1
|
Shiomi I, Makuuchi Y, Noura I, Kakuno S, Niki M, Kaimi Y, Ido K, Sakatoku K, Kuno M, Takakuwa T, Okamura H, Nishimoto M, Nakashima Y, Nakamae M, Kakeya H, Kohashi K, Hino M, Nakamae H. Invasive fungal infection caused by Blastobotrys mokoenaii in an immunocompromised patient with acute myeloid leukemia: A case report. J Infect Chemother 2024; 30:557-561. [PMID: 38092335 DOI: 10.1016/j.jiac.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/26/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
Blastobotrys is a genus of rare yeast that is increasingly recognized as a cause of fungal infections in humans. However, there have been no reports of fungal infections in humans caused by Blastobotrys mokoenaii. We describe a case of invasive fungal infection (IFI) caused by B. mokoenaii in an immunocompromised patient with acute myeloid leukemia (AML). A 46-year-old man with relapsed/refractory AML underwent a second allogeneic peripheral blood hematopoietic stem cell transplantation (allo-PBSCT) during remission. The patient had prolonged neutropenia and received systemic steroid therapy for graft-versus-host disease before the second allo-PBSCT. Uncommon yeast was isolated from the blood cultures obtained on day 4. We initially suspected that the uncommon yeast was Trichosporon spp. based on its morphology. However, unlike Trichosporon spp., in vitro antifungal susceptibility tests showed that this yeast isolate was resistant to micafungin, caspofungin, voriconazole, itraconazole, and fluconazole. We performed DNA sequencing and identified it as B. mokoenaii. B. mokoenaii was persistently isolated from blood cultures taken during combination therapy with liposomal amphotericin B and voriconazole. The patient died of multiorgan failure on day 24. B. mokoenaii can cause severe IFI in immunocompromised patients; however, it may not be correctly identified by routine clinical microbiology testing in a hospital laboratory and DNA sequencing is useful for diagnosis.
Collapse
Affiliation(s)
- Ichiro Shiomi
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yosuke Makuuchi
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
| | - Ikue Noura
- Department of Diagnostic Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Shigeki Kakuno
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, Osaka, Japan; Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Makoto Niki
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, Osaka, Japan
| | - Yuto Kaimi
- Department of Diagnostic Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kentaro Ido
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; Department of Laboratory Medicine and Medical Informatics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Kazuki Sakatoku
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Masatomo Kuno
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Teruhito Takakuwa
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Okamura
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Mitsutaka Nishimoto
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yasuhiro Nakashima
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Mika Nakamae
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; Department of Laboratory Medicine and Medical Informatics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Kakeya
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, Osaka, Japan; Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kenichi Kohashi
- Department of Diagnostic Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Masayuki Hino
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
2
|
Kobayashi K, Hata A, Imoto W, Kakuno S, Shibata W, Yamada K, Kawaguchi H, Sakurai N, Ito T, Uenoyama K, Takahashi T, Ueda S, Katayama T, Onoue M, Kakeya H. Evaluation of predictors of third-generation cephalosporin non-susceptibility and factors affecting recurrence or death in bacteremia caused by Citrobacter freundii complex , Enterobacter cloacae complex, and Klebsiella aerogenes. J Chemother 2024:1-11. [PMID: 38451087 DOI: 10.1080/1120009x.2024.2323326] [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: 04/25/2023] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
Factors involved in the susceptibility of third-generation cephalosporins (3GCs) to bacteremia caused by Citrobacter freundii complex, Enterobacter cloacae complex, and Klebsiella aerogenes were investigated based on a case-case-control design. Antimicrobial therapy administered 30 days prior to bacteremia and hospitalization within 90 days were common risk factors for the 3GC susceptible and 3GC non-susceptible groups, while hospitalization from an institution or another hospital was a specific risk factor for the 3GC non-susceptible group. We also attempted to examine the factors affecting the clinical outcome of bacteremia. Hospitalization more than 14 days before the onset of bacteremia was an independent factor indicating poor clinical outcome. In contrast, the implementation of source control was an independent predictor of successful treatment. Although a longer hospital stay before the onset of bacteremia was associated with worse clinical outcomes, implementation of source control may have contributed to improved treatment outcomes for bacteremia.
Collapse
Affiliation(s)
- Kazuhiro Kobayashi
- Department of Pharmacy, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Department of Infection Diseases, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Atsuko Hata
- Department of Infection Diseases, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Waki Imoto
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shigeki Kakuno
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Wataru Shibata
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Koichi Yamada
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Kawaguchi
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Norihiro Sakurai
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Toshikazu Ito
- Department of Pharmacy, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Kazuya Uenoyama
- Department of Pharmacy, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Tamotsu Takahashi
- Department of Pharmacy, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
- Department of Infection Diseases, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Satoru Ueda
- Department of Pharmacy, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
- Department of Infection Diseases, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Toshiro Katayama
- Department of Medical Engineering, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Masahide Onoue
- Department of Pharmacy, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Hiroshi Kakeya
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Research Centre for Infectious Disease Sciences, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Osaka International Research Centre for Infectious Disease, Osaka Metropolitan University, Osaka, Japan
| |
Collapse
|
3
|
Kakuno S, Imoto W, Teranishi Y, Kakeya H. Lomentospora prolificans-induced Invasive Fungal Sinusitis. Intern Med 2023; 62:2761-2762. [PMID: 36642520 PMCID: PMC10569913 DOI: 10.2169/internalmedicine.1074-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/13/2022] [Indexed: 01/15/2023] Open
Affiliation(s)
- Shigeki Kakuno
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
- Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, Japan
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, Japan
| | - Waki Imoto
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
- Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, Japan
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, Japan
| | - Yuichi Teranishi
- Department of Otorhinolaryngology, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - Hiroshi Kakeya
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
- Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, Japan
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, Japan
| |
Collapse
|
4
|
Yamada K, Imoto W, Shibata W, Kakuno S, Nakaie K, Myodo Y, Takayama N, Dobashi A, Imai M, Mitani K, Ogawa M, Niki M, Sakurai N, Nonose Y, Okada Y, Fujita A, Kaneko Y, Kakeya H. Impact of antimicrobial stewardship with the Xpert MRSA/SA BC assay at a tertiary hospital in Japan. J Infect Chemother 2023; 29:693-699. [PMID: 37028799 DOI: 10.1016/j.jiac.2023.03.021] [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: 01/20/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION Genetic testing is gaining increasing importance as a part of antimicrobial stewardship (AS). Rapid identification and determination of methicillin susceptibility using the Xpert MRSA/SA BC assay can improve the management of Staphylococcus aureus bacteremia (SAB) and reduce inappropriate antibiotic use. However, few reports have described the effectiveness of this approach. METHODS The present study aimed to assess the influence of AS using the Xpert MRSA/SA BC assay. Cases were classified into the pre-intervention group (n = 98 patients), in which SAB was identified by traditional culture (November 2017 to November 2019), and the post-intervention group (n = 97 patients), in which the Xpert MRSA/SA BC assay was performed when necessary (December 2019 to December 2021). RESULTS Patient characteristics, prognosis, duration of antimicrobial use, and length of hospital stay were compared between the groups. The Xpert assay was performed in 66 patients in the post-intervention group (68.0%). The two groups showed no significant differences in severity and mortality. The rate of cases treated with anti-MRSA agents reduced following the intervention (65.3% vs. 40.4%, p = 0.008). The number of cases involving definitive therapy within 24 h was higher in the post-intervention group (9.2% vs. 24.7%, p = 0.007). The hospitalization rate at >60 days was lower in Xpert implementation cases among MRSA bacteremia cases (28.6% vs. 0%, p = 0.01). CONCLUSIONS Thus, the Xpert MRSA/SA BC assay has potential as an AS tool, especially for early definitive treatment to SAB and reduction of long-term hospitalization in MRSA bacteremia cases.
Collapse
Affiliation(s)
- Koichi Yamada
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan; Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
| | - Waki Imoto
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Wataru Shibata
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Shigeki Kakuno
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Kiyotaka Nakaie
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Yuka Myodo
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Naomi Takayama
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Akane Dobashi
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Minami Imai
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Kei Mitani
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Masashi Ogawa
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Makoto Niki
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Norihiro Sakurai
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Yuka Nonose
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Yasuyo Okada
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Akiko Fujita
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan.
| | - Yukihiro Kaneko
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan; Bacteriology, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
| | - Hiroshi Kakeya
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8586, Japan; Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-machi, Abeno-ku, Osaka-shi, Osaka, 545-8585, Japan.
| |
Collapse
|
5
|
Imoto W, Matsumoto S, Suzuki M, Ban N, Horikawa M, Mitani K, Ogawa M, Kakuno S, Shibata W, Niki M, Yamada K, Okada M, Kakeya H. First report of Mycobacterium virginiense-induced synovitis and tenosynovitis of flexor digitorum superficialis and profundus muscles in Japan. J Infect Chemother 2023; 29:410-413. [PMID: 36574930 DOI: 10.1016/j.jiac.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/04/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
Mycobacterium virginiense, a species of the Mycobacterium terrae complex, was first identified in 2016. Although M. virginiense has only been reported to cause tenosynovitis, there have been only a few reports. Moreover, there is no established standard treatment, and no cases of M. virginiense infection have been reported in Japan. A 70-year-old Japanese man with a history of hand injury and wound contamination was diagnosed with synovitis and tenosynovitis of the left flexor digitorum superficialis and profundus muscles. M. virginiense was detected in perisynovial reservoirs and surgically removed synovium and was identified by hsp65 and rpoB sequencing. Postoperative chemotherapy with clarithromycin, rifabutin, and ethambutol was administered. Infection with M. virginiense can occur in patients with synovitis and tenosynovitis who have experienced injury or wound contamination, requiring surgery and long-term treatment with multiple antibiotics.
Collapse
Affiliation(s)
- Waki Imoto
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Seishiro Matsumoto
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Orthopedic Surgery, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Maya Suzuki
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Orthopedic Surgery, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Nozomi Ban
- Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Masayoshi Horikawa
- Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Kei Mitani
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Masashi Ogawa
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Shigeki Kakuno
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Wataru Shibata
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Makoto Niki
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Koichi Yamada
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Mitsuhiro Okada
- Department of Orthopedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Orthopedic Surgery, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan
| | - Hiroshi Kakeya
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| |
Collapse
|
6
|
Ogawa M, Niki M, Imoto W, Dobashi A, Imai M, Takayama N, Mitani K, Kakuno S, Shibata W, Yamada K, Kakeya H. Characterization of Aspergillus spp. isolated from patients with coronavirus disease 2019. J Infect Chemother 2023; 29:580-585. [PMID: 36758677 PMCID: PMC9904853 DOI: 10.1016/j.jiac.2023.02.001] [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: 10/14/2022] [Revised: 01/11/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Invasive pulmonary aspergillosis (IPA) is an important complication of coronavirus disease 2019 (COVID-19), and while there are case reports and epidemiological studies, few studies have isolated Aspergillus strains from patients. Therefore, we analyzed the strains, sensitivities, and genetic homology of Aspergillus spp. Isolated from patients with COVID-19. METHODS We investigated the Aspergillus strains detected from patients with COVID-19 hospitalized in Osaka Metropolitan University Hospital from December 2020 to June 2021. A molecular epidemiological analysis of Aspergillus fumigatus was performed using drug susceptibility tests and TRESPERG typing, and data on patient characteristics were collected from electronic medical records. RESULTS Twelve strains of Aspergillus were detected in 11 of the 122 patients (9%) with COVID-19. A. fumigatus was the most common species detected, followed by one strain each of Aspergillus aureolus, Aspergillus nidulans, Aspergillus niger, and Aspergillus terreus. A. aureolus was resistant to voriconazole, and no resistance was found in other strains. All A. fumigatus strains were genetically distinct strains. Six of the 11 patients that harbored Aspergillus received antifungal drug treatment and tested positive for β-D-glucan and/or Aspergillus galactomannan antigen. The results indicated that Aspergillus infections were acquired from outside the hospital and not from nosocomial infections. CONCLUSION Strict surveillance of Aspergillus spp. is beneficial in patients at high-risk for IPA. When Aspergillus is detected, it is important to monitor the onset of IPA carefully and identify the strain, perform drug sensitivity tests, and facilitate early administration of therapeutic agents to patients with IPA.
Collapse
Affiliation(s)
- Masashi Ogawa
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Makoto Niki
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Waki Imoto
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Akane Dobashi
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Minami Imai
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Naomi Takayama
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Kei Mitani
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Shigeki Kakuno
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Wataru Shibata
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Koichi Yamada
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan.
| | - Hiroshi Kakeya
- Department of Infection Control and Prevention, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan; Department of Infectious Disease Medicine, Osaka Metropolitan University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan; Research Center for Infectious Disease Sciences, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
| |
Collapse
|
7
|
Kobayashi K, Hata A, Imoto W, Kakuno S, Shibata W, Yamada K, Kawaguchi H, Sakurai N, Nakaie K, Nakatsuka Y, Ito T, Uenoyama K, Takahashi T, Ueda S, Katayama T, Onoue M, Kakeya H. The Clinical Evaluation of Third-generation Cephalosporins as Definitive Therapy for Enterobacter spp. and Klebsiella aerogenes Bacteremia. Intern Med 2022. [PMID: 36384899 PMCID: PMC10372282 DOI: 10.2169/internalmedicine.0612-22] [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] [Indexed: 11/16/2022] Open
Abstract
Background Third-generation cephalosporins (3GCs) may be susceptible in vitro to Enterobacter spp. and Klebsiella aerogenes. However, treatment with mainly fourth-generation cephalosporins or carbapenems is currently recommended. Diversification of antimicrobial agents in therapy is required to avoid the selection pressure of resistant organisms by broad-spectrum antimicrobial agents. Aims This study investigated the clinical efficacy of 3GC therapy for Enterobacter spp. and Klebsiella aerogenes bacteremia in a multicenter, retrospective, observational study. Methods Patients with Enterobacter spp. or Klebsiella aerogenes detected in blood cultures and treated with a susceptible antimicrobial agent were included in the study. Propensity score matching was performed to align patient background bases, and clinical outcomes between the 3GC and non-3GC groups were compared. Treatment success was defined as having no need for treatment escalation or the addition of other antimicrobial agents, no recurrence, or no death within 30 days. Results The study included 188 cases, of which 57 and 131 were included in the 3GC and non-3GC treatment groups, respectively; 53 patients in each group were matched by propensity score matching. There were no significant differences between groups in rates of switching to a susceptible antimicrobial or adding another agent, relapse within 30 days, or death within 30 days. In the 3GC group, source control was associated with favorable clinical outcomes. Conclusions Definitive 3GC therapy for susceptible Enterobacter spp. and Klebsiella aerogenes bacteremia is as clinically effective and valuable a targeted therapy as non-3GC therapy and can be implemented under conditions in which infection source control measures are in place.
Collapse
Affiliation(s)
- Kazuhiro Kobayashi
- Department of Pharmacy, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
- Department of Infection Diseases, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Atsuko Hata
- Department of Infection Diseases, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Waki Imoto
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - Shigeki Kakuno
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - Wataru Shibata
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - Koichi Yamada
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - Hiroshi Kawaguchi
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - Norihiro Sakurai
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - Kiyotaka Nakaie
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - Yukari Nakatsuka
- Department of Infection Diseases, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
- Department of Clinical Laboratory, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Toshikazu Ito
- Department of Pharmacy, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Kazuya Uenoyama
- Department of Pharmacy, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Tamotsu Takahashi
- Department of Pharmacy, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
- Department of Infection Diseases, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Satoru Ueda
- Department of Pharmacy, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
- Department of Infection Diseases, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Toshiro Katayama
- Department of Medical Engineering, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Japan
| | - Masahide Onoue
- Department of Pharmacy, Tazuke Kofukai, Medical Research Institute, Kitano Hospital, Japan
| | - Hiroshi Kakeya
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Japan
- Research Centre for Infectious Disease Sciences, Osaka Metropolitan University Graduate School of Medicine, Japan
| |
Collapse
|
8
|
Sawada M, Araki Y, Obata Y, Mastusita H, Kakuno S, Masuda K. [Indications of chromic oxygen therapy]. Kokyu To Junkan 1987; 35:617-22. [PMID: 3306855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|