory diseases including psoriasis. MAbs 2019; 11:1428-1442. [PMID: 31397631 DOI: 10.1080/19420862.2019.1654305] [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] [Indexed: 12/24/2022] Open
Abstract
Interleukin (IL)-26, known as a Th17 cytokine, acts on various cell types and has multiple biological functions. Although its precise role still remains to be elucidated, IL-26 is suggested to be associated with the pathology of diverse chronic inflammatory diseases such as psoriasis, inflammatory bowel diseases and rheumatoid arthritis. To develop novel neutralizing anti-human IL-26 monoclonal antibodies (mAbs) for therapeutic use in the clinical setting, we immunized mice with human IL-26 protein. Hybridomas producing anti-IL-26 mAbs were screened for various in vitro functional assays, STAT3 phosphorylation and antibiotic assays. Although the IL-20RA/IL-10RB heterodimer is generally believed to be the IL-26 receptor, our data strongly suggest that both IL-20RA-dependent and -independent pathways are involved in IL-26-mediated stimulation. We also investigated the potential therapeutic effect of anti-IL-26 mAbs in the imiquimod-induced psoriasis-like murine model using human IL-26 transgenic mice. These screening methods enabled us to develop novel neutralizing anti-human IL-26 mAbs. Importantly, administration of IL-26-neutralizing mAb did not have an effect on the antimicrobial activity of IL-26. Taken together, our data strongly suggest that our newly developed anti-human IL-26 mAb is a potential therapeutic agent for the treatment of diverse chronic inflammatory diseases including psoriasis.
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Affiliation(s)
- Ryo Hatano
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Takumi Itoh
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Haruna Otsuka
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Sayo Okamoto
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Eriko Komiya
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan.,Institute for Environmental and Gender Specific Medicine, Juntendo University Graduate School of Medicine , Urayasu , Japan
| | - Satoshi Iwata
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Thomas M Aune
- Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt University Medical Center , Nashville , TN , USA
| | - Nam H Dang
- Division of Hematology/Oncology, University of Florida , Gainesville , FL , USA
| | - Kyoko Kuwahara-Arai
- Department of Microbiology, Juntendo University School of Medicine , Tokyo , Japan
| | - Kei Ohnuma
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
| | - Chikao Morimoto
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University , Tokyo , Japan
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Wolff AM, Young ID, Sierra RG, Brewster AS, Martynowycz MW, Aquila A, Nango E, Nakane T, Koralek JD, Sugahara M, Tanaka R, Zhao W, Ito K, Woldeyes RA, Biel JT, Thompson EM, Samelson A, Cortez S, van den Bedem H, Yumoto F, Tono K, Gonen T, Iwata S, Boutet S, Sauter NS, Fraser JS, Thompson MC. Optimizing and evaluating protein microcrystallography experiments: strengths and weaknesses of X-rays and electrons. Acta Crystallogr A Found Adv 2019. [DOI: 10.1107/s0108767319096156] [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: 11/10/2022] Open
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Thompson MC, Wolff AM, Nango E, Kubo M, Young ID, Nakane T, Sugahara M, Tanaka R, Ito K, Brewster AS, Sierra RG, Yumoto F, Nomura T, Owada S, Hino T, Tosha T, Tanaka T, Im D, Aquila A, Carbajo S, Koralek J, Yamashita A, Luo F, Boutet S, Sauter NK, Tono K, Iwata S, Fraser JS. Turning up the heat on dynamic proteins: observing molecular motion in real time with temperature-jump X-ray crystallography. Acta Crystallogr A Found Adv 2019. [DOI: 10.1107/s0108767319098349] [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: 11/10/2022] Open
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Hatano R, Yamada T, Madokoro H, Otsuka H, Komiya E, Itoh T, Narita Y, Iwata S, Yamazaki H, Matsuoka S, Dang NH, Ohnuma K, Morimoto C. Development of novel monoclonal antibodies with specific binding affinity for denatured human CD26 in formalin-fixed paraffin-embedded and decalcified specimens. PLoS One 2019; 14:e0218330. [PMID: 31194830 PMCID: PMC6564021 DOI: 10.1371/journal.pone.0218330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/08/2019] [Accepted: 05/30/2019] [Indexed: 11/19/2022] Open
Abstract
A 110-kDa type II transmembrane glycoprotein with dipeptidyl peptidase IV (DPPIV) activity in its extracellular region, CD26 has a multitude of biological functions and plays an important role in the regulation of inflammatory responses and tumor biology. Our work has focused on CD26 as a novel therapeutic target for various tumors and immune disorders, and we have recently developed a humanized anti-CD26 monoclonal antibody (mAb), YS110, which has promising safety profile and clinical activity in patients with malignant pleural mesothelioma. The development of an anti-human CD26 mAb that can clearly and reliably detect the denatured CD26 molecule in formalin-fixed paraffin-embedded (FFPE) tissues in the clinical setting is therefore of the utmost importance. To develop novel anti-CD26 mAbs capable of binding to denatured CD26, we immunized mice with urea-treated CD26 protein. Hybridoma supernatants were screened for specific reactivity with human CD26 by immunostaining through the use of a set of FFPE human CD26-positive or negative tumor cell lines. This screening method enables us to develop novel anti-human CD26 mAbs suitable for immunohistochemical staining of CD26 in FFPE non-tumor and tumor tissue sections with reliable clarity and intensity. Specifically, these mAbs display strong binding affinity to denatured human CD26 rather than undenatured human CD26, and are capable of detecting denatured human CD26 in decalcified specimens. These novel anti-CD26 mAbs are potentially useful for the analysis of CD26 expression in cancer patients with bony metastasis, and may help decide the appropriateness of YS110 therapy for future cancer patients.
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Affiliation(s)
- Ryo Hatano
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Taketo Yamada
- Department of Pathology, Saitama Medical University, Moroyama-machi, Iruma-gun, Saitama, Japan
- Department of Pathology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hiroko Madokoro
- Department of Pathology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Haruna Otsuka
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Eriko Komiya
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Takumi Itoh
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yuka Narita
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Iwata
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroto Yamazaki
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Shuji Matsuoka
- Department of Immunological Diagnosis, Juntendo University Graduate School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Nam H. Dang
- Division of Hematology/Oncology, University of Florida, Gainesville, FL, United States of America
| | - Kei Ohnuma
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Chikao Morimoto
- Department of Therapy Development and Innovation for Immune Disorders and Cancers, Graduate School of Medicine, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
- * E-mail:
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Yanagihara K, Matsumoto T, Aoki N, Sato J, Wakamura T, Kiyota H, Tateda K, Hanaki H, Ohsaki Y, Fujiuchi S, Takahashi M, Akiba Y, Masunaga S, Takeuchi K, Takeda H, Miki M, Kumagai T, Takahashi H, Utagawa M, Nishiya H, Kawakami S, Ishigaki S, Kobayasi N, Takasaki J, Mezaki K, Iwata S, Katouno Y, Inose R, Niki Y, Kawana A, Fujikura Y, Kudo M, Hirano T, Yamamoto M, Miyazawa N, Tsukada H, Aso S, Yamamoto Y, Iinuma Y, Mikamo H, Yamagishi Y, Nakamura A, Ohashi M, Kawabata A, Sugaki Y, Seki M, Hamaguchi S, Toyokawa M, Kakeya H, Fujikawa Y, Mitsuno N, Ukimura A, Miyara T, Hayasi M, Mikasa K, Kasahara K, Koizumi A, Korohasi N, Matumoto T, Yosimura Y, Katanami Y, Takesue Y, Wada Y, Sugimoto K, Yamamoto T, Kuwabara M, Doi M, Simizu S, Tokuyasu H, Hino S, Negayama K, Mukae H, Kawanami T, Yatera K, Fujita M, Kadota J, Hiramatsu K, Aoki Y, Magarifuchi H, Oho M, Morinaga Y, Suga M, Muranaka H, Fujita J, Higa F, Tateyama M. Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for clinical microbiology in 2014: General view of the pathogens' antibacterial susceptibility. J Infect Chemother 2019; 25:657-668. [PMID: 31196772 DOI: 10.1016/j.jiac.2019.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 03/18/2019] [Accepted: 05/15/2019] [Indexed: 11/28/2022]
Abstract
The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from the patients in Japan was conducted by Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2014. The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period between January 2014 and April 2015 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical Laboratory Standards Institute. Susceptibility testing was evaluated in 1534 strains (335 Staphylococcus aureus, 264 Streptococcus pneumoniae, 29 Streptococcus pyogenes, 281 Haemophilus influenzae, 164 Moraxella catarrhalis, 207 Klebsiella pneumoniae, and 254 Pseudomonas aeruginosa). Ratio of methicillin-resistant S. aureus was 43.6%, and those of penicillin-susceptible S. pneumoniae was 100%. Among H. influenzae, 8.2% of them were found to be β-lactamase-producing ampicillin-resistant strains, and 49.1% to be β-lactamase-non-producing ampicillin-resistant strains. Extended spectrum β-lactamase-producing K. pneumoniae and multi-drug resistant P. aeruginosa with metallo β-lactamase were 9.2% and 0.4%, respectively.
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Affiliation(s)
- Katsunori Yanagihara
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Nagasaki University School of Medicine, Nagasaki, Japan.
| | - Tetsuya Matsumoto
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Nobuki Aoki
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Tomotaro Wakamura
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Hiroshi Kiyota
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Kazuhiro Tateda
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | | | | | - Satoru Fujiuchi
- National Hospital Organization Asahikawa Medical Center, Hokkaido, Japan
| | - Manabu Takahashi
- National Hospital Organization Asahikawa Medical Center, Hokkaido, Japan
| | - Yuji Akiba
- Asahikawa Kosei Hospital, Hokkaido, Japan
| | | | | | | | - Makoto Miki
- Japanese Red Cross Sendai Hospital, Miyagi, Japan
| | | | | | | | | | | | | | | | - Jin Takasaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuhisa Mezaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | | | | | - Akihiko Kawana
- National Defense Medical College Hospital, Saitama, Japan
| | - Yuji Fujikura
- National Defense Medical College Hospital, Saitama, Japan
| | - Makoto Kudo
- Yokohama City University Hospital, Kanagawa, Japan
| | - Tomo Hirano
- Yokohama City University Hospital, Kanagawa, Japan
| | | | | | | | - Sakura Aso
- Niigata City General Hospital, Niigata, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Keiichi Mikasa
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Akira Koizumi
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | | | | | | | | | | | - Yasunao Wada
- Hyogo College of Medicine Hospital, Hyogo, Japan
| | | | | | | | - Masao Doi
- Hiroshima Prefectural Hospital, Hiroshima, Japan
| | | | | | | | | | - Hiroshi Mukae
- University of Occupational and Environmental Health Hospital, Fukuoka, Japan; Nagasaki University School of Medicine, Nagasaki, Japan
| | - Toshinori Kawanami
- University of Occupational and Environmental Health Hospital, Fukuoka, Japan
| | - Kazuhiro Yatera
- University of Occupational and Environmental Health Hospital, Fukuoka, Japan
| | - Masaki Fujita
- Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | | | | | | | | | | | | | | | | | - Jiro Fujita
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| | - Futoshi Higa
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| | - Masao Tateyama
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
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Shimizu R, Sakemura R, Iwata S, Hayakawa H, Miyao K, Kajiguchi T. [Pneumocystis pneumonia prophylaxis with low-dose trimethoprim/sulfamethoxazole during rituximab-containing chemotherapy]. Rinsho Ketsueki 2019; 60:365-371. [PMID: 31167996 DOI: 10.11406/rinketsu.60.365] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Although Pneumocystis pneumonia (PCP), a life-threatening infection, has been reported in patients with non-Hodgkin B-cell lymphoma (BNHL) who were treated with rituximab-containing chemotherapies (R-CTX), the PCP prophylaxis regimen awaits establishment to date. This study reports a retrospective analysis of the efficacy and safety of a low-dose trimethoprim/sulfamethoxazole (TMP/SMX) in patients with BNHL receiving R-CTX. We retrospectively analyzed 156 patients newly diagnosed with BNHL who received R-CTX at our institute from 2010 to 2015. We collected patients' clinical and laboratory data, including lymphocytes count, IgG level, PCP prophylaxis regimens, and adverse events (AEs). Patients were categorized into the following two groups based on the TMP/SMX regimen: group A (33 patients; 80 mg/400 mg×3/week) or group B (65 patients; 160 mg/800 mg×2/week). Both lymphocytes count and IgG level declined during R-CTX. No patient developed PCP. Patients in group B exhibited a significantly higher incidence of AEs (18.2% vs. 63.1%; p<0.05) and increased AST (6.1% vs. 26.6%; p<0.05), compared with those in group A. Thus, TMP/SMX (80 mg/400 mg×3/week) effectively prevents PCP and is preferable because of the lower rates of AEs.
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Affiliation(s)
- Rie Shimizu
- Department of Hematology and Oncology, Tosei General Hospital
| | - Reona Sakemura
- Department of Hematology and Oncology, Tosei General Hospital.,T-Cell Engineering Program, Division of Hematology, Mayo Clinic
| | - Satoshi Iwata
- Department of Hematology and Oncology, Tosei General Hospital
| | | | - Kotaro Miyao
- Department of Hematology and Oncology, Tosei General Hospital
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Ubukata K, Takata M, Morozumi M, Chiba N, Wajima T, Hanada S, Shouji M, Sakuma M, Iwata S. Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010-2017. Emerg Infect Dis 2019; 24:2010-2020. [PMID: 30334707 PMCID: PMC6200004 DOI: 10.3201/eid2411.180326] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
To clarify year-to-year changes in capsular serotypes, resistance genotypes, and multilocus sequence types of Streptococcus pneumoniae, we compared isolates collected from patients with invasive pneumococcal disease before and after introductions of 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PVC13, respectively). From April 2010 through March 2017, we collected 2,856 isolates from children and adults throughout Japan. Proportions of PCV13 serotypes among children decreased from 89.0% in fiscal year 2010 to 12.1% in fiscal year 2016 and among adults from 74.1% to 36.2%. Although nonvaccine serotypes increased after introduction of PCV13, genotypic penicillin resistance decreased from 54.3% in 2010 to 11.2% in 2016 among children and from 32.4% to 15.5% among adults. However, genotypic penicillin resistance emerged in 9 nonvaccine serotypes, but not 15A and 35B. Multilocus sequence typing suggested that resistant strains among nonvaccine serotypes may have evolved from clonal complexes 156 and 81. A more broadly effective vaccine is needed.
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